Prediction of development of early postoperative complications of the contact ultrasound lithotripsy
DOI:
https://doi.org/10.15587/2519-4798.2017.94123Keywords:
ureterolithiasis, ureteroscopy, contact ureterolithotripsy, ureteral stone density, ureteral stone size, complicationsAbstract
Nowadays, endoscopic treatment of kidney and upper ureter stones is the method of choice in a large group of patients. The success of ureteroscopic treatment of stones is a result of the development of efficient flexible ureteroscopes, new capture devices and laser lithotripters.
Aim. The analysis of the reasons and the character of early postoperative complications after ureteroscopy and contact lithotripsy using semi-rigid ureteroscope and ultrasonic lithotripter.
Methods. Ureteroscopy with contact lithotripsy and (or) lithoextraction against concrements of various ureter departments was made in 1268 patients. The patients were monitored after discharge in dynamics from 8 weeks to 1.5 years, and on the testimony - until the elimination of complications. All complications were divided in accordance with their severity degree by Satava classification.
Results. 179 patients with early postoperation complications were found. In 62 (34.6%) hyperthermia, in 56 (31.3%) - persistent hematuria, and in 61 (34.1%) – renal colic were detected.
Conclusion. In 60% of patients with 1 cm stones and 50% of patients with stones up to 1.5 cm early postoperative complications were found when the stone density was more than 1500 HU. When the stone size was 1.5 cm or more, the complications were found regardless of its density. When the stone size was less then 1 cm, early postoperative complications in the main were found at concrement’s localization in upper ureter (59.5 % of the patients). In patients with the stone density more than 1500 HU the highest number of complications was detected at the stones’ localization in upper and lower ureter – 14 (37.8%) and 16 (43.2%) cases, respectively
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