The algorithm for choosing the method of lithotripsy in patients with nephrolithiasis without ureteropelvic junction obstruction using micro- and ultra-mini-percutaneous nephrolithotomy

V.I. Savenkov, A.V. Maltsev, D.A. Levchenko


It is important to increase the effectiveness of treatment in patients with nephrolithiasis who do not have ureteropelvic junction obstruction by creating an algorithm for choosing the proper surgical method. In the present study, 111 patients were examined who used the proposed algorithm, including new endovideoscopic methods such as micro- and ultra-mini-percutaneous nephrolithotomy. In the comparison group (73 patients), standard methods and approaches to the choice of lithotripsy procedures were used, without including new mentioned me­thods. It has been found that during the planning of percutaneous nephrolithotomy, computed tomography should be performed in the prone position which allows choosing more precisely the access site and, therefore, prevent trauma to the colon during percutaneous access. Compliance with the developed algorithm, taking into account the peculiarities of the clinical form of nephrolithiasis and using new endovideoscopic techniques, makes possible to select the most effective and least traumatic method of nephrolithotripsy therefore reducing the number of additional procedures per patient and associated complications.


nephrolithiasis; nephrolithotripsy; algorithm; choice of surgical technique; extracorporeal shock-wave lithotripsy; retrograde intrarenal surgery


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