[Colon injury during percutaneous nephrolithotomy (clinical case, literature review)].

Urolithiasis occupies one of the leading places in terms of the frequency of requests for urgent urological care and emergency hospitalization in specialized departments. Percutaneous surgery for urolithiasis, like any of the surgical methods, is associated with a number of specific and non-specific complications. Of course, the frequency of occurrence is dominated by hemorrhagic and inflammatory complications. But damage to the colon is quite rare and amounts to 0.3-0.4%. Focusing on the literature data, it is possible to identify risk factors for colon damage and clinical manifestations of this complication. Given the small clinical experience, both in the world and in the domestic literature, there is no recommendatory base for the management of patients with colon damage during percutaneous interventions. Publications available for analysis indicate the possibility of both an operative approach with the removal of a colostomy and conservative management of patients with such complications. The article presents a clinical observation of successful conservative management of a patient with damage to the descending colon during percutaneous nephrolithotomy. An assessment of risk factors for colon damage in this patient was given. Imaging methods are presented that confirm the presence of this complication and the resulting recovery during the follow-up examination.

[Hemorrhagic complications of percutaneous interventions for nephrolithiasis].

Hemorrhagic complications are one of the major problems of percutaneous urolithiasis interventions. AIM: To investigate the incidence of hemorrhagic complications after percutaneous nephrolithotripsy. MATERIAL AND METHODS: This was a comparative analysis of 146 percutaneous nephrolithotripsies. The study group comprised 81 patients with stag horn nephrolithiasis; the rest of the patients were assigned to the control group. RESULTS: Both groups were comparable in age and sex (p>0.05). The body weight of the patients in the study group was statistically significantly higher than in the control group, amounting to 94.1+/-15.4 and 68.3+/-9.6 kg, respectively (p<0.05), the body mass index in the study group averaged 45.9+/-7.6 kg/m2 versus 28.5+/-9.4 kg/m2 in the control group (p<0.05). 50.6% of the study group patients had urate urolithiasis. The blood loss depended on operative time and the number of accesses to the kidney. The incidence of hemorrhagic complications did not differ in both groups and was in the range of 16 to 16.9% (p> 0.05). Early hemorrhagic complications did not exceed Grade II, according to Clavien-Dindo classification. Anticoagulant and antiplatelet therapy did not increase the number of hemorrhagic complications. Arterial hypertension was the main risk factor for hemorrhagic complications. CONCLUSION: Arterial hypertension in patients scheduled for percutaneous nephrolithotripsy should be corrected. To stop ongoing renal bleeding, image-guided endovascular interventions should be used.

[Extracorporeal partial nephrectomy, is it worth?]

OBJECTIVE: To assess the effectiveness of extracorporeal partial nephrectomy. MATERIAL AND METHODS: The article presents a comparative analysis of 65 radical nephrectomy, 47 partial nephrectomy and 5 extracorporeal partial nephrectomy on the renal parenchymal tumors. RESULTS AND DISCUSSION: This article discusses the advantages and disadvantages of extracorporeal partial nephrectomy in comparison with the intracorporeal interventions. The results of their observations are illustrated by two clinical examples. CONCLUSION: The authors concluded the feasibility of extracorporeal partial nephrectomy for renal cell cancer in selected patients.

[EFFECTIVENESS OF URETERAL STENTS WITH NANOSTRUCTURED COATING IN RENAL TRANSPLANTATION (PRELIMINARY RESULTS)].

From a surgeon's perspective, intraureteral jj-stent is an optimal tool to ensure upper urinary tract drainage. This paper presents preliminary results of our study investigating the use of ureteral stents with nanostructured coating in renal transplant recipients. The use of nanostructured coating based on amorphous carbon and silver nanocrystallites eliminated bacteriuria by week 4 after stenting in the treatment group with significant decrease of urine sediments while in the control group bacteriuria was found in 83,3% cases. Symptoms of bladder irritability depended on stent construction rather than presence of coating.

[COMPLICATIONS OF STENTINGOF UPPER URINARY TRACT].

Restoring the passage of urine through the upper urinary tract routinely is achieved by installing of external or internal drainage. Due to its objective advantages, internal drainage has been successfully used in surgery of the upper urinary tract. This review outlines the problems associated with the use ofinternal stents, namely difficultyin installation, migration, and reflux and stent obstruction, bacterial colonization of the stent, the development of functional and morphological changes in the drained segment of urinary tract.