[DRAINLESS TRANSCUTANEOUS NEPHROLITHOTRIPSY. OUR FIRST EXPERIENCE].

Experience of performance of a drainless transcutaneous nephrolitotripsy (DTN) for renal concrements was summarized. In 245 patients mini­DTN was done, оperation was finished with the nephrostomic drain installation ­ in 224 (91.4%), and without such procedure ­ in 21 (8.6%), in these patients an ureteric JJ­stent was installed in antegrade fashion. Indications for the DTN performance were substantiated, the patients for such treatment were selected, peculiarities of the DTN performance are adduced. JJ­stents were removed from ureter on the 2­nd ­ 7­th postoperative day, and in some patients ­ in ambulatory setting. After the operation the patients with out nephrostomic drain needed anesthesia in twice rarely. DTN constitutes a secure procedure, which must be conducted by experienced surgeon, сomplient with all demands and criteria of renal transcutaneous surgery, what permits to reduce the pain syndrome severity in patients in the early postoperative period stationary state.

PECULIARITIES OF APPLICATION OF THE LASER ENERGY IN TREATMENT OF URETERIC STRICTURE.

Efficacy of the ureteric stricture (UC) treatment, using energy of the Holmium (in 55% patients) and the diode (in 45%) lasers was analyzed. In 37 (77%) patient spositive results were achieved already after one session, in 4 (8.3%) ­ one more session was performed in terms up to 3 mo after the first one, in 3 (6.3%) ­ two sessions were per' formed. Positive results were achieved in total in 91.6% patients. Application of laser energy in treatment of UC is effective and not dependent from the energy kind and con' stitutes a perspective method of the patient's endoscopic treatment.

[[Peculiarities of transcutaneous nephrolithotripsy in the patient's position lying on the back].]

In 2014 - 2016 yrs transcutaneous nephrolithotripsy was performed in 245 patients for nephrolithiasis, of them in 228 (93.1%) - in position of patient lying on the abdomen (1st group), in 17 (6.9%) - lying on the back (2nd group) because of various concur- rent cardio-vascular and respiratory diseases present. Mini- transcutaneous nephro- lithotripsy was performed under regional epidural anesthesia in 224 (91.4%) patients, and under endotracheal narcosis - in 21 (8.6%). While conduction of mini- transcu- taneous nephrolithotripsy in position of patient lying on the back the operation duration is reducing, and it is possible to perform simultant endoscopic interventions (trans- ureteric, transcutaneous). Position of patient lying on the back while performing tran- scutaneous nephrolithotripsy in a complex with regional (epidural) anesthesia consti- tutes a relatively secure procedure. Hemodynamical and respiratory parameters are simply intraoperatively controlled, what is important for the patients, urologists and anesthesiologists. The complications rate and results of treatment are comparable with such while performing transcutaneous nephrolithotripsy in accordance to standard in position of patient lying on the abdomen.