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1.
Urologiia ; (2): 26-31, 2023 May.
Artículo en Ruso | MEDLINE | ID: mdl-37401701

RESUMEN

INTRODUCTION: Stent encrustation is one of the most difficult problems that can lead to difficulties in stent removal, while ureteral obstruction can lead to renal failure. Despite the search for various preventive measures, it still remains unresolved. AIM: To study the effect of Blemaren on stent encrustation in patients with calcium-containing and uric acid stones after ureteroscopy with lithotripsy. MATERIALS AND METHODS: A total of 60 patients with ureteral stones who underwent ureteroscopy with lithotripsy in A.V. Vishnevsky National Medical Research Center of Surgery from January to August 2022, were included in the study. In all cases ureteral stents 6 Ch were placed at the end of the procedure. Patients with uric acid and calcium oxalate stones (n=48) were randomized into two groups: in the main group (n=20), they were prescribed Blemaren up to the stent removal. In the control group (n=28), patients did not receive additional therapy. To determine the severity of incrustation, we used our own classification, where the percentage of lithogenic deposits relative to the lumen of the stent was calculated. Visual assessment and microscopic examination of the removed stents were performed on days 30+/-4.1 and 60+/-7.3. RESULTS: In patients of both groups, the severity of encrustation on the 30th day after stent placement was low (up to 30%). There were no significant differences between the groups (p=0.421). The main changes were detected 60 days after stent placement. Microscopic study revealed significant differences between two groups. In patients who did not receive Blemaren, microscopic signs of encrustation of the proximal curl of the stent occurred 2.5 times more often than in the main group (p=0.001). CONCLUSIONS: 1. The number of encrusted stents in patients with calcium oxalate and uric acid stones who did not receive Blemaren significantly increases after two months. 2. Upper urinary tract drainage with a stent for a period of more than 2 months is possible if clinically necessary, however, preventive measures to reduce the risk of encrustation should be applied.


Asunto(s)
Nefrolitiasis , Uréter , Cálculos Ureterales , Cálculos Urinarios , Humanos , Oxalato de Calcio , Ácido Úrico , Cálculos Urinarios/terapia , Uréter/cirugía , Cálculos Ureterales/cirugía , Ureteroscopía/efectos adversos , Ureteroscopía/métodos , Stents/efectos adversos
2.
Khirurgiia (Mosk) ; (6): 5-17, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-32573526

RESUMEN

The Russian consensus document on topical issues of the diagnosis and treatment of obstructive jaundice syndrome was prepared by a group of experts in various fields of surgery, endoscopy, interventional radiology, radiological diagnosis and intensive care. The goal of this document is to clarify and consolidate the opinions of national experts on the following issues: timing of diagnosis of obstructive jaundice, features of diagnostic measures, the need and possibility of conservative measures for obstructive jaundice, and strategy of biliary decompression depending on the cause and level of biliary block.


Asunto(s)
Ictericia Obstructiva/diagnóstico , Ictericia Obstructiva/terapia , Consenso , Humanos , Federación de Rusia
3.
Khirurgiia (Mosk) ; (5): 67-74, 2018.
Artículo en Ruso | MEDLINE | ID: mdl-29798994

RESUMEN

AIM: To assess the role of CO2-laser in treatment of various scars and to determine the indications for its application. PATIENTS AND METHODS: It has been carried out a prospective analysis of treatment of 218 patients with scars of different duration, locations and anatomic areas with the use of CO2-laser for the period 2011-2017. POSAS scale and sonography were used for analysis. RESULTS: 1. Laser therapy is not effective for scarring-related functional defects (contractures, ectropion, microstomia), when surgery is indicated. 2. The outcomes of treatment (both surgical and laser) depend on the time of existence of the scars rather their cause and anatomical region. 3. Laser therapy is not effective enough for formed scars existing over 12 months. 4. Laser therapy is effective for immature scars, especially indicated for cicatricial deformation when the aesthetics cannot be repaired with traditional surgery. CONCLUSION: Application of CO2-laser in scars treatment with regard to its real efficiency determines the effectiveness of therapy.


Asunto(s)
Cicatriz , Contractura , Terapia por Láser , Láseres de Gas/uso terapéutico , Terapia por Luz de Baja Intensidad , Adulto , Cicatriz/complicaciones , Cicatriz/cirugía , Cicatriz/terapia , Contractura/etiología , Contractura/cirugía , Femenino , Humanos , Terapia por Láser/instrumentación , Terapia por Láser/métodos , Terapia por Luz de Baja Intensidad/instrumentación , Terapia por Luz de Baja Intensidad/métodos , Masculino , Persona de Mediana Edad , Selección de Paciente , Resultado del Tratamiento
4.
Khirurgiia (Mosk) ; (1): 42-47, 2017.
Artículo en Ruso | MEDLINE | ID: mdl-28209953

RESUMEN

AIM: To develop the method for extracorporeal partial nephrectomy under pharmaco-cold ischemia without ureter intersection with orthotopic replantation of renal vessels for RCC. MATERIAL AND METHODS: The study included 37 patients with morphologically confirmed RCC pT1a-Т3bN0M0-1G1-3 with intraparenchymal and central location of the tumor in cases of single kidney, comorbidity of contralateral kidney and kidney on the side of lesion. RESULTS: Mean surgery time was 413.97±89.14 minutes. Mean time of warm ischemia was 8.39±4.75 minutes, cold ischemia - 151.41±41.29 minutes. Intraoperative and postoperative complications were detected in 3 (8.1%) and 18 (48.6%) patients respectively. CONCLUSION: Extracorporeal partial nephrectomy under pharmaco-cold ischemia without ureter intersection with orthotopic replantation of renal vessels for RCC is a relatively safe organ-sparing treatment. It provides resection of large tumors with any location under prolonged cold ischemia without ureter intersection.


Asunto(s)
Carcinoma de Células Renales , Isquemia Fría/métodos , Neoplasias Renales , Nefrectomía , Tratamientos Conservadores del Órgano/métodos , Complicaciones Posoperatorias , Carcinoma de Células Renales/patología , Carcinoma de Células Renales/cirugía , Femenino , Tasa de Filtración Glomerular , Humanos , Neoplasias Renales/patología , Neoplasias Renales/cirugía , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Nefrectomía/efectos adversos , Nefrectomía/métodos , Evaluación de Procesos y Resultados en Atención de Salud , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Federación de Rusia
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