Morphometric modelling as a factor improving outcomes of percutaneous nephrolitholapaxy
The objective. Assessment of the outcomes of operative treatment of 120 patients with urolithiasis (UL). Patients and methods. The study included 120 operated patients with UL who stayed at the urology and nephrology clinic in 2013 to 2015 (48 men and 72 women). In the post-operative period, all patients underwent complex examination including laboratory, radiological, radionuclide examination, and multislice spiral computed tomography (MSCT) with 3D reconstruction and subsequent biomodelling of operational tactics. Results. Single stones were found in 45 patients, multiple stones in 24 and coral-shaped in 51 patients. Signs of urinary infections were found in 64 patients of both sexes. The time of pre-operative preparation did not exceed 1 day. The mean time of operative intervention was 110 minutes (65-240 min). Radiological examination lasted for 7 to 34 min (on the average 20.5 min). Body mass index, number of previous interventions, and stone configuration did not influence significantly the duration of operation. The main complications of operative intervention were parenchymal bleeding (5%), perforation of the upper urinary tract (3.3%), and technical difficulties in obtaining approach to the renal collecting system (7.5%). Complete removal of stones was obtained in 78% of patients. The presence of residual stones was noted first of all in patients with multiple and coral stones (K 3-4). Conclusion. The use of morphometric modelling in percutaneous nephrolitholapaxy is currently a highly effective and low-traumatic method permitting to manage coral nephrolithiasis, to reduce possible intra- and post-operative risks and to help patients to return to work soon.