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Significance of definition category of complexity of urinary stones in the systematization of complications of endosopic surgery of urolitiasis
DOI: https://dx.doi.org/10.18565/urology.2020.1.39-45
Sh.I. Giyasov, F.A. Akilov, Sh.T. Mukhtarov, A.A. Abdurashidov, E.T. Azimov
1) “Republican specialized scientific and practical medical center of urology” (RSSPMCU), Tashkent, Uzbekistan; 2) Department of Urology, Tashkent Medical Academy, Tashkent, Uzbekistan
Aim. To determine the complexity of urinary stones from the standpoint of endoscopic surgery in order to create the standard for the postoperative course of endoscopic surgery for urolithiasis.
Material and methods. A total of 1317 endoscopic operations (PNL, URS), performed for upper urinary tract stones, were analyzed. Treatment results of 290 patients were studied prospectively, taking into account a stone density, determined by MSCT using HU scale. In 1027 patients, results were studied retrospectively, with a consideration of stone quantitative characteristics, size and shape.
Results. According to the study, stone density does not have a significant impact on the frequency and severity of complications and the efficacy of endoscopic treatment for urolithiasis. The number of stones, their size and stereometric configuration have a significant influence on the surgical procedure. From the position of endoscopic interventions, single upper urinary tract stones were determined as “simple”, while multiple and staghorn stones were considered as “complexed” cases.
Conclusion. The "standard of the postoperative period" of endoscopic surgery for urolithiasis created with a consideration of specific features of endoscopic surgery for urolithiasis and the complexity of urinary stones is proved to be objective. Any deviation in the postoperative period from the standard course should be regarded as a complication and it is necessary to systematize them according to the Clavien-Dindo classification.
Material and methods. A total of 1317 endoscopic operations (PNL, URS), performed for upper urinary tract stones, were analyzed. Treatment results of 290 patients were studied prospectively, taking into account a stone density, determined by MSCT using HU scale. In 1027 patients, results were studied retrospectively, with a consideration of stone quantitative characteristics, size and shape.
Results. According to the study, stone density does not have a significant impact on the frequency and severity of complications and the efficacy of endoscopic treatment for urolithiasis. The number of stones, their size and stereometric configuration have a significant influence on the surgical procedure. From the position of endoscopic interventions, single upper urinary tract stones were determined as “simple”, while multiple and staghorn stones were considered as “complexed” cases.
Conclusion. The "standard of the postoperative period" of endoscopic surgery for urolithiasis created with a consideration of specific features of endoscopic surgery for urolithiasis and the complexity of urinary stones is proved to be objective. Any deviation in the postoperative period from the standard course should be regarded as a complication and it is necessary to systematize them according to the Clavien-Dindo classification.
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