Ретроградная интраренальная хирургия: современный взгляд на проблему


DOI: https://dx.doi.org/10.18565/urology.2018.5.175-181

Н.А. Григорьев

АО «Европейский Медицинский Центр», Москва, Россия
Ретроградная интраренальная хирургия (РИРХ) – активно развивающееся направление эндоскопического лечения мочекаменной болезни. Считавшаяся ранее дополнительной методикой для пациентов с неэффективной дистанционной литотрипсией или при камнях нижней чашечки, в настоящее время РИРХ завоевывает лидирующие позиции в лечении камней почек наряду с перкутанной хирургией. Она рекомендована сегодня как основная методика лечения камней размером менее 2 см, особенно в случаях, где дистанционная литотрипсия малоперспективна или не желательна. Ретроградная интраренальная хирургия не имеет специфических противопоказаний, за исключением активного воспалительного процесса в мочевыводящих путях, и может применяться даже в отношении пациентов с различными коагулопатиями. В данной работе представлена информация об истории возникновения и становления РИРХ, показаниях и противопоказаниях, дооперационной подготовке пациентов, особенностях анестезии, технике выполнения операции, а также об особенностях мочеточниковых кожухов, струн, литоэкстракторов. Представлены рекомендации по лазерной литотрипсии, послеоперационному ведению пациентов и возможным осложнениям с обзором современной литературы.
Ключевые слова: ретроградная интраренальная хирургия, гибкая уретероскопия, камень почки, мочеточниковый кожух, лазерная литотрипсия

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Об авторах / Для корреспонденции


А в т о р д л я с в я з и: Н. А. Григорьев – д.м.н., профессор, заведующий урологическим отделением АО «Европейский Медицинский Центр», заведующий кафедрой урологии ЧУ ДПО «Медицинская школа ЕМС», Москва, Россия


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