[Risk factors for complications of ureterolithotripsy].

Autor:	Mamedov EA; GBUZ Moscow district Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia., Dutov VV; GBUZ Moscow district Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia., Bazaev VV; GBUZ Moscow district Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia., Podoynitsyn AA; GBUZ Moscow district Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia., Urenkov SB; GBUZ Moscow district Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia., Ivanov AE; GBUZ Moscow district Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia., Romanov DV; GBUZ Moscow district Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia., Morozov AA; GBUZ Moscow district Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia.
Jazyk:	ruština
Zdroj:	Urologiia (Moscow, Russia : 1999) [Urologiia] 2020 Sep (4), pp. 60-65.
Abstrakt:	Aim: to determine main risk factors for complications of ureterolithotripsy. Materials and Methods: a retrospective analysis of the results of 545 ureteroscopies performed in 506 patients with ureteral stones over the past 7 years at the urological clinic named after M.F. Vladimirsky was carried out. The relationship between preoperative and intraoperative factors and complications of ureterolithotripsy was analyzed. Results: The overall complication rate was 22.4%. The risk of intraoperative complications was proved to increase (p<0.05) along with the stone size, location in proximal ureter, stone impaction for more than 3 weeks and the degree of hydronephrosis. No preoperative stenting or nephrostomy tube prior to ureteroscopy was associated to an increased risk of intraoperative complications (RR=2.88; p=0.03). Patients with preoperative drainage of upper urinary tract has lower probability of intraoperative complications (OR=0.35; p=0.03). The risk of developing stricture and ureteral obliteration in uncomplicated ureteroscopy was minimal (RR=0.008, p=0.0001). Small ureteral perforation and pronounced mucosal inflammation around the stone have the similar influence on the risk of complications, which was more than 7.5 times (p=0.0001) higher than in uncomplicated ureteroscopy. Large ureteral perforation was associated with the highest risk of stricture formation and ureteral obliteration, which was 64 times (p=0.0001) higher than in uncomplicated ureteroscopy. Conclusion: The rate of complications of ureterolithotripsy directly depends on the following factors: size and location of the stone, the stone impaction, pre- and intraoperative (nephrostomy tube) drainage of the upper urinary tract, the degree of hydronephrosis, level of bacteriuria and intraoperative trauma complications.
Databáze:	MEDLINE
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