35 research outputs found
The three-dimensional reconstruction of the dilated renal pelvicalyceal system by non-enhanced computed tomography
Introduction. The three-dimensional reconstruction of the renal pelvicalyceal system (PCS) is possible when performing enhanced computed tomography (CT). However, the use of a contrast agent has its limitations associated with the presence of allergy and chronic kidney disease.Purpose of the study. To describe the method of semi-autonomous three-dimensional (3D) reconstruction of the PCS based on non-enhanced CT images of patients with upper urinary tract obstruction.Materials and methods. Five patients diagnosed with renal colic were recruited from April-May 2021. All patients underwent CT-urography after informed consent. Medical Imaging Interaction Toolkit program (MITK) expanded with explainable update were used for 3D-reconstruction of PCS via excretory and native phases. To assess the accuracy of the latter, both contrast and non-contrast models were compared regarding their surface area. Also, the PCS of one patient was used to reconstruct virtual endoscopic views based on enhanced and non-enhanced models. Five urologists estimated their similarity and potential use of non-enhanced models for the interventional planning via a Likert scale questionnaire. The resulting models were also analyzed by programmer-engineers to test their suitability for 3D-printing.Results. The average surface area of enhanced and non-enhanced models was 3291 mm2 and 2879 mm2, respectively. Obtained models were suitable for their intraluminal reconstruction and potential 3D-printing. Analyzed properties of non-enhanced models were estimated at 4.5 out of 5.0.Conclusion. The described semi-autonomous reconstruction of the renal PCS based on non-enhanced CT images allows for a short time to reconstruct its 3D-view in patients with the upper urinary tract obstruction
ΠΠΠ£Π’Π ΠΠΠΠΠ ΠΠ ΠΠΠΠ ΠΠΠΠΠΠ ΠΠΠ Π₯ΠΠΠ₯ ΠΠΠ§ΠΠΠ«ΠΠΠΠ―Π©ΠΠ₯ ΠΠ£Π’ΠΠ ΠΠ Π ΠΠΠ£Π₯ΠΠΠΠΠ«Π₯ ΠΠΠ‘Π’Π Π£ΠΠ¦ΠΠ―Π₯ ΠΠΠ§ΠΠ’ΠΠ§ΠΠΠΠΠ
The paper analyzes procedures for internal drainage of the upper urinary tract in ureteral tumor obstructions. It details indications for and contraindications to ureteral stenting or endoprostethic replacement, subcutaneous nephrovesical bypass. Postoperative complications and procedures for their prevention and treatment are considered. The data available in the literature on rare drainage procedures for the upper urinary tract, such as ureteral endoprosthetic replacement and nephrovesical bypass, are summarized.ΠΡΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· Π²Π½ΡΡΡΠ΅Π½Π½ΠΈΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² Π΄ΡΠ΅Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π²Π΅ΡΡ
Π½ΠΈΡ
ΠΌΠΎΡΠ΅Π²ΡΡ
ΠΏΡΡΠ΅ΠΉ ΠΏΡΠΈ ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΡ
ΠΎΠ±ΡΡΡΡΠΊΡΠΈΡΡ
ΠΌΠΎΡΠ΅ΡΠΎΡΠ½ΠΈΠΊΠΎΠ². ΠΠΎΠ΄ΡΠΎΠ±Π½ΠΎ ΠΎΡΠ²Π΅ΡΠ΅Π½Ρ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΈ ΠΏΡΠΎΡΠΈΠ²ΠΎΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΊ ΡΡΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΈΠ»ΠΈ ΡΠ½Π΄ΠΎΠΏΡΠΎΡΠ΅Π·ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΌΠΎΡΠ΅ΡΠΎΡΠ½ΠΈΠΊΠ°, Π½Π΅ΡΡΠΎΠ²Π΅Π·ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠΌΡ ΠΏΠΎΠ΄ΠΊΠΎΠΆΠ½ΠΎΠΌΡ ΡΡΠ½ΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ. Π Π°ΡΡΠΌΠΎΡΡΠ΅Π½Ρ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΠ΅ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡ, ΡΠΏΠΎΡΠΎΠ±Ρ ΠΈΡ
ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ. ΠΠ±ΠΎΠ±ΡΠ΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ ΠΏΠΎ ΡΠ°ΠΊΠΈΠΌ ΡΠ΅Π΄ΠΊΠΈΠΌ ΡΠΏΠΎΡΠΎΠ±Π°ΠΌ Π΄ΡΠ΅Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π²Π΅ΡΡ
Π½ΠΈΡ
ΠΌΠΎΡΠ΅Π²ΡΡ
ΠΏΡΡΠ΅ΠΉ, ΠΊΠ°ΠΊ ΡΠ½Π΄ΠΎΠΏΡΠΎΡΠ΅Π·ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΌΠΎΡΠ΅ΡΠΎΡΠ½ΠΈΠΊΠ° ΠΈ Π½Π΅ΡΡΠΎΠ²Π΅Π·ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠ΅ ΡΡΠ½ΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅
Comparative analysis of the results of standard and minipercutaneous nephrolithotripsy for staghorn stones
Introduction. There are conflicting data in the literature on the results of mini-percutaneous nephrolithotripsy (PCNL) in staghorn stones.Objective. To compare the results of standard and mini-PCNL.Materials and methods. The results of PCNL in 90 patients with staghorn stones were analyzed, which were divided into two groups. In the I group, 58 (64.4%) patients underwent standard PNL with a nephroscope 24 Fr, in the II group, 32 (35.6%) patients underwent mini-PCNL with an endoscope 15 Fr. The operative time and the number of postoperative complications were compared. To assess the effectiveness of PCNL, an overview radiography or native computed tomography was performed. The operation was considered successful with residual fragments less than 3 mm.Results. Operative time, number of complications and blood transfusions, the effectiveness of PCNL in groups I and II were 80.0 Β± 20.6 and 96.5 Β± 25.0 min, 24.1% and 15.6%, 10.3% and 3.1%, 86.2% and 84.4%. Additional interventions were resorted to in 7 (12.1%) patients in I group, and in 4 (12.5%) patients in II group. Complications in I and II groups were observed in 14 (24.1%) and 5 (15.6%) cases. The frequency of blood transfusions was significantly higher after standard PCNL (10.3% / 3.1%, p < 0.05). Complications of grade III with mini-PCNL, replacement of an incorrectly installed stent was included in 2 patients, and with standard PCNL, ureteral stenting with urine leakage through the nephrostomic tract in 2 patients, drainage of the pleural cavity in one case.Conclusion. Standard PCNL is an effective method in staghorn stones, but the number of complications after it remains higher. In selected patients with staghorn stones, the results of mini-PCNL are comparable to those of standard PCNL
Π ΠΎΠ±ΠΎΡ-Π°ΡΡΠΈΡΡΠΈΡΠΎΠ²Π°Π½Π½Π°Ρ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½Π°Ρ ΡΠΈΡΡΡΠΊΡΠΎΠΌΠΈΡ Ρ ΠΈΠ½ΡΡΠ°ΠΊΠΎΡΠΏΠΎΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΎΡΡΠΎΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠΈΡΡΠΎΠΏΠ»Π°ΡΡΠΈΠΊΠΎΠΉ
Background. Radical cystectomy uses laparoscopic and robotic approaches along with the open ones.Objective: to study immediate results of robot-assisted radical cystectomy with intracorporeal orthotopic cystoplasty.Materials and methods. Robot-assisted radical cystectomy with intracorporeal orthotopic cystoplasty was performed in 15 patients (13 male, 2 female), aged 64β76 years. Fourteen patients had bladder cancer, 1 female β a postradiation bladder fistula and microcystis. T2 stage was detected in 8 (57.1 %) patients, T3 β in 6 (42.9 %). After the operation we evaluated operation time, blood loss volume, hospital stay, functional and oncological results.Results. Average operation time was 380 (320β560) minutes, blood loss volume β 80β200 ml, blood transfusion was not performed. Early complications (up to 30 days) were observed in 7 patients (46.7 %), late ones (90βdays) β in 6 (40.0 %). There were no cases of intestinal obstruction. Patients with ureteral-intestinal (n = 2) and reservoir-urethral (n = 1) anastomosis failure underwent percutaneous renal drainage. One patient died of acute myocardial infarction. Daytime continence was 80.0 %, nocturnal β 53.3 %. One patient died of disease progression within 7.6 observation months.Conclusion. Robot-assisted radical cystectomy with intracorporeal urine diversion is a modern and minimally invasive method for patients with muscle-invasive bladder cancer. More experience in this field will allow to reduce surgery time and number of complications.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. ΠΡΠΈ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΈΡΡΡΠΊΡΠΎΠΌΠΈΠΈ Π½Π°ΡΡΠ΄Ρ Ρ ΠΎΡΠΊΡΡΡΡΠΌ ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΡΡΡΡ Π»Π°ΠΏΠ°ΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΈ ΡΠΎΠ±ΠΎΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π΄ΠΎΡΡΡΠΏΡ.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΈΠ·ΡΡΠ΅Π½ΠΈΠ΅ Π±Π»ΠΈΠΆΠ°ΠΉΡΠΈΡ
ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΡΠΎΠ±ΠΎΡ-Π°ΡΡΠΈΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΈΡΡΡΠΊΡΠΎΠΌΠΈΠΈ Ρ ΠΈΠ½ΡΡΠ°ΠΊΠΎΡΠΏΠΎΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΎΡΡΠΎΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΈΡΡΠΎΠΏΠ»Π°ΡΡΠΈΠΊΠΎΠΉ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΎΠ±ΠΎΡ-Π°ΡΡΠΈΡΡΠΈΡΠΎΠ²Π°Π½Π½Π°Ρ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½Π°Ρ ΡΠΈΡΡΡΠΊΡΠΎΠΌΠΈΡ Ρ ΠΈΠ½ΡΡΠ°ΠΊΠΎΡΠΏΠΎΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΎΡΡΠΎΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΈΡΡΠΎΠΏΠ»Π°ΡΡΠΈΠΊΠΎΠΉ Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π° 15 Π±ΠΎΠ»ΡΠ½ΡΠΌ (13 ΠΌΡΠΆΡΠΈΠ½Π°ΠΌ, 2 ΠΆΠ΅Π½ΡΠΈΠ½Π°ΠΌ). ΠΠΎΠ·ΡΠ°ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΠΎΡΡΠ°Π²ΠΈΠ» 64β76 Π»Π΅Ρ. Π£ 14 Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΠ΅ΠΌ ΠΊ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ Π±ΡΠ» ΡΠ°ΠΊ ΠΌΠΎΡΠ΅Π²ΠΎΠ³ΠΎ ΠΏΡΠ·ΡΡΡ, Ρ 1 ΠΆΠ΅Π½ΡΠΈΠ½Ρ β ΠΏΠΎΡΡΠ»ΡΡΠ΅Π²ΠΎΠΉ ΠΏΡΠ·ΡΡΠ½ΠΎ-ΡΠΈΠ³ΠΌΠΎΠ²ΠΈΠ΄Π½ΡΠΉ ΡΠ²ΠΈΡ, ΠΌΠΈΠΊΡΠΎΡΠΈΡΡΠΈΡ. Π‘ΡΠ°Π΄ΠΈΡ T2 Π²ΡΡΠ²Π»Π΅Π½Π° Ρ 8 (57,1 %), Π’3 β Ρ 6 (42,9 %) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠΎΡΠ»Π΅ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΠΈ Π²ΡΠ΅ΠΌΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ, ΠΎΠ±ΡΠ΅ΠΌ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ, ΡΡΠΎΠΊΠΈ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ, ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΠ΅ ΠΈ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π‘ΡΠ΅Π΄Π½Π΅Π΅ Π²ΡΠ΅ΠΌΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΎ 380 (320β560) ΠΌΠΈΠ½. ΠΠ±ΡΠ΅ΠΌ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ β 80β200 ΠΌΠ», Π³Π΅ΠΌΠΎΡΡΠ°Π½ΡΡΡΠ·ΠΈΡ Π½Π΅ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»Π°ΡΡ. Π Π°Π½Π½ΠΈΠ΅ (Π΄ΠΎ 30 Π΄Π½Π΅ΠΉ) ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡ Π½Π°Π±Π»ΡΠ΄Π°Π»ΠΈΡΡ Ρ 7 (46,7 %), ΠΏΠΎΠ·Π΄Π½ΠΈΠ΅ (90βΠ΄Π½Π΅Π²Π½ΡΠ΅) β Ρ 6 (40,0 %) Π±ΠΎΠ»ΡΠ½ΡΡ
. Π‘Π»ΡΡΠ°Π΅Π² ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠΉ Π½Π΅ΠΏΡΠΎΡ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΠΈ Π½Π΅ ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ. ΠΠΎΠ»ΡΠ½ΡΠΌ Ρ Π½Π΅ΡΠΎΡΡΠΎΡΡΠ΅Π»ΡΠ½ΠΎΡΡΡΡ ΠΌΠΎΡΠ΅ΡΠΎΡΠ½ΠΈΠΊΠΎΠ²ΠΎ-ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠ³ΠΎ (n = 2) ΠΈ ΡΠ΅Π·Π΅ΡΠ²ΡΠ°ΡΠ½ΠΎ-ΡΡΠ΅ΡΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Π°Π½Π°ΡΡΠΎΠΌΠΎΠ·Π° (n = 1) ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΎΡΡ ΠΏΠ΅ΡΠΊΡΡΠ°Π½Π½ΠΎΠ΅ Π΄ΡΠ΅Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΠΎΡΠ΅ΠΊ. ΠΠ΄ΠΈΠ½ ΠΏΠ°ΡΠΈΠ΅Π½Ρ ΡΠΌΠ΅Ρ ΠΎΡ ΠΎΡΡΡΠΎΠ³ΠΎ ΠΈΠ½ΡΠ°ΡΠΊΡΠ° ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π°. ΠΠ½Π΅Π²Π½Π°Ρ ΠΊΠΎΠ½ΡΠΈΠ½Π΅Π½ΡΠΈΡ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 80,0 %, Π½ΠΎΡΠ½Π°Ρ β 53,3 %. ΠΠ° 7,6 ΠΌΠ΅Ρ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ 1 Π±ΠΎΠ»ΡΠ½ΠΎΠΉ ΡΠΌΠ΅Ρ ΠΎΡ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π ΠΎΠ±ΠΎΡ-Π°ΡΡΠΈΡΡΠΈΡΠΎΠ²Π°Π½Π½Π°Ρ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½Π°Ρ ΡΠΈΡΡΡΠΊΡΠΎΠΌΠΈΡ Ρ ΠΈΠ½ΡΡΠ°ΠΊΠΎΡΠΏΠΎΡΠ°Π»ΡΠ½ΠΎΠΉ Π΄Π΅ΡΠΈΠ²Π°ΡΠΈΠ΅ΠΉ ΠΌΠΎΡΠΈ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠΌ ΠΌΠ°Π»ΠΎΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΌΡΡΠ΅ΡΠ½ΠΎ-ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ ΠΌΠΎΡΠ΅Π²ΠΎΠ³ΠΎ ΠΏΡΠ·ΡΡΡ. ΠΠ°Π»ΡΠ½Π΅ΠΉΡΠ΅Π΅ Π½Π°ΠΊΠΎΠΏΠ»Π΅Π½ΠΈΠ΅ ΠΎΠΏΡΡΠ° ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΡ ΡΠΎΠΊΡΠ°ΡΠΈΡΡ Π²ΡΠ΅ΠΌΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ ΠΈ ΠΌΠΈΠ½ΠΈΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°ΡΡ ΡΠΈΡΠ»ΠΎ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ
ΠΡΠ³Π°Π½ΠΎΡΠΎΡ ΡΠ°Π½ΡΡΡΠΈΠ΅ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ ΠΏΡΠΈ ΠΎΠΏΡΡ ΠΎΠ»ΡΡ Π²Π΅ΡΡ Π½ΠΈΡ ΠΌΠΎΡΠ΅Π²ΡΠ²ΠΎΠ΄ΡΡΠΈΡ ΠΏΡΡΠ΅ΠΉ
The results of organ-preserving interventions are analyzed in 12 patients (7 males and 5 females) with neoplasms of the renal pelvis and ureter. Endoscopic operations were performed in 4 patients with the normally functioning contralateral kidney and in one patient with the single kidney. Early complications developed in 2 of the 12 patients and were infectious and inflammatory. The mean duration of endoscopic surgery was 32.8Β±4.9 min; intraoperative blood loss is 83.0Β±15.3 ml; the duration of open surgery averaged 157.2Β±29.7 min and intraoperative blood loss was 1930Β±69.3 ml. After 4 years of a follow-up, the frequency of tumor relapse was 40%; 5-year survival was 80%. Thus, in patients with upper urinary tract neoplasms, organ-preserving operations are a justifiable alternative to nephroureterectomy with urinary bladder resection and most reasonable in uni- and bilateral renal tumor. Urinary tract endoscopic examination assessing the possibilities of freely manipulating an endoscope in the ureteral lumen and renal cavitary system for biopsy of a tumor and its further removal is a major and determining factor in defining indications for this type of intervention.The results of organ-preserving interventions are analyzed in 12 patients (7 males and 5 females) with neoplasms of the renal pelvis and ureter. Endoscopic operations were performed in 4 patients with the normally functioning contralateral kidney and in one patient with the single kidney. Early complications developed in 2 of the 12 patients and were infectious and inflammatory. The mean duration of endoscopic surgery was 32.8Β±4.9 min; intraoperative blood loss is 83.0Β±15.3 ml; the duration of open surgery averaged 157.2Β±29.7 min and intraoperative blood loss was 1930Β±69.3 ml. After 4 years of a follow-up, the frequency of tumor relapse was 40%; 5-year survival was 80%. Thus, in patients with upper urinary tract neoplasms, organ-preserving operations are a justifiable alternative to nephroureterectomy with urinary bladder resection and most reasonable in uni- and bilateral renal tumor. Urinary tract endoscopic examination assessing the possibilities of freely manipulating an endoscope in the ureteral lumen and renal cavitary system for biopsy of a tumor and its further removal is a major and determining factor in defining indications for this type of intervention
ΠΠ΄Π½ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½Π°Ρ ΠΊΠΈΡΠ΅ΡΠ½Π°Ρ ΠΏΠ» Π°ΡΡΠΈΠΊΠ° ΠΌΠΎΡΠ΅ΡΠΎΡΠ½ΠΈΠΊΠΎΠ² ΠΈ ΠΌΠΎΡΠ΅Π²ΠΎΠ³ΠΎ ΠΏΡΠ·ΡΡΡ
The purpose of the investigation was to study the long-term results of reconstructive surgery in patients who had undergone simultaneousΒ ureteral and bladder intestinoplasty. The investigation enrolled 33 patients with different bladder diseases complicated by secondary hydroureteronephrosis.Β After radical cystectomy, the U. E. Studer method was used to form a low-pressure orthotopic reservoir from the ileum withΒ an afferent tubular segment in 23 (69.7 %) patients. Y-shaped ileoureterocystoplasty was carried out to recover extensive ureteral and bladderΒ defects in 10 (30.3 %) cases. Long-term surgical results were assessed on the basis of a comprehensive examination involving laboratory,Β X-ray, radionuclide, and endourological studies. An isolated loop of the small bowel is a universal plastic material that may be used not onlyΒ to bilaterally replace any ureteral defect, but also to simultaneously repair the bladder, by preserving independent urination.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΈΠ·ΡΡΠ΅Π½ΠΈΠ΅ ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΡΡ
ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΡΠ΅ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠ²Π½ΡΡ
ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΉ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
, ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠΈΡ
ΠΎΠ΄Π½ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ ΠΏΠ»Π°ΡΡΠΈΠΊΡ ΠΌΠΎΡΠ΅ΡΠΎΡΠ½ΠΈΠΊΠΎΠ² ΠΈ ΠΌΠΎΡΠ΅Π²ΠΎΠ³ΠΎ ΠΏΡΠ·ΡΡΡ. Π ΡΠ°Π±ΠΎΡΡ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ 33 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°, ΠΊΠΎΡΠΎΡΡΠ΅ ΡΡΡΠ°Π΄Π°Π»ΠΈ ΡΠ°Π·Π»ΠΈΡΠ½ΡΠΌΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΠΌΠΈ ΠΌΠΎΡΠ΅Π²ΠΎΠ³ΠΎ ΠΏΡΠ·ΡΡΡ, ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½Π½ΡΠΌΠΈ Π²ΡΠΎΡΠΈΡΠ½ΡΠΌ Π³ΠΈΠ΄ΡΠΎΡΡΠ΅ΡΠ΅ΡΠΎΠ½Π΅ΡΡΠΎΠ·ΠΎΠΌ. Π£ 23 (69,7 %) Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΏΠΎΡΠ»Π΅ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΈΡΡΡΠΊΡΠΎΠΌΠΈΠΈ Π±ΡΠ» ΡΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ ΠΎΡΡΠΎΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ΅Π·Π΅ΡΠ²ΡΠ°Ρ Π½ΠΈΠ·ΠΊΠΎΠ³ΠΎ Π΄Π°Π²Π»Π΅Π½ΠΈΡ ΠΈΠ· ΠΏΠΎΠ΄Π²Π·Π΄ΠΎΡΠ½ΠΎΠΉ ΠΊΠΈΡΠΊΠΈ Ρ Π°ΡΡΠ΅ΡΠ΅Π½ΡΠ½ΡΠΌ ΡΡΠ±ΡΠ»ΡΡΠ½ΡΠΌ ΡΠ΅Π³ΠΌΠ΅Π½ΡΠΎΠΌ ΠΏΠΎ ΠΌΠ΅ΡΠΎΠ΄ΡΒ U. E. Studer. Π 10 (30,3 %) ΡΠ»ΡΡΠ°ΡΡ
Π΄Π»Ρ Π²ΠΎΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ ΠΏΡΠΎΡΡΠΆΠ΅Π½Π½ΡΡ
Π΄Π΅ΡΠ΅ΠΊΡΠΎΠ² ΠΌΠΎΡΠ΅ΡΠΎΡΠ½ΠΈΠΊΠΎΠ² ΠΈ ΠΌΠΎΡΠ΅Π²ΠΎΠ³ΠΎ ΠΏΡΠ·ΡΡΡ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈΒ Y-ΠΎΠ±ΡΠ°Π·Π½ΡΡ ΠΈΠ»Π΅ΠΎΡΡΠ΅ΡΠ΅ΡΠΎΡΠΈΡΡΠΎΠΏΠ»Π°ΡΡΠΈΠΊΡ. ΠΡΠ΅Π½ΠΊΡ ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΡΡ
ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ Π½Π° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ, Π²ΠΊΠ»ΡΡΠ°ΡΡΠ΅Π³ΠΎ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΠ΅, ΡΠ΅Π½ΡΠ³Π΅Π½ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅, ΡΠ°Π΄ΠΈΠΎΠΈΠ·ΠΎΡΠΎΠΏΠ½ΡΠ΅ ΠΈ ΡΠ½Π΄ΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΠ·ΠΎΠ»ΠΈΡΠΎΠ²Π°Π½Π½Π°Ρ ΠΏΠ΅ΡΠ»Ρ ΡΠΎΠ½ΠΊΠΎΠΉ ΠΊΠΈΡΠΊΠΈ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠ½ΠΈΠ²Π΅ΡΡΠ°Π»ΡΠ½ΡΠΌ ΠΏΠ»Π°ΡΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»ΠΎΠΌ, ΠΏΡΠΈ ΠΏΠΎΠΌΠΎΡΠΈ ΠΊΠΎΡΠΎΡΠΎΠ³ΠΎ ΠΌΠΎΠΆΠ½ΠΎ Π·Π°ΠΌΠ΅ΡΡΠΈΡΡΒ Π½Π΅ ΡΠΎΠ»ΡΠΊΠΎ Π»ΡΠ±ΠΎΠΉ Π΄Π΅ΡΠ΅ΠΊΡ ΠΌΠΎΡΠ΅ΡΠΎΡΠ½ΠΈΠΊΠΎΠ² Ρ ΠΎΠ±Π΅ΠΈΡ
ΡΡΠΎΡΠΎΠ½, Π½ΠΎ ΠΈ ΠΎΡΡΡΠ΅ΡΡΠ²ΠΈΡΡ ΠΎΠ΄Π½ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎ ΡΠ΅ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΡ ΠΌΠΎΡΠ΅Π²ΠΎΠ³ΠΎ ΠΏΡΠ·ΡΡΡ Ρ ΡΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΠ΅ΠΌ ΡΠ°ΠΌΠΎΡΡΠΎΡΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΌΠΎΡΠ΅ΠΈΡΠΏΡΡΠΊΠ°Π½ΠΈΡ
Π§Π ΠΠ‘ΠΠΠΠΠΠ― ΠΠΠΠΠ‘ΠΠΠΠΠ§ΠΠ‘ΠΠΠ― ΠΠΠΠΠ’Π ΠΠ ΠΠΠΠΠ¦ΠΠ― ΠΠΠ£Π₯ΠΠΠΠ ΠΠΠ₯ΠΠΠΠ
The paper gives the results of percutaneous electroresection of the renal pelvic wall with a tumor in 4 patients. The operation has been made for absolute indications: 3 patients had a single kidney and the fourth patient had a single functioning left kidney (the right pelvic dystopic kidney failed to function). In all the patients, the primary symptom of the disease was macrohematuria, the examination for which revealed a renal pelvic tumor measuring 1.2 to 2.5 cm in size. There were no complications after percutaneous electroresection of the renal pelvic wall with a tumor. Intrarenal BCG therapy was performed in the postoperative period. Percutaneous electroresection is indicated for tumors of the renal pelvis and the upper third of the ureter of the single kidney.Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠΈΠ²Π΅Π΄Π΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΡΡΠ΅ΡΠΊΠΎΠΆΠ½ΠΎΠΉ ΡΠ»Π΅ΠΊΡΡΠΎΡΠ΅Π·Π΅ΠΊΡΠΈΠΈ ΡΡΠ΅Π½ΠΊΠΈ Π»ΠΎΡ
Π°Π½ΠΊΠΈ Ρ ΠΎΠΏΡΡ
ΠΎΠ»ΡΡ, Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π½ΠΎΠΉ Ρ 4 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠΏΠ΅ΡΠ°ΡΠΈΡ Π±ΡΠ»Π° ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΏΠΎ Π°Π±ΡΠΎΠ»ΡΡΠ½ΡΠΌ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΡΠΌ: ΡΡΠΎΠ΅ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΈΠΌΠ΅Π»ΠΈ Π΅Π΄ΠΈΠ½ΡΡΠ²Π΅Π½Π½ΡΡ ΠΏΠΎΡΠΊΡ, Π° ΡΠ΅ΡΠ²Π΅ΡΡΡΠΉ β Π΅Π΄ΠΈΠ½ΡΡΠ²Π΅Π½Π½ΠΎ ΡΡΠ½ΠΊΡΠΈΠΎΠ½ΠΈΡΡΡΡΡΡ Π»Π΅Π²ΡΡ ΠΏΠΎΡΠΊΡ (ΠΏΡΠ°Π²Π°Ρ ΡΠ°Π·ΠΎΠ²ΠΎΠ΄ΠΈΡΡΠΎΠΏΠΈΡΠΎΠ²Π°Π½Π½Π°Ρ ΠΏΠΎΡΠΊΠ° Π½Π΅ ΡΡΠ½ΠΊΡΠΈΠΎΠ½ΠΈΡΠΎΠ²Π°Π»Π°). ΠΠ΅ΡΠ²ΠΈΡΠ½ΡΠΌ ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Ρ Π²ΡΠ΅Ρ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΠ²Π»ΡΠ»ΠΎΡΡ Π½Π°Π»ΠΈΡΠΈΠ΅ ΠΌΠ°ΠΊΡΠΎΠ³Π΅ΠΌΠ°ΡΡΡΠΈΠΈ, ΠΏΡΠΈ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΠΎ ΠΏΠΎΠ²ΠΎΠ΄Ρ ΠΊΠΎΡΠΎΡΠΎΠΉ Π±ΡΠ»Π° Π²ΡΡΠ²Π»Π΅Π½Π° ΠΎΠΏΡΡ
ΠΎΠ»Ρ Π»ΠΎΡ
Π°Π½ΠΊΠΈ ΡΠ°Π·ΠΌΠ΅ΡΠ°ΠΌΠΈ ΠΎΡ 1,2 Π΄ΠΎ 2,5 ΡΠΌ. ΠΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ ΠΏΠΎΡΠ»Π΅ ΠΎΡΡΡΠ΅ΡΡΠ²Π»Π΅Π½ΠΈΡ ΠΏΠ΅ΡΠΊΡΡΠ°Π½Π½ΠΎΠΉ ΡΠ»Π΅ΠΊΡΡΠΎΡΠ΅Π·Π΅ΠΊΡΠΈΠΈ ΡΡΠ΅Π½ΠΊΠΈ Π»ΠΎΡ
Π°Π½ΠΊΠΈ Ρ ΠΎΠΏΡΡ
ΠΎΠ»ΡΡ Π½Π΅ Π½Π°Π±Π»ΡΠ΄Π°Π»ΠΈ. Π ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΈΠ½ΡΡΠ°ΡΠ΅Π½Π°Π»ΡΠ½Π°Ρ ΠΠ¦Π-ΡΠ΅ΡΠ°ΠΏΠΈΡ. ΠΡΠΈ ΠΎΠΏΡΡ
ΠΎΠ»ΡΡ
Π»ΠΎΡ
Π°Π½ΠΊΠΈ ΠΈ Π²Π΅ΡΡ
Π½Π΅ΠΉ ΡΡΠ΅ΡΠΈ ΠΌΠΎΡΠ΅ΡΠΎΡΠ½ΠΈΠΊΠ° Π΅Π΄ΠΈΠ½ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΏΠΎΡΠΊΠΈ ΠΏΠΎΠΊΠ°Π·Π°Π½Π° ΠΈΡ
ΠΏΠ΅ΡΠΊΡΡΠ°Π½Π½Π°Ρ ΡΠ»Π΅ΠΊΡΡΠΎΡΠ΅Π·Π΅ΠΊΡΠΈΡ