Bilateral percutaneous mininephrolithotripsy: simultaneous or staged approach?

Introduction. Patients with bilateral nephrolithiasis are a challenge for the treating physician. Therefore, such patients traditionally are subject to phased surgery to reduce the rate of complications. At the same time, the enhancement of endoscopic technologies and anesthesia makes it possible to perform surgical treatment of bilateral nephrolithiasis simultaneously.Objective. To evaluate the effectiveness and safety of performing simultaneous bilateral percutaneous nephrolithotripsy (PCNL).Materials & methods. The main group comprises 19 patients (avg age 45.0 ± 2.25 years) suffering from bilateral nephrolithiasis (13 men and 6 women). The control group include 20 patients (avg age 45.80 ± 2.29 years) suffering from bilateral nephrolithiasis. Main group patients underwent simultaneous bilateral mini-PCNL, control group patients — staged PCNL within two hospitalisations. The visual analogue scale (VAS) was used to assess the pain severity. Patients noted subjective pain sensations on post-op days 1 and 3. QoL indicators were assessed using the SF-36 general questionnaire, as well as the Russian-language validated version of the WISQoL questionnaire.Results. There were no statistically significant differences between the parameters (the difference between the hemoglobin before and after mini-PCNL was 12 g/l; between the serum creatinine was 18 µmol/l). There was a decrease in total surgery time (121.0 ± 6.1 min) for main group patients compared to (147.0 ± 7.3 min) control group patients (total surgery time during the first and second hospitalisations) and a reduction in hospital stay (4.50 ± 0.23 days) for main group patients compared to control group patients (10.0 ± 0.5 days). Complications observed by us in the two groups were comparable. The valuesobtained on the SF, RE and MH scales in main group patients were higher both on post-op day 1 (67.9 ± 3.39; 56.90 ± 2.85 and 63.80 ± 3.19, respectively) and post-op day 3 (86.80 ± 4.34; 83.70 ± 4.19 and 82.50 ± 4.13, respectively) compared to control group patients during the first and second hospitalizations. Statistically significant differences were also recorded according to the grades "Social functioning" and "Emotional influence" in main group patients (80.90 ± 0.26 and 82.6 ± 0.19, respectively).Conclusion. Simultaneous bilateral mini-PCNL is safe and effective in well-selected patients

Родственная трансплантация почки - первый опыт в клинической больнице Святителя Луки

Kidney transplantation (KT) is regarded as the most effective therapeutic approach for people with end-stage renal disease. However, for a number of reasons - constant increase in the incidence of diseases contributing to formation and development of chronic kidney disease, as well as continuing shortage of donor organs - 78-95% of patients in need of a kidney transplant do not receive the necessary treatment, and the waiting list stretches for several years. This paper presents the first outcomes of KT for chronic glomerulonephritis performed at St. Luke’s Clinical Hospital in St. Petersburg, in collaboration with the staff of Shumakov National Medical Research Center of Transplantology and Artificial Organs. Трансплантация почки является наиболее эффективным видом медицинской помощи пациентам с терминальной почечной недостаточностью. Однако по ряду причин (постоянное увеличение частоты встречаемости заболеваний, способствующих формированию и развитию хронической болезни почек, а также сохраняющийся дефицит донорских органов) 78-95% пациентов, нуждающихся в пересадке почки, не получают необходимого лечения, а очередь в листах ожидания растягивается на несколько лет. В статье в виде клинического случая представлены первые результаты родственной трансплантации почки при хроническом гломерулонефрите, проведенной в СПб ГБУЗ «Клиническая больница Святителя Луки» совместно с сотрудниками ФГБУ «НМИЦ ТИО им. ак. В.И. Шумакова» Минздрава России

Выбор метода лечения симптоматической инфравезикальной обструкции У пациентов С доброкачественной гиперплазией предстательной железы, перенесших трансплантацию почки

St. Petersburg, Russian Federation The paper presents a comparative assessment of different methods of treating symptomatic bladder outlet obstruction (BOO) in patients with benign prostatic hyperplasia (BPH) who underwent kidney transplantation (KT).Статья посвящена сравнительной оценке различных методов лечения симптоматической инфравезикальной обструкции (ИВО) у пациентов с доброкачественной гиперплазией предстательной железы (ДГПЖ), перенесших трансплантацию почки (ТП)