NEW PERSPECTIVES IN TREATMENT OF UROLITHIASIS

Abstract

THE AIM of the investigation was to find out the advantages and disadvantages of the open, lumboscopic operations and distance shock wave lithotripsy (DSWL) in treatment of large calculi of the kidneys and upper parts of the ureter and to determine the place of these methods in treatment of patients with urolithiasis. PATIENTS AND METHODS. A statistical analysis was made of 97 case histories of patients with large (from 0.9 to 2.5 cm) concrements of the pelvis, upper and middle third of the ureters down to their crossing of the iliac vessels. The patients were subjected to traditional (18) and lumboscopic (48) operations, distance shock wave lithotripsy (31).RESULTS. The hospital period after DSWL was 5.7± 1.1 days, after lumboscopic operations 5.2 ± 0.8 days, and after open interventions it was 10.2±2.1 days. The minimum number of the nearest and distant complications was noted after the lumboscopic operations. About one third of the patients after DSWL needed relithotrisies. CONCLUSION. The lumboscopic interventions are an alternative to open surgery and are in a considerable competition with DSWL in cases of large concrements of the pelvis, upper and middle thirds of the ureters.