[Errors, hazards and complications in percutaneous nephroureterolithotomy and their prevention].
For patients who are suffering from urolithiasis percutaneous surgery remains actual even now then the method of remote intracorporeal lithotripsy is widely used, which arises the necessity of discussing typical errors, hazards and complications of percutaneous nephroureterolithotomy and the means of their prevention and eradication. Based on the experience with 137 percutaneous invasions in 125 patients (56 males and 69 females) aged from 10 to 79 yrs who suffered from various nephroureterolithiases the authors defined the improper formation of an antegrade access to the concrement as a general and most frequent cause of failure and complications occurred in percutaneous treatment. In their number parenchyma-avoiding fistulization of the kidney through the renal pelvis, erroneous choice of a calix to be punctured which resulted in the acute angle position of the canal axis to the calculus thus making its removal impossible or inconvenient; supermedial access to the kidney and transparent puncturing of the calices increasing surgery-related traumatism and the risk for hemorrhages. The prevention of these complications should include a careful preoperational examination of patients with multipositional urotelescopy (graphy), the formation of a transcaliceal access for the removal of the concrement through the distal part of the renal parenchyma, atraumatic performance of all the stages of the surgery performed under the roentgenoscopic monitoring in several projection, etc. The most dangerous complications of percutaneous nephroureterolithotomy are vascular ones presented as intra- or postsurgical hemorrhages. Timely balloon, bougie or tubal tamponades of the fistula (the size of the tools should be the same or more than the diameter of the fistula) is simple and quite efficient to avoid these complications.(ABSTRACT TRUNCATED AT 250 WORDS)
Zenkov
S S
SS
Martov
A G
AG
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology* / Q000517:prevention & control; D007669:Kidney Calculi / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D014514:Ureteral Calculi / Q000150:complications / Q000601:surgery; D014519:Ureterostomy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods
Oshibki, opasnosti, oslozhneniia perkutannoĭ nefroureterolitotomii i ikh profilaktika.