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X-ray-free ureterolithotripsy for ureteral stones DOI: 10.29188/2222-8543-2022-15-4-32-36
- Guliev B.G. – Dr. Sc., professor of urology department of North-Western State Medical University, Head of urology center with robot-assisted surgery of Mariinsky hospital; Saint-Petersburg, Russia; https://orcid.org/0000-0002-2359-6973
- Talyshinskii A.E. – postgraduent student of Department of Urology, North-Western State Medical University named after I.I. Mechnikov; Saint-Petersburg, Russia; https://orcid.org/0000-0002-3521-8937
- Komyakov B.K. – Dr. Sc., professor, Chief of urology department of North-Western State Medical University; Saint-Petersburg, Russia; https://orcid.org/0000-0002-8606-9791
- Povago I.A. – postgraduent student of Department of Urology, North-Western State Medical University named after I.I. Mechnikov; Saint-Petersburg, Russia; https://orcid.org/0000-0002-3145-0245
- Allakhverdiev O.N. – student, North-Western State Medical University named after I.I. Mechnikov; Saint-Petersburg, Russia; https://orcid.org/0000-0001-5897-0729
523 Introduction. The main treatment option for symptomatic ureteral stones is contact ureterolithotripsy (CULT), which is usually performed under Xray guidance. However, the risks of complications associated with radiation do not always justify the benefits obtained from its use, which justifies the study of the results of performing Х-ray-free ureterolithotripsy.
Purpose. Evaluation of the efficacy and safety of non-fluoroscopic ureteroscopy in the treatment of symptomatic ureteral stones.
Materials and methods. Data from 240 patients with ureterolithiasis who underwent CULT were retrospectively recruited. Clinical and demographic data of patients, stone parameters and intraoperative parameters were evaluated. A multivariate analysis of the above factors was carried out to determine their diagnostic value for predicting the results of CULT. Data collection and analysis was carried out using MS Excel and SPSS Statistics 22.0 tables, respectively.
Results. The average stone size and density were 6,7±2,4 mm and 785,8±293,0 HU, respectively. The lasting of the surgery and the stone free rate were 39,5±14,6 min and 84,6%, respectively. Complications, in particular ureteral perforation, occurred in 17,0% and 6,7% of cases. According to the results of multivariate analysis, the following parameters influence the effectiveness of contact ureterolythotripsy (CULT) in symptomatic calculi: density, size and localization of the calculus, as well as the presence of ureteral stent (p <0.05). The preoperative indicators presented below significantly determined the frequency of complications: the density and localization of calculus, the presence of a ureteral stent, and the lasting of the surgery (p <0.05).
Comparative analysis of CULT with and without fluoroscopy revealed identical results and the complications number. The repeated interventions were more frequent in patients without X-ray, but there were no a statistically significant differences between groups. Our data indicate that CULT without X-ray not compromising the effectiveness of the surgery.
Conclusion. X-ray-free CULT for symptomatic ureteral stones eliminates possible complications from radiation without compromising the success of the operation itself
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