Фатихов Р.Р.

Introduction. Percutaneous nephrolithotomy is considered as the gold standard in the treatment of patients with full staghorn kidney stones. Its effectiveness varies from 55% to 98%, which depends on many factors, and in particular, on the accessibility to the stones.

The aim of the study was to analyze out own experience of performing PCNL in patients with staghorn kidney stones (stages K3-K4).

In this article we present our experience and analysis of periand postoperative complications after percutaneous nephrolithtomy (PCNL) in patients with large and staghorn kidney stones. In period from 2009 up to 2013 we have performed 1649 PCNLs with a growth tendency of 36% pro year.

Percutaneous nephrolithotripsy (PCNL) became a standard for the large and staghorn stones of the kidney, forcing out the open surgery. Today the standard PCNL is being compared in terms of efficacy to the technique using the instrument with smaller diameter. The desire to use the smallest possible access stems from the necessity to reduce the intra- and postoperative complications.

According to the recommendations of the European and American urological associations percutaneous nephrolithotripsy (PCNL) stands ahead of the other operative modalities in treatment of the patients with large and staghorn stones with the efficacy of approximately 80%. Aim of the current investigation was to estimate the influence of the body mass index (BMI) on the efficacy of the PCNL and on the frequency of the complications during the retrospective analysis of our surgical data.

Current trend in the treatment of patients with nephrolithiasis is decreasing of the invasiveness of the surgery. Recent technical innovations for effective stone disintegration, permanent kidney access, good visualization of endoscopy and decrease in the instruments size raised the urological interest in efficacy and improvements in the area of retrograde intrarenal surgery (RIRS) for large and staghorn urinary stones. It is typical for RIRS to have high efficacy (50-94.6%) and low rate of perioperative complications.

The purpose of the study – a synthesis and analysis of experience with transurethral endoscopic techniques in patients with large renal stones and staghorn nephrolithiasis.