Puncture access with a new atraumatic needle MG for mini-percutaneous nephrolithotomy

Мұқаба

Дәйексөз келтіру

Толық мәтін

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Рұқсат жабық Тек жазылушылар үшін

Аннотация

Introduction. An important aspect of the prevention of complications in percutaneous nephrolithotomy (PCNL) is to reduce the likelihood of injury to the adjacent structures and perirenal tissues.

Aim. To determine the efficiency and safety of renal puncture during mini-PCNL with a new atraumatic needle MG.

Materials and methods. A total of 67 patients who underwent mini-percutaneous nephrolithotomy at the Institute of Urology and Human Reproductive Health of Sechenov University were included in the prospective study. For the purpose of homogeneity of the groups, those with staghorn nephrolithiasis, nephrostomy, a history of prior kidney surgery (including PCNL), renal and collecting system anomalies, acute pyelonephritis, and blood clotting disorders were not included. The main group consisted of 34 (50.7%) patients who underwent atraumatic kidney puncture with a new needle MG (MIT, Russia), while in the control group there were 33 (49.3%) patients, who underwent standard puncture with Chiba or Troakar needles (Coloplast A/S, Denmark). The outer diameter of all needles was 18 G.

Results. In patients with a standard access, a hemoglobin decrease in the early postoperative period was more pronounced (p=0.024). The incidence of complications according to the Clavien-Dindo classification did not differ significantly (p=0.351), however, a JJ stent was placed in two patients from the control group due to impaired urine flow and the development of urinoma.

Conclusion. Together with a similar stone-free rate, atraumatic needle allows to reduce a hemoglobin drop, as well as less development of severe complications.

Толық мәтін

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Авторлар туралы

N. Kalinin

Institute of Urology and Human Reproductive Health, FGAOU VO I.M. Sechenov First Moscow State Medical University

Хат алмасуға жауапты Автор.
Email: gazimiev@yandex.ru

Ph.D. student

Ресей, Moscow

S. Ali

Institute of Urology and Human Reproductive Health, FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: gazimiev@yandex.ru

Ph.D., urologist

Ресей, Moscow

A. Dymov

Institute of Urology and Human Reproductive Health, FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: gazimiev@yandex.ru

Ph.D., urologist

Ресей, Moscow

D. Chichenov

Institute of Urology and Human Reproductive Health, FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: gazimiev@yandex.ru

Ph.D., urologist

Ресей, Moscow

G. Akopyan

Institute of Urology and Human Reproductive Health, FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: gazimiev@yandex.ru

MD, Ph.D., professor

Ресей, Moscow

M. Gazimiev

Institute of Urology and Human Reproductive Health, FGAOU VO I.M. Sechenov First Moscow State Medical University; National Medical Research Center of Urology on Urology

Email: gazimiev@yandex.ru

Ph.D., MD, Professor, Deputy Director on Science of the Institute for Urology and Human Reproductive Health

Ресей, Moscow; Moscow

Әдебиет тізімі

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Әрекет
1. JATS XML
2. Fig. 1. (A) A new low-traumatic MG needle; (B) the distal end of the needle with a pointed cannula and an atraumatic mandrel-bulb extending beyond it; (C) Needle pavilion with spring mechanism. The red arrow shows the ultrasonic notch

Жүктеу (41KB)
3. Fig. 2. The scheme of operation of the low-traumatic MG needle. (A) The needle meets a dense structure; (B) the mandrin-bulb goes behind the sharp cannula; (C) the needle pierces the dense structure; (D) return of the mandrel to its original position; (E) Soft tissue augmentation

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