ОPTIMIZATION OF MULTIPLE TRANSCUTANEOUS ACCESS WHILE PERFORMING INTERVENTION FOR A CORAL-LIKE NEPHROLITHIASIS, USING ULTRA-МІNІ TRANSCUTANEOUS NEPHROLITHOTRIPSY
Comparative analysis of efficacy of two variants of transcutaneous nephrolithotripsy (TCNLT) in 26 patients, suffering a coral-like nephrolithiasis, is adduced. In 11 patients (group І) TCNLT was conducted, using one standard tubus 24 Сh and several ultra-mini accesses, applying tubuses 11 Сh. Мultiple ultra-mini transcutaneous (UMTC) accesses were used for lithotripsy and relocation of the calculus fragments into the line of sight of standard access. In 15 patients (group ІІ) TCNLT was conducted, using tubus 24Сh. A «stone-free» state in group І was achieved in 90.9% patients, and in group ІІ - in 86.6%. Combined application of one standard and multiple UMTC accesses is effective, it permits to reduce the intervention traumaticity and rate of hemorrhagic complications, to avoid nephrostomic drainage of microtranscutaneous accesses, to reduce severity of postoperative pain syndrome, especially while applying intercostal access.