INDIVIDUALIZED APPROACH TO UPPER URINARY TRACT DRAINAGE AFTER RETROPERITONEOSCOPIC URETEROLITHOTOMY

Abstract

Aim. To clarify the indications for the use of ureteral stents during retroperitoneoscopic ureterolithotomy (RULT). Materials and methods. We analyzed the results of treatment of 53 patients who underwent RULT for ureteral stone. In 18 (34%) patients, a stent was not placed after the operation (group 1), and in 35 (66.0%) patients, a stent was placed (group 2). Indications for stent placement were determined during surgery. Results. When performing RULT for the treatment of patients with ureteral stones, postoperative complications were not severe, resolved on their own or required a slight increase in therapy in the postoperative period. These complications did not significantly affect the duration of treatment or its results. There were no significant differences in the main clinical and laboratory parameters in both groups 2 weeks after surgery. The incidence of complications was low and did not differ significantly in both groups. Conclusions. No significant differences were found in terms of the immediate results of treatment of patients with ureterolithiasis after RULT, depending on whether a stent was used to drain the ureteral lumen in the patient or not, when a stent was used according to indications. Complications after RULT are infrequent, transient, and require only minimal therapeutic correction. Stenting of the ureter is expected to lead to a significant increase in the duration of surgery. Drainage of the ureter by placing a stent is an absolutely justified procedure in the presence of severe changes in the ureteral wall, manifested by edema of all layers, the presence of mucosal ulcers, as well as perifocal inflammation in the surrounding tissues surrounding the ureter. On the other hand, stenting of the ureter after RPU is not a routine procedure, and in the absence of the above changes, it can be abandoned without any complications.