urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2022-10-4-179-200urovest-616Research ArticleКЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИCLINICAL GUIDELINESКлинические рекомендации международного альянса мочекаменной болезни по чрескожной нефролитотомииInternational alliance of Urolithiasis (IAU) guideline on percutaneous nephrolithotomyhttps://orcid.org/0000-0002-6387-8633ЦзэнГ.ZengG.

Цзэн Гохуа — доктор медицины, профессор, заведующий кафедрой урологии и Гуандунской лабораторией урологии, отделение урологии, Первая дочерняя больница Медицинского университета Гуанчжоу.

511436, провинция Гуандун, Гуанчжоу, р-н Панью, шоссе Кангда д.1

Guohua Zeng — M.D., Prof., Head, Dept. of Urology and Guangdong Key Laboratory of Urology, the First Affiliated Hospital of Guangzhou Medical University.

1 Kangda Rd., Panyu District, Guangzhou City, Guangdong Province, 511436

https://orcid.org/0000-0002-7568-3112ЧжунВ.ZhongW.

Чжун Вэнь — доктор медицины, врач-уролог, кафедра урологии, Гуандунская лаборатория урологии, Первая дочерняя больница Медицинского университета Гуанчжоу.

511436, провинция Гуандун, Гуанчжоу, р-н Панью, шоссе Кангда д.1

Wen Zhong — M.D., Urologist, Dept. of Urology, Guangdong Laboratory of Urology, the First Affiliated Hospital of Guangzhou Medical University.

1 Kangda Rd., Panyu District, Guangzhou City, Guangdong Province, 511436

https://orcid.org/0000-0002-7890-2018МаццонДж.MazzonG.

Маццон Джорджио— доктор медицины, врач-уролог, отделение урологии, Больница Сан-Бассиано.

36061, р-н Венето, Бассано-дель-Граппа, Венето, ул. дей Лотти д.40

Giorgio Mazzon — M.D., Urologist, Dept. of Urology, San Bassano Hospital.

40 dei Lotti St., Bassano del Grappa, Veneto, 36061

https://orcid.org/0000-0001-9289-415XЧунС.ChoongS.

Чун Саймон — хирург-уролог-консультант, руководитель, отделение по лечению почечных камней, Институт урологии, Больницы Университетского колледжа Лондона.

NW1 2BU, Лондон, шоссе Юстон д.235

Simon Choong — MBBS FRCS (Eng) FRCSEd MS FRCS (Urol), Сonsultant urological surgeon; Head, Kidney Stone Unit, Institute of Urology, University College London Hospital.

235 Euston Rd., University College Hospital, London, NW1 2BU

https://orcid.org/0000-0002-2929-508XПирлМ.PearleM.

Пирл Маргарет— доктор медицины, доктор философии, врач-уролог, отделение урологии, Юго-Западный медицинский центр Университета Техаса.

ТХ 75390, штат Техас, Даллас, б-р Гарии Хайнса 5323

Margaret Pearle — M.D., Ph.D., Urologist, Department of Urology, Southwestern Medical Center, University of Texas.

5323 Harry Hines Blvd., Dallas, Texas, ТХ 75390

https://orcid.org/0000-0002-6584-7865АгравалМ.AgrawalM.

Агравал Махду — мастер хирургии, заведующий отделением урологии и центром малоинвазивной эндоурологии, Больница Global Rainbow.

282002, штат Уттар-Прадеш, Агра, Гражданские линии, шоссе Бах Фарзана д.23

Mahdu Agrawal — MCh (Urol), Head, Dept. of Urology, Centre for Minimally Invasive Endourology, Global Rainbow Healthcare.

23 Bagh Farzana Rd, Civil Lines, Agra, Uttar Pradesh, 282002

https://orcid.org/0000-0002-8991-7709СкоффонеЧ. М.ScoffoneC. M.

Скоффоне Чезаре М.— доктор медицины, заведующий отделением урологии, Больница Коттоленго.

10152, Турин, ул. Коттоленго д.9

Cesare M. Scoffone — M.D., Urologist, Dept. of Urology, Cottolengo Hospital.

9 Cottolengo St., Torino, 10152

https://orcid.org/0000-0002-6345-1322ФиориК.FioriC.

Фиори Кристиан — доктор медицины, врач-уролог, отделение урологии, Больница Сан-Луиджи, Туринский университет.

10043, пров-я Турин, р-н Пьемонт, коммуна Орбассано, рег. Гонзоле д.10

Christian Fiori — M.D., Urologist, Dept. of Urology, San Luigi Gonzaga Hospital, University of Torino.

10 Reg. Gonzole, Torino, Piedmont, Orbassano, 10043

https://orcid.org/0000-0003-1632-4168ГекчеМ. И.GökceM. I.

Гекче Мехмет И.— доктор медицины, врач-уролог, отделение урологии, Медицинский факультет Университета Анкары.

060610, Анкара, Сельскохозяйственный р-н, б-р. мученика Омера Халисдемира д.1

Mehmet I. Gökce — M.D., Urologist, Dept. of Urology, Faculty of Medicine, Ankara University.

1 Martyr Omer Halisdemir Blvd., Ankara, Agricultural Dist., 060610

https://orcid.org/0000-0003-1632-4168ЛамУ.LamW.

Лам Уэйн — доктор медицины, клинический ассистент-профессор в урологии, отделение урологии, Больница Королевы Марии, Университет Гонконга.

3838, р-н Гонконг, Гонконг, шоссе Пок Фу Лам д.102

Wayne Lam — M.D., Clinical Assist.Prof in Urology, Dept. of Urology, Queen Mary Hospital.

102 Pok Fu Lam Rd., Hong Kong, Hong Kong Dist. 3838

https://orcid.org/0000-0003-4810-4485ПетковаК.PetkovaK.

Петкова Кремена— доктор медицины, отделение урологии и нефрологии, Военная медицинская академия г. София.

1606, София, ул.“Св. Георги Софийски” д.3

Kremena Petkova — M.D., Sofia Military Medical Academy, Dept. of Urology and Nephrology.

9 Saint Georgi Sofiyski St., Sofia, 1606

https://orcid.org/0000-0002-1905-0302СабункуК.SabuncuK.

Сабунку Кубилай — доктор медицины, врач-уролог, отделение урологии, Государственная больница Каракабей.

16700, Меджидие, Каракабей-Бурса,  ул. Бурса Канаккале Шифа д.2 

Kubilai Sabunku — M.D.; Urologist, Dept. of Urology, Karakabey State Hospital.

2 Çanakkale Yolu Şifa St., Karakabey-Bursa, Medjidie Mach., 16700

https://orcid.org/0000-0002-6255-0193ГаджиевН. К.GadzhievN. K.

Гаджиев Нариман Казиханович — доктор медицинских наук, заместитель директора по медицинской части (урология) Клиники высоких медицинских технологий им. Н.И. Пирогова СПбГУ.

199034, Санкт-Петербург, наб. реки Фонтанки, д.154

Nariman K. Gadzhiev — M.D., Dr.Sc.(Med.), Deputy CEO for Medical (Urology), St. Petersburg State University – Pirogov Clinic of Advanced Medical Technologies.

154 Fontanka River Emb., St. Petersburg, 199034

https://orcid.org/0000-0001-7631-3108ПьетропаолоA.PietropaoloA.

Пьетропаоло Амелия— младший специалист по урологической хирургии, отделение урологии, Университетская больница Саутгемптона, Саутгемптонский университет.

SO16 6YD, графство Хэмпшир, Саутгемптон, шоссе Тремона

Amelia Pietropaolo — Assoc.Specialist at the Urological Surgery, Dept. of Urology, University Hospital Southampton, University of Southampton.

Tremona Rd., Southampton, Hampshire, SO16 6YD

https://orcid.org/0000-0003-4488-0022ЭмилианиЭ.EmilianiE.

Эмилиани Эстебан — доктор медицины, доктор философии, врач-уролог, отделение урологии, Автономный университет Барселоны.

08193, автономный округ Барселона, Барселона, р-н Беллатерра, Гражданская площадь

Esteban Emiliani — M.D., Ph.D., FEBU, Urologist, Dept. of Urology, Autonomous University of Barcelona.

Plaça Nova, Bellaterra, Barcelona, 08193, Autonomous District of Barcelona

https://orcid.org/0000-0001-7277-3764СарикаК.SaricaK.

Сарика Кемаль— доктор медицины, доктор философии, профессор, отделение урологии, Медицинская школа Университета Бируни.

34010, Стамбул, р-н Зейтинбурну, Протокольная дорога №:45, ул. 10-го года

Kemal Sarika — M.D., Ph.D., Prof., Dept. of Urology, Medical School, Biruni University.

10th Year St., Protocol Rd No.45, Zeytinburnu Dist., Istanbul, 34010

saricakemal@gmail.comМедицинский университет Гуанчжоу — Гуандунская лаборатория урологии, Первая аффилированная больницаКитайThe First Affiliated Hospital of Guangzhou Medical University — Guangdong Laboratory of UrologyChinaБольница Сан-БассианоИталияSan Bassiano HospitalItalyБольница Лондонского университетского колледжа — Институт урологииВеликобританияUniversity College London Hospital — Institute of UrologyUnited KingdomУниверситет Техаса — Юго-Западный медицинский центрСоединённые Штаты АмерикиUniversity of Texas — Southwestern Medical CenterUnited StatesБольница Global Rainbow — Центр минимально инвазивной эндоурологииИндияGlobal Rainbow Healthcare — Centre for Minimally Invasive EndourologyIndiaБольница КоттоленгоИталияCottolengo HospitalItalyТуринский университет — Больница Сан-Луиджи ГонзагаИталияUniversity of Torino — San Luigi Gonzaga HospitalItalyМедицинский факультет Университета Анкары — Учебно-исследовательская больница Дишкапи Йылдырым БеязитТурцияAnkara University, Faculty of Medicine — Turkey Diskapi Yildirim Beyazit Educational and Research HospitalTurkeyУниверситет Гонконга — Больница Королевы МарииКитайUniversity of Hong Kong — Queen Mary’s HospitalChinaВоенная медицинская академия г. СофияБолгарияSofia Military Medical AcademyBulgariaГосударственная больница КаракабейТурцияKarakabey State Hospital MinistryTurkeyСанкт-Петербургский государственный университет — Клиника высоких медицинских технологий им. Н.И. ПироговаРоссияSt. Petersburg State University – Pirogov Clinic of Advanced Medical TechnologiesRussian FederationСаутгемптонский университет — Университетская больница СаутгемптонВеликобританияUniversity of Southampton — University Hospital SouthamptonUnited KingdomАвтономный университет БарселоныИспанияAutonomous University of BarcelonaSpainУниверситет Бируни — Медицинская школаТурцияBiruni University, Medical SchoolTurkey202226122022104179200Copyright © Цзэн Г., Чжун В., Маццон Д., Чун С., Пирл М., Агравал М., Скоффоне Ч.М., Фиори К., Гекче М.И., Лам У., Петкова К., Сабунку К., Гаджиев Н.К., Пьетропаоло A., Эмилиани Э., Сарика К., 20232023Цзэн Г., Чжун В., Маццон Д., Чун С., Пирл М., Агравал М., Скоффоне Ч.М., Фиори К., Гекче М.И., Лам У., Петкова К., Сабунку К., Гаджиев Н.К., Пьетропаоло A., Эмилиани Э., Сарика К.Zeng G., Zhong W., Mazzon G., Choong S., Pearle M., Agrawal M., Scoffone C.M., Fiori C., Gökce M.I., Lam W., Petkova K., Sabuncu K., Gadzhiev N.K., Pietropaolo A., Emiliani E., Sarica K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.urovest.ru/jour/article/view/616

Международный альянс мочекаменной болезни (The International Alliance of Urolithiasis (IAU)) хотел бы опубликовать последнее руководство по чрескожной нефролитотомии (ЧНЛ) и предоставить клиническую основу для хирургов, выполняющих ЧНЛ. Эти рекомендации были собраны и оценены на основе систематического обзора и оценки литературы, охватывающей все аспекты ЧНЛ, из базы данных PubMed в период с 1 января 1976 года по 31 июля 2021 года. Каждая сгенерированная рекомендация была оценена с применением модифицированной методологии GRADE. Качество доказательств оценивалось с использованием системы классификации, модифицированной Оксфордским центром доказательной медицины (Levels of Evidence). Сорок семь рекомендаций были обобщены и классифицированы. Рекомендации охватывали следующие вопросы: показания и противопоказания к ЧНЛ, оценку сложности камней и их предоперационную визуализацию, стратегию назначения антибиотиков, ведение антитромботической терапии, анестезию, положение пациента во время ЧНЛ, пункцию, бужирование, литотрипсию, интраоперационную оценку остаточных камней, стратегию по завершению операции, послеоперационную визуализацию и оценку наличия резидуальных камней, осложнения ЧНЛ. Настоящее руководство по ЧНЛ было первым в серии руководств IAU по ведению мочекаменной болезни. Рекомендации и советы по процедурам ЧНЛ послужат адекватным руководством для урологов, выполняющих ЧНЛ, а также для обеспечения безопасности и эффективности ЧНЛ.

The International Alliance of Urolithiasis (IAU) would like to release the latest guideline on percutaneous nephrolithotomy (PCNL) and to provide a clinical framework for surgeons performing PCNL. These recommendations were collected and appraised from a systematic review and assessment of the literature covering all aspects of PCNLs from the PubMed database between January 1, 1976, and July 31, 2021. Each generated recommendation was graded using a modified GRADE methodology. The quality of the evidence was graded using a classification system modified from the Oxford Center for Evidence-Based Medicine Levels of Evidence. Forty-seven recommendations were summarized and graded, which covered the following issues, indications and contraindications, stone complexity evaluation, preoperative imaging, antibiotic strategy, management of antithrombotic therapy, anesthesia, position, puncture, tracts, dilation, lithotripsy, intraoperative evaluation of residual stones, exit strategy, postoperative imaging and stone-free status evaluation, complications. The present guideline on PCNL was the first in the IAU series of urolithiasis management guidelines. The recommendations, tips and tricks across the PCNL procedures would provide adequate guidance for urologists performing PCNLs to ensure safety and efficiency in PCNLs.

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The authors declare that there are no conflicts of interest present.