urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2023-11-2-18-27urovest-716Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESСравнительный анализ одно- и двусторонней гибкой уретерореноскопии: когортное многоцентровое исследованиеComparative analysis of unilateral and bilateral flexible ureterorenoscopy: a cohort multicentre studyhttps://orcid.org/0000-0002-6255-0193ГаджиевН. К.GadzhievN. K.

Нариман Казиханович Гаджиев — доктор медицинских наук; заместитель директора по организации медицинской помощи.

Санкт-Петербург

Nariman K. Gadzhiev — M.D., Dr.Sc.(Med); Deputy CEO for Medical Care Organization.

St. Petersburg

nariman.gadjiev@gmail.comhttps://orcid.org/0000-0001-5804-2033ПетровА. Д.PetrovA. D.

Александр Денисович Петров — врач-уролог.

Санкт-Петербург

Alexander D. Petrov — M.D.; Urologist.

St. Petersburg

adpetrov94@gmail.comhttps://orcid.org/0000-0002-8514-5510ГоргогоцкийИ. А.GorgotskyI. A.

Иван Александрович Горгоцкий — кандидат медицинских наук; врач-уролог.

Санкт-Петербург

Ivan A. Gorgotsky — M.D., Cand.Sc.(Med); Urologist.

St. Petersburg

igorgotsky@gmail.comhttps://orcid.org/0000-0001-9813-7483ЛабетовИ. А.LabetovI. A.

Иван Антонович Лабетов — врач-уролог.

Санкт-Петербург

Ivan. A. Labetov — M.D.; Urologist.

St. Petersburg

ivanlabetov@gmail.comhttps://orcid.org/0000-0002-2993-884XМалхасянВ. А.MalkhasyanV. A.

Виген Андреевич Малхасян — доктор медицинских наук; профессор кафедры урологии.

Москва

Vigen A. Malkhasyan — M.D., Dr.Sc.(Med); Prof., Dept. of Urology.

Moscow

vigenmalkhasyan@gmail.comhttps://orcid.org/0000-0003-3285-5559ВоробьевВ. А.VorobyovV. A.

Владимир Анатольевич Воробьев — кандидат медицинских наук; врач-уролог кафедры общей хирургии.

Иркутск

Vladimir A. Vorobyev — M.D., Cand.Sc.(Med); Urologist, Dept. of General Surgery.

Irkutsk

denecer@yandex.ruhttps://orcid.org/0000-0003-0489-3451ШкарупаД. Д.ShkarupaD. D.

Дмитрий Дмитриевич Шкарупа — доктор медицинских наук; директор.

Санкт-Петербург

Dmitry D. Shkarupa — M.D., Dr.Sc.(Med); Director.

St. Petersburg

shkarupa.dmitry@mail.ruКлиника высоких медицинских технологий им. Н.И. Пирогова — Санкт-Петербургский государственный университетРоссияSt. Petersburg State University — Pirogov Clinic of Advanced Medical TechnologiesRussian FederationМосковский государственный медико-стоматологический университет им. А.И. ЕвдокимоваРоссияYevdokimov Moscow State University of Medicine and DentistryRussian FederationИркутский государственный медицинский университетРоссияIrkutsk State Medical UniversityRussian Federation2023180720231121827Copyright © Гаджиев Н.К., Петров А.Д., Горгогоцкий И.А., Лабетов И.А., Малхасян В.А., Воробьев В.А., Шкарупа Д.Д., 20232023Гаджиев Н.К., Петров А.Д., Горгогоцкий И.А., Лабетов И.А., Малхасян В.А., Воробьев В.А., Шкарупа Д.Д.Gadzhiev N.K., Petrov A.D., Gorgotsky I.A., Labetov I.A., Malkhasyan V.A., Vorobyov V.A., Shkarupa D.D.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/716Введение

Введение. Гибкая уретерореноскопия (УРС) с лазерной литотрипсией является «золотым стандартом» малоинвазивного лечения пациентов с камнями почек размером до 20 мм. В настоящее время недостаточно объективных данных о безопасности и эффективности билатеральных вмешательств.

Цель исследования

Цель исследования. Изучить эффективность и безопасность одномоментной последовательной двусторонней гибкой УРС (Д-УРС) в сравнении с односторонней гибкой УРС (О-УРС).

Материалы и методы

Материалы и методы. В исследование включены результаты лечения 80 пациентов, которым выполнены гибкие УРС В период с июля 2022 года по декабрь 2022 года. Пациенты распределены на 2 группы: группа 1 (n = 40) выполнена О-УРС, группа 2 (n = 40) — Д-УРС. Показанием для операции было наличие единичного камня размерами до 20 мм или множественных чашечковых камней малых размеров. Исходные показатели в группах сопоставимы, однако в группе Д-УРС на 39,0% чаще (p > 0,002) встречались множественные камни, и на 28,0% чаще (p > 0.001) камни находились в нижних группах чашечек. Ранее перенесённые вмешательства также чаще наблюдались у пациентов Д-УРС группы.

Результаты

Результаты. Частоты полного освобождения от камней не различалась (р > 0,9) между группами и составила 95,0% и 97,5%, соответственно. Серьёзных осложнений уровня Clavien III – V не было отмечено (р > 0,9) ни у одного из пациентов в обеих группах.

Заключение

Заключение. Двусторонняя гибкая уретерореноскопия является безопасным и эффективным методом лечения пациентов с двусторонними камнями почек, позволяющим удалить камни за одну анестезию с обеих сторон.

Introduction

Introduction. Flexible ureteroscopy (fURS) with laser lithotripsy is the «gold standard» for minimally invasive treatment in patients with kidney stones less than 20 mm. Currently, there are no objective data on the efficacy and safety of bilateral interventions.

Objective

Objective. To study the results of bilateral flexible URS (B-fURS) versus unilateral flexible URS (U-fURS).

Materials & methods

Materials & methods. Eighty patients prospectively enrolled in the study from July 2022 to December 2022 and was divided into 2 groups. Group 1 (n = 40) underwent U-fURS and Group 2 (n = 40) underwent B-fURS. A single stone up to 20 mm or multiple small calyx stones was an indication for the operation. The baseline values were comparable between the groups, but in the B-fURS group a 39.0% higher incidence (p > 0.002) of multiple stones and a 28.0% higher incidence (p > 0.001) of stones in the lower pole. Previous interventions were also more frequent in Group 1 (B-fURS) patients.

Results

Results. Stone-free rate did not differ (p > 0.9) between the groups and was 95.0% and 97.5%, respectively. No serious complications (p > 0.9) of Clavien III–V were observed in both groups.

Conclusion

Conclusion. Bilateral flexible ureteroscopy is a safe and effective option for patients with bilateral kidney stones, allowing removal of stones in one anesthesia on both sides.

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