DETERMINATION OF CRITERIA FOR STENT PLACEMENT IN THE ENDOSCOPIC TREATMENT OF COMPLICATED UROLITHIASIS

Objective – to evaluate the value of intraoperative intraluminal manometry for determining the timing of stenting after endoscopic treatment of patients with complicated ureterolithiasis.Materials and Methods. In 87 patients of the group under study, intraluminal pressure inside the ureter was measured during endoscopic surgery for complicated ureterolithiasis. Based on the obtained intraluminal pressure measurement data, the intraluminal pressure coeffi cient (IPC) was calculated, which in its turn made it possible to predict the need for longer stenting. Depending on the coeffi cient, patients were divided into 2 subgroups, which determined the duration of stenting in the postoperative period.Results. The value of CIT in group 1 ranged from 0.50 to 0.74 units, reaching an average of 0.61 ± 0.04 units, and in group 2 from 0.33 to 0.45 units, with an average of 0.39 ± 0.02 units (diff erences are signifi cant, p<0.05). With the value of the CIT above and below the zone of stone fi xation in the ureter from 0.50 to 0.74 units, the duration of stenting after surgery was 10-14 days. When the value of this ratio was from 0.33 to 0.45 units, the duration of stenting was increased to 3-4 weeks. The use of the modifi ed tactics allowed to reduce the incidence of postoperative complications from 35.22 ± 3.26 % (31 complications in the comparison group of 88 patients) to 4.60 ± 0.97 % (4 complications in a group of 87 patients).Conclusions. A diff erentiated approach to the timing of stenting after endoscopic surgery in patients with complicated ureterolithiasis based on the defi nition of CIT reduces the incidence of postoperative complications by 7 times and reduces the duration of disability by 1.5 times.