Chaplіa M. Prediction features and algorithm for the treatment of percutaneous nephrolithotomy complications in patients with nephrolithiasis

The thesis is devoted to the aspects of prediction and determination of treatment optimal tactics of percutaneous nephrolithotomy complications of patients with nephrolithiasis. In this work we analysis 507 cases percutaneous nephrolithotomy complications after 2223 surgical interventions. All patients were treated with percutaneous nephrolithotomy (PCNL) in the position on the abdomen.On the basis of analysed results of treatment patients, complications after percutaneous nephrolithotomy in patients with nephrolithiasis were observed in 22.81% of cases. The types of possible complications and the frequency of their occurrence were determined. Infection-inflammatory complications, which make up 8,14% of cases, are most commonly observed. The most dangerous complications of percutaneous nephrolithotomy are renal bleeding, which is observed in 2.83% and iatrogenic traumas of adjacent organs - 0.31%. Using the Guy's Stone Score (GSS) and Charlson Comorbidity Index Scale, the Charlson Comorbidity Index (CCI) allows you to predict the risk of possible complications of percutaneous nephrolithotomy. Correspondingly, in patients with GSS-3 and GSS-4 stones, the total score of CCI =3 can be considered as a negative prognostic factor in the development of complications.The mortality after percutaneous nephrolithotomy is 0.13%, which is modly largely due to the concomitant deseases of the patient, and this led to a fatal outcome on the background of surgical intervention.Using the results of this study, an optimal algorithm for the treatment of percutaneous nephrolithotomy complications has been developed.