Stetsyshyn R. Explanation of therapeutic tactics choice during complex calculi of ureter with use of minimally invasive methods.

The thesis deals with improvement of results of patients' treatment who suffer from "complex" calculi of the ureter based on correlation analysis of possible complications and failures of contact urological lithotripsy, clinical and experimental explanation of different methods of surgery of ureterolithiasis. The frequency and spectrum of intra-and postoperative complications of contact ureterolithotripsy was presented on large clinical material. It has been proved that complications of different level of severity occur during disintegration of "complex" calculi of ureter using ultrasound lithotripsy. Based on results of comparative analysis of different types of lithotripsy which included average duration of intervention, duration of postoperative treatment, infusive and antibacterial therapy advantages of ureterolithotripsy were proved. Based on bivariate analysis prognostic meanings of factors were presented and they affect the frequency of complications of contact ureterolithotripsy. It allowed realizing the term "complex" calculus as derivative localization, sizes, density of concrement Results of experimental investigations with ureter obstruction and further morphological and immunohistochemical study of its wall which determine high possibility of complications development during contact lithotripsy in patients with long-lasting obstruction and define ways and duration of drainage of upper urinary tracks after endoscopic intervention. It was determined retroperitoneoscopic ureterolithotomy in treatment of "complex" calculi of ureter on modern stage of urology.