Assessment Of The Risk And Frequency Of Intra- And Postoperative Complications In Endoscopic Combined Intrarenal Surgery Of Coralloid Nephrolithiasis.

Abstract

The aim of the study was to determine the frequency and nature of intra— and postoperative complications in endoscopic combined intrarenal surgery (ECIRS) in patients with coralloid nephrolithiasis, as well as to evaluate the effectiveness of the method. A retrospective study included 63 patients with coralloid kidney stones who had undergone ECIRS. Demographic and clinical data, intervention parameters, the frequency of complications classified according to the Clavien–Dindo scale, and the stone-free rate (SFR) according to CT data 4-6 weeks after surgery were analyzed. The average duration of the operation was 124 ± 27 minutes. In 81% of cases, one percutaneous approach was used, tubeless technique was used in 27% of patients. Intraoperative complications were recorded in 11.1% of patients, postoperative — in 25.4%, of which 1.6% were grade IIIb complications. The frequency of complete stone removal was 74.6%, and 14.3% had residual fragments of less than 4 mm. Repeated interventions were required in 9.5% of cases. No deaths or complications of IV–V degree were registered. ECIRS demonstrates high clinical efficacy and an acceptable safety profile in the treatment of coral nephrolithiasis. The method allows to achieve a high level of stone-free with a minimum number of accesses and a low incidence of severe complications. A promising direction is the further standardization of indications and the conduct of prospective comparative studies.