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The value of tomographic densitometry în the treatment of renoureteral lithiasis using extracorporeal shock wave lithotripsy


Author: Bradu Andrei
Degree:doctor of medicine
Speciality: 14.00.40 - Urology
Year:2020
Scientific adviser: Emil Ceban
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 1 July, 2020 at the meeting of the Scientific Council and now it is under consideration of the National Council.

Abstract

Adobe PDF document0.99 Mb / in romanian
Adobe PDF document0.97 Mb / in english

Thesis

CZU [616.613+616.617]-003.7-089.879-073.756.8(042.3)

Adobe PDF document 5.40 Mb / in romanian
125 pages


Keywords

extracorporeal shock wave lithotripsy, stone densitometry, renoureteral lithiasis, Hounsfield Units

Summary

Structure of the thesis. The study is presented on 125 pages and contains: annotation in Romanian, Russian and English, introduction, four chapters, general conclusions and practical recommendations, bibliography with 227 sources, 16 figures, 23 tables, 9 apendicies. The obtained results are published in 24 scientific papers, including 3 without co-authors and 2 in well-known database (SCOPUS, Index Copernicus, ProQvest, EBSCO).

The aim of the study and objectives. The required number of sessions applied during extracorporeal shock waves lithotripsy for the treatment of renoureteral stones was dependent on the density of stones estimated in Hounsfield units, by performing the computed tomography (CT) at the time of the examination of the patient.

Scientific novelty and originality. It has been shown that the assessment of the stone density by computed tomography in Hounsfield units is a determinant of the number of sessions needed for the disintegration of the renoureteral stones by extracorporeal shock wave lithotripsy.

Problem solved scientifically: the evaluation of TC densitometry in the assessment of the results and the success of the treatment using extracorporeal lithotripsy with shock waves has not been studied so far.

Theoretical significance of the study. This research demonstrated the importance of estimating the density of the calculation in order to make the precise indications for the treatment of renoureteral lithiasis using extracorporeal lithotripsy with shock waves, and selecting the adequate method. The effectiveness of treatment with extracorporeal lithotripsy with shock waves was argued based on the study of the density of stones. The author developed the criteria for tomographic evaluation of the calculus density in patients with renoureteral lithiasis that allow to reduce the number of unnecessary useless extracorporeal lithotripsy sessions with shock waves, to structure clearly the indications, reduce the duration of exposure of patients and doctors to radiological rays, prevent complications leading to a decrease in renal functions and have significant economic effects.

The application value of the thesis. The research allowed the development of an algorithm for the treatment of renoureteral lithiasis using extracorporeal shock lithotripsy, based on the computer tomography calculus density evaluation.

The implementation of the scientific results: The results of the study were implemented into the didactic process of the Department of Urology and Surgical Nephrology în the training of students, residents and doctors.