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Differential treatment of kidney stones


Author: Botnari Vasile
Degree:doctor of medicine
Speciality: 14.00.40 - Urology
Year:2016
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 19 October, 2016
Approved by NCAA on the 28 December, 2016

Abstract

Adobe PDF document – 0.83 Mb / in romanian

Thesis

CZU 616.613-003.7-07-089

Adobe PDF document 3.08 Mb / in romanian
160 pages

Keywords

kidney stones, renal pelvic stones, percutaneous nephrolithotomy, extracorporeal shock wave lithotripsy, pielolithotomy, complications.

Summary

Structure of the thesis: The study is exposed on 132 pages and includes: introduction, 4 chapters, conclusions, recommendations, summary in Romanian, Russian, English, 185 references, 34 figures, 6 tables, 6 formulas and 3 appendices. There were published 17 scientific works, including 2 works without co-authors in 4 reviewed editions.

The aim of the study and objectives: Urolithiasis continues to occupy one of the leading places in the structure of urological disease, having globally frequency of 5-15% in the population from industrialized countries and represents one of the most common causes of hospitalization. The purpose of this study is to improve the treatment results at the patients with pelvic stones using extracorporeal shock wave lithotripsy (ESWL), percutaneous surgery (PCNL) and open surgery (pielolithotomy). The objectives of exploration included a complex methods of study and efficacy of treatment for the patients with renal pelvic stones using extracorporeal shock wave lithotripsy (ESWL), percutaneous surgery (PCNL) and open surgery (pielolithotomy), depending of the composition, location, size, chemical structure of the kidney stones, the duration of stone presence and complications, determining optimal term of recovery of kidney according to the applied method, study the postoperative complications, determining the tactics of before, in and after surgery management of patients with indications for percutaneous surgery, examination of indications of differential treatment and developing therapeutic algorithm for the patients with pelvic stones.

Scientific novelty and originality. This paper is the first comparative study of the results obtained in the treatment of kidney stones using ESWL, PCNL and pielolithotomy, determined the tactics of treatment of pelvic stones according to the chemical structure, localization, persistence, size and complications. Based on the outcomes were developed indications and the algorithm of management using open surgical treatment, percutaneous and extracorporeal treatment of kidney stones. It was studied the incidence and the type of intraoperative complications depending on the applied method.

Solved scientifically problem: to improve the results of differential treatment at the patients with kidney stones using the comparative study of efficacy with ESWL, PCNL and pielolithotomy.

Theoretical significance of study is manifested by improving the methodology of complex examination of patients with kidney stones, developing the indications of extracorporeal treatment, percutaneous and open surgery depending on the size, location, chemical structure, persistence time of stone, complications occurred; assessing kidney function and determining the terms of restoration depending on the treatment method applied.

The value of the workis significant in that in base on the results of study was developed the algorithm of diagnostic and surgical treatment of kidney stones using the percutaneous nephrolithotomy, extracorporeal shock wave lithotripsy, pielolithotomy.

Implementation of scientific results. The main results of the study are applied in the teaching process at the Department of Urology and Surgical Nephrology of State Medical University and Pharmacy "Nicolae Testemitanu" and in clinical activity at Department of Urology, Republican Clinical Hospital from Republic of Moldova.