D. M. Ivashchenko, M. O. Dudchenko, M. I. Kravtsiv, M. P. Shevchuk, H. O. Ivanova

RETROGRADE INTRARENAL SURGERY AS A METHOD OF IMPROVING THE ENDOSCOPIC MANAGEMENT OF OCCLUSIVE CONCREMENTS OF THE UPPER PARTS OF THE URETER

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About the author:	D. M. Ivashchenko, M. O. Dudchenko, M. I. Kravtsiv, M. P. Shevchuk, H. O. Ivanova
Heading	CLINICAL MEDICINE
Type of article	Scentific article
Annotation	The paper presents upper ureter stone treatment with use of retrograde intrarenal surgery. This is the latest method, which has advantages in treatment of complex cases of nephrolithiasis, stone translocations and residual cases. We analyzed treatment of patients with ureteral stones. Two representative groups were formed and underwent surgical interventions. Patients of first group underwent contact lithotripsy with semi-rigid ureteroscope, in patients of group 2 used flexible ureteroscope. We compare total operation time, average size and density of stones, presence of residual fragments, surgical and postoperative complications. Performing lithotripsy using a retrograde intrarenal surgery provides higher frequency of achieving “stone-free state”, which is the ultimate goal of intervention. Also, this is a method that has fewer intraoperative complications, but has a slightly longer duration of surgical intervention. The use of combination of retrograde intrarenal surgery and semi-flexible ureteroscopy should facilitate operations, speed up patient recovery and minimize complications.
Tags	ureteral stones,retrograde intrarenal surgery,lithotripsy,flexible ureteroscopy
Bibliography	Aghamir SMK. Successful retrograde intrarenal surgery (RIRS) for a 2-centimeter stone in a chronic renal failure (CRF) patient. Int J Surg Case Rep. 2021 Oct; 87:106375. doi: 10.1016/j.ijscr.2021.106375 Alkan E, Arpali E, Ozkanli AO, Basar MM, Acar O, Balbay MD. RIRS is equally efficient in patients with different BMI scores. Urolithiasis. 2015 Jun;43(3):243–8. doi: 10.1007/s00240-015-0750-z. Berardinelli F, De Francesco P, Marchioni M, Cera N, Proietti S, Hennessey D, et.al. RIRS in the elderly: Is it feasible and safe? Int J Surg. 2017 Jun; 42:147–151. doi: 10.1016/j.ijsu.2017.04.062 Boulalas I, De Dominicis M, Defidio L. Semirigid ureteroscopy prior retrograde intrarenal surgery (RIRS) helps to select the right ureteral access sheath. Arch Ital Urol Androl. 2018 Mar 31;90(1):20–24. doi: 10.4081/aiua.2018.1.20. Chai CA, Teoh YC, Tailly T, Emiliani E, Inoue T, Tanidir Y, Gadzhiev N, Bin Hamri S, Ong WL, Shrestha A, Ragoori D, Lakmichi MA, Gorelov D, Soebhali B, Vaddi CM, Bhatia TP, Desai D, Durai P, Heng CT, Chew B, Castellani D, Somani B, Traxer O, Gauhar V. Influence of pre-stenting on RIRS outcomes. Inferences from patients of the Global Multicentre Flexible Ureteroscopy Outcome Registry (FLEXOR). Minerva Urol Nephrol. 2023 Aug;75(4):493–500. doi: 10.23736/S2724-6051.23.05239-4. Corrales M, Sierra A, Doizi S, Traxer O. Risk of Sepsis in Retrograde Intrarenal Surgery: A Systematic Review of the Literature. Eur Urol Open Sci. 2022 Aug 30; 44:84-91. doi: 10.1016/j.euros.2022.08.008. Hein S, Wilhelm K, Miernik A, Schoenthaler M, Suarez-Ibarrola R, Gratzke C, Salem J, Karapanos L, Netsch C, Becker B, Secker A, Veser J, Neisius A, Fritsche HM, Schnabel MJ. Radiation exposure during retrograde intrarenal surgery (RIRS): a prospective multicenter evaluation. World J Urol. 2021 Jan;39(1):217–224. doi: 10.1007/s00345-020-03160-9. Ivashchenko DM., Dudchenko MO., Kravtsiv MI. Evaluation of the role of application of contact lithotripsy in large occlusing ureteral stones. World of Medicine and Biology. 2020; 74(4):59–63. doi: 10.26724/2079-8334-2020-4-74-59-63 Ivashchenko DM., Dudchenko MO., Kravtsiv MI., Prykhidko RA., Shevchuk MP., Shchasnyi DM. The role of various methods of kidney drainage in obstructive pyelonephritis. World of Medicine and Biology. 2021; 78(4):66–70. doi: 10.26724/2079-8334-2021-4-78-66-70 Palmero Martí JL, Ganau Ituren A, Valls González L. Resultados actuales de la CRIR y comparación con NLPC [Current results of RIRS and comparison with PCNL.]. Arch Esp Urol. 2017 Jan;70(1):147–154. Peretti D, Dalmasso E, Pecoraro A, Ambruosi C, Venzano F, Fiori C, Porpiglia F, Maugeri O. Low-energy high-frequency HoYAG lithotripsy: is RIRS going forward? A case-control study. Urolithiasis. 2022 Feb;50(1):79–85. doi: 10.1007/s00240-021-01282-2 Pustovoit GL, Sarychev LP, Savchenko RB, Sarychev YV, Ustenko RL, Sukhomlin SA. Anticholinergic burden in aging patients and its role in the development of bladder decompensation. World of Medicine and Biology. 2021; 91(3):138–142. doi: 10.26724/2079-8334-2022-3-81-138-142 Sarychev LP, Sarychev YV, Pustovoyt AL, Suprunenko SM, Savchenko RB, Ustenko RL, Sukhomlyn SA. Efficacy of percutaneous draining operations for simple renal cysts. World of Medicine and Biology. 2021; 78(4):146–149. doi: 10.26724/2079-8334-2021-4-78-146-149 Setthawong V, Srisubat A, Potisat S, Lojanapiwat B, Pattanittum P. Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones. Cochrane Database Syst Rev. 2023 Aug 1;8(8):CD007044. doi: 10.1002/14651858.CD007044.pub4 Zeng G, Traxer O, Zhong W, Osther P, Pearle MS, Preminger GM, Mazzon G, Seitz C, Geavlete P, Fiori C, Ghani KR, Chew BH, Git KA, Vicentini FC, Papatsoris A, Brehmer M, Martinez JL, Cheng J, Cheng F, Gao X, Gadzhiev N, Pietropaolo A, Proietti, S, Ye Z, Sarica K. International Alliance of Urolithiasis guideline on retrograde intrarenal surgery. BJU Int. 2023 Feb;131(2):153–164. doi: 10.1111/bju.15836
Publication of the article	«World of Medicine and Biology» №4(86), 2023 year, 052-056 pages, index UDK 616.617-072.1-089.9
DOI	10.26724/2079-8334-2023-4-86-52-56