Komiakov B K, Guliev B G
Urologiia. 2014 Sep-Oct(5):107-10.
The treatment of patients with large calculi, formed on both ends of the long-standing stent, remains difficult problem of modern urology. We observed 6 patients with long-term (16 to 24 months) standing stents. Large calculi on both ends of the drain were detected in 5 patients, fragmentation of stent--in 1 patient. Indication for stenting was ureteral calculus in 4 patients, staghorn stone of the left kidney in one pregnant woman 26 years old, and the stent was installed during orthotopic cystoplasty in 1 patient. At the first stage, contact laser lithotripsy of calculus on cystic end of the stent was performed, and distal portion was removed with forceps. 2-3 weeks after, PCNL was performed and renal end of the stent was removed. Patient with fragmentation of stent underwent ureteroscopy, and parts of the drainage were removed. To remove the stent, on average 1.8 endourological intervention was required. Results of operations in all cases were successful. Endourological operations are an effective method for the treatment of patients with large calculi, formed at both ends of the "forgotten" stents.
治疗长期留置支架两端形成大结石的患者，仍然是现代泌尿外科的难题。我们观察了6例长期（16至24个月）留置支架的患者。5例患者在引流管两端发现大结石，1例患者出现支架破碎。留置支架的指征为4例输尿管结石，1例26岁孕妇左肾鹿角形结石，1例患者在原位膀胱成形术期间安装了支架。第一阶段，对支架囊性端的结石进行接触式激光碎石术，并用钳子取出远端部分。2至3周后，进行经皮肾镜取石术并取出支架的肾端。支架破碎的患者接受了输尿管镜检查，并取出了部分引流物。为取出支架，平均需要1.8次腔内泌尿外科干预。所有病例的手术结果均成功。腔内泌尿外科手术是治疗“被遗忘”支架两端形成大结石患者的有效方法。
