Guliev Bg

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Komiakov Bk

Novikov Ai

Gorelov Ai

St Petersburg University

Sergeev Av

Fadeev Va

Serov Ra

Bakulev Scientific Center for Cardiovascular Surgery Russian Academy of Medical Sciences

Pecherskiĭ Vi

Ochelenko Va

North-Western State Medical University named after I.I. Mechnikov

Ode M

Dorofeev SIa

Cooperative Institutions

North-Western State Medical University named after I.I. Mechnikov

Ministry of Health of the Russian Federation

St Petersburg University

Bakulev Scientific Center for Cardiovascular Surgery Russian Academy of Medical Sciences

Institute of Evolutionary Physiology and Biochemistry

Lomonosov Moscow State University

Moscow State University

Max Planck Institute of Biochemistry

Skolkovo Institute of Science and Technology

National Research University Higher School of Economics

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[Supine percutaneous nephrolithotripsy].

PubMed (2012)

Komiakov Bk Guliev Bg

The report included the results of PNL in 64 patients. In 34 of patients (Group I), the surgery was performed in the prone position, and in 30 patients (Group II) - in semilateral (supine) position. The study included patients with one or more pelvic stones larger than 2.5 cm and requiring only a single percutaneous approach, with a body mass index less than 30 kg/m2 and the absence of contraindications to the PNL in the prone position. Average size of stones was 3.2 cm in Group I, and 3.0 cm in Group II. For the comparative analysis between the two groups, timing of surgery, intra- and postoperative complication rates, extent of blood loss and length of hospital stay were evaluated.Analysis of the results of PNL performed in prone and supine position of patient showed the absence of statistically significant difference in the effectiveness of the surgery, extent of blood loss, and length of hospital stay between the two groups. Significant difference was observed only in the timing of surgery (Group I, 68 min; Group II, 43 min).When performing PNL in patients with uncomplicated nephrolithiasis in prone and supine position of patients on the operating table, significant difference was observed only in the timing of surgery.

Supine position

Prone position

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Citations (2)

Nephrovesical subcutaneous bypass in ureteral obstruction in cancer patients

Urologii︠a︡ (Russia) (2007)

Komiakov Bk Guliev Bg Davranov AZh

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[LAPAROSCOPIC PYELOPLASTY WITH ANTEGRADE URETERAL STENTING].

PubMed (2015)

Guliev Bg

Results of laparoscopic pyeloplasty (LP) with different the methods of the upper urinary tract (UUT) stenting were compared. A total of 76 patients with hydronephrosis were enrolled in the study. Antegrade and retrograde ureteral stenting was used in 42 (55.2%) and 34 (44.8%) patients, respectively. In the first group after resection of the narrowed pyeloureteral segment (PUS) and formation of posterior wall of pyeloureteral anastomosis, antegrade stent was placed into the bladder, which followed by suturing of anterior wall of pyeloureteral anastomosis. While performing transurethral ureteral stenting, cystoscopy with retrograde ureteropyelography was carried out in lithotomy position, and the stent was put into the renal pelvis. Next, the patient was put into the lateral position, and LP was performed by transperitoneal access. There were no cases of conversion. The duration of the LP with antegrade stenting was significantly shorter than LP with retrograde stenting--135 versus 170 minutes (p < 0.05). Differences in the blood loss (55 ± 20 and 60 ± 15 ml) and the length of hospital stay (5 ± 2 and 6 ± 1 day) were not statistically significant. In the group of retrograde stenting there were two cases of stent migration, which required repositioning of the stents. In one patient with antegrade stent placement, the distal end of the stent curled in ureterovesical junction. The stent position was corrected during the ureteroscopy. There was one case of antegrade stenting failure requiring ureteroscopy with retrograde ureteral stenting. Laparoscopic pyeloplasty is an efficient method of surgical management of patients with PUS narrowing. The duration of antegrade stenting was significantly shorter than retrograde stenting. LP with antegrade ureteral stenting as compared to LP with retrograde stenting enables significantly reduced surgery duration.

Ureteroscopy

Pyeloplasty

Renal pelvis

Lithotomy position

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Ureteral obstruction as a complication of reconstructive surgery on the aorta and ileal arteries

Urologii︠a︡ (Russia) (2008)

Komiakov Bk Guliev Bg Ochelenko Va

The results of surgical interventions in patients with ureteral obstruction after reconstruction of the abdominal part of the aorta and aortofemoral bifurcation bypass are analysed. Of 168 patients of the retrospective group ureteral obstruction after angiosurgery arose in 7 (4.2%) patients. Ureterolysis of the lumbar part of the ureter followed by peritonisation was made in 5 of them, ureterolysis and ureteral resection with ureteroureteroanastomosis end-to-end--in the rest patients. Two patients had relapse of the obstruction after ureterolysis. This was managed with ureteral endoprosthesis with nitilon stent. Treatment outcomes were good. No lethality was registered. Among patients of the prospective group moderate unilateral hydronephrosis was detected in 5 (4.8%) patients. They had no urinary complaints, hydroureteronephrosis was diagnosed in them at ultrasound examination. Surgical policy in early diagnosis of ureteral obstruction seems optimal as it restores urodynamics of the urinary tract and preserves function of the kidney.

Ureterolysis

Aortic bifurcation

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[Intestinal plastic surgery of the ureter].

PubMed (2005)

Komiakov Bk Guliev Bg Novikov Ai Dorofeev SIa Mikhail Lebedev

Intestinal plastic surgery for ureteral stricture was made in 25 patients (10 unilateral and 15 bilateral strictures). Stricture of the lower third of both ureters was primarily second to operations for colorectal cancer, urinary bladder diverticulesis and scars after radiotherapy. Unilateral strictures resulted from postradiation changes in 9 patients and a shotgun wound of the ureter in 1 patient. Grafts of an isolated segment of the ileum and the vermiform process on the mesentery were transplanted in 22 and 3 patients, respectively. Postoperative intestinal ileus was observed only in one patient who was treated with relaparotomy, intestinal intubation and abdominal drainage. Another patient was reoperated for failure of ureteroappendicoanastomosis. The results of the reoperations were successful. No lethal outcomes were recorded. Upon 0.5-7 year follow-up, all the patients restored normal urodynamics and function of the affected kidney. Thus, use of an isolated segment of the small intestine ensures repair of the defects of one or both the ureters of any location and length. Intestinal repair in extended ureteral lesion is an operation of choice as it reestablishes urine outflow from the kidney, improves its function, relieves symptoms of chronic pyelonephritis and puts away continuous renal and ureteral fistulas.

Urinary diversion

Ileus

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Citations (1)

Arterial hypertension caused by a small cyst of the kidney

Urologii︠a︡ (Russia) (2009)

Komiakov Bg Guliev Bg

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[Laparoscopic plasty in primary stricture of pyeloureteral segment].

PubMed (2014)

Komiakov Bk Guliev Bg Aliev Rv

The article presents the results of laparoscopic pyeloplasty in 72 patients with primary stricture of pyeloureteral segment (PUS). The study included 34 men, 38 women; mean age was 32 +/- 4,6 years. The operation was performed by transperitoneal approach in side position of patients. 4 trocars were used. There were no conversions to open surgery. Urinary leak after surgery was observed in 4 patients; in 3 patients it has discontinued independently, and in one patient it has required a repeat laparoscopy and suturing of anastomotic defect. Due to recurrent narrowing of the PUS, two patients underwent retrograde endopyelotomy, and one patient--open pyeloplasty. The effectiveness of laparoscopic pyeloplasty in these series was 94.4%. Impediments for performing laparoscopic pyeloplasty included small pelvis size, the presence of inferior polar vessels, and frequent exacerbations of chronic pyelonephritis, which led to the development of adhesive process in the PUS. Thus, laparoscopic pyeloplasty is the treatment of choice in patients with primary constrictions of PUS and is as effective as open plasty of PUS.

Pyeloplasty

Open surgery

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Citations (1)

[Plastic surgery of the proximal segment of the right ureter after gunshot wound of the appendix].

PubMed (2003)

Komiakov Bk Novikov Ai Guliev Bg

Gunshot wound

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[Endoprosthetic operation of the solitary kidney ureter in Burneville-Pringle disease complicated with hydronephrosis].

Urologii︠a︡ (Russia) (2005)

Komiakov Bk Guliev Bg Novikov Ai

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Plastic repair of the urinary tract with intestinal graft

Urologii︠a︡ (Russia) (2005)

Komiakov Bk Novikov Ai Guliev Bg Dorofeev SIa Zuban' On

Enteroplasty of the urinary tract was made in 224 patients (175 male and 49 female, age 21-72 years): enteroplasty of the ureter (n = 25), augmentation cystoplasty (n = 38), replacement of the urinary bladder after radical cystectomy for cancer (n = 161). The grafts were made of the small intestine segments--149 (66,5%), sigmoid--45 (20%), stomach--25 (11.2%), appendix--3 (1.3%). Total postoperative lethality reached 2.7%. Early and late complications occurred in 26.8 and 32.2% patients, respectively. In half the cases complications were related to the derivation method. Fifty three reoperations were made, most frequent of them was percutaneous nephrostomy. Thus, use of gastrointestinal tract segments for replacement of the urinary tract provides adequate urine outflow from the kidneys, close to natural micturition. Introduction of advanced methods of urine derivation prevents formation of urinary fistulas and improves quality of the patients' life.

Urinary diversion

Urination

Nephrostomy

Upper urinary tract

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Citations (2)