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Б. Г. Гулиев

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

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B. K. Komyakov

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

Ali Talyshinskii

Astana Medical University

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Б К Комяков

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

E. O. Stetsik

St. Petersburg State Health Care Foundation "Mariinsky City Hospital"

V.А. Ochelenko

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

Zhaloliddin P. Avazkhanov

St. Petersburg State Health Care Foundation "Mariinsky City Hospital"

M. U. Agagyulov

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

A. E. Talyshinskiy

A.P. Karpinsky Russian Geological Research Institute

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Т Х Ал-Аттар

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

Maksim Shevnin

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

Cooperative Institutions

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

Ministry of Health of the Russian Federation

A.P. Karpinsky Russian Geological Research Institute

St. Petersburg State Health Care Foundation "Mariinsky City Hospital"

European Association of Urology

S. M. Kirov Military Medical Academy

Astana Medical University

Manipal Academy of Higher Education

Saint Petersburg State Pediatric Medical University

St Petersburg University

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The infective complications of the percutaneous nephrolithotomy

Urologiia (2018)

Б. Г. Гулиев A.Yu. Zaikin Zaikin O. Ismati Ismati

In the article the main causes of the development of infective complications after percutaneous nephrolithotomy and their predictors described by the different authors are presented. A review of studies, dedicated to analysis of baseline risk factors of postoperative fever, systemic inflammatory response syndrome and/or sepsis was conducted. It was established that stone size and true bacteriuria are reliable risk factors as well as technical features of PCNL and the duration of the surgery. The staghorn and multiple stones increase the postoperative complications rate by three times. Despite low incidence of postoperative sepsis after PCNL, it is the serious complication and the main cause of mortality in a postoperative period. The use of prophylactic antibiotics with consideration of bacteria, isolated from the urinary tract significantly reduces the incidence of the postoperative infectious complications. The scheme of a single injection of the antibiotic 30 minutes before the surgery is effective.

10.18565/urology.2018.5.128-133

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Using of a dismountable 3D-model of the collecting system with color segmentation to improve the learning curve of residents

Urologiia (2020)

Б. Г. Гулиев B. K. Komyakov A. E. Talyshinskiy E. O. Stetsik

to determine the efficiency of using a non-biological dismountable 3D-model of the collecting system with color segmentation for better understanding of its anatomy by residents and to determine the optimal tactics of percutaneous nephrolithotomy (PNL).3D-models of the collecting system were developed based on CT data of 5 patients with staghorn stones, for whom PNL was planned. CT images were obtained in the Dicom format. RadiAnt DICOM Viewer was used for delineation and segmentation of the collecting system with 3D visualization. Using slicer 4.8.1 software, virtual models were processed to convert DICOM files to STL format. Then, virtual color extraction of each group of calyxes was performed for convenient disassembling and intraluminal study of the anatomy of the collecting system. The final stage included the printing of each area by the method of layer-by-layer deposition using a 3D printer Picaso designer X. To assess the efficiency of the dismountable 3D-model that simulates a certain collecting system, a questionnaire was used. It allowed to evaluate the understanding of the anatomy of the collecting system by residents, as well as the ability to determine the optimal calyx for PNL by comparing the answers with the result of a survey of practicing urologists who had performed more than 50 cases.After studying 3D-models by residents, determination of the number of calyxes in each group was not statistically significantly different from those for practicing urologists who used CT images. The choice of the calyx for primary puncture was not different between groups. However, residents chose the calyx for additional access worse (p=0.009).The dismountable 3D-model of the collecting system is promising for training of residents and planning PNL. Studying the anatomy of a single group of calyxes as well as the entire collecting system allows to choose the optimal calyx for percutaneous puncture during PNL.

DICOM

Calyx

3d model

10.18565/urology.2019.6.21-25

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[LAPAROSCOPIC URETERO-CYSTO-ANASTOMOSIS IN TREATMENT OF PELVIC URETERAL STRICTURES].

PubMed (2015)

B K Komjakov Б. Г. Гулиев

The aim of the paper was to evaluate the efficacy of laparoscopic uretero-cysto-anastomosis (UCA) in patients with lower ureteral strictures of various etiologies. Over the period from 2010 to 2014, 12 patients (8 females and 4 males) aged 19 to 64 years (mean age 35.6 ± 8.5 years) underwent laparoscopic UCA. In all females, iatrogenic ureteral injury occurred during gynecological surgery. Types of gynecological surgeries were an open or laparoscopic hysterectomy (5), excision of endometriosis nodules (2), and resection of the ovaries (1). In men indications for surgery were ureteral strictures after ureteroscopy (3) and neuromuscular dysplasia (1). The operation was performed in lithotomy position by transperitoneal access using 4 trocars. In all cases, extravesical ureteral reimplantation into the bladder was performed. The stent was removed after week four, excretory urography and cystography were conducted. The operation was thought to be successful in all patients. There were no cases of conversion and no need in blood transfusion. In 4 patients we performed psoas-hitch + UCA, in 2--Boari operation, in 5--direct UCA. The patient with neuromuscular dysplasia longitudinal resection of the lower third of the ureter was carried out. Then it was sutured on the stent by interrupted sutures, and extravesical implantation into the bladder was performed. Mean duration of surgery was 145 minutes (110 to 230 minutes), mean blood loss--180 ml (from 120 to 245 ml). Passive asymptomatic vesicoureteral reflux was observed in 3 patients. Laparoscopic UCA is a highly effective intervention with the functional results similar to those of open surgery.

Lithotomy position

Ureteroscopy

Cystography

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ОЦЕНКА РАЗЛИЧНЫХ МЕТОДОВ ГЕМОСТАЗА ПРИ ВЫПОЛНЕНИИ ЛАПАРОСКОПИЧЕСКОЙ РЕЗЕКЦИИ ПОЧКИ

Urologii︠a︡ (Russia) (2008)

Б К Комяков Anastasia Novikov Б. Г. Гулиев Сергій Віталійович Попов

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Miniaturization of flexible ureteroscopes: a comparative trend analysis of 59 flexible ureteroscopes

Urolithiasis (2023)

Ali Talyshinskii B. M. Zeeshan Hameed Nithesh Naik Б. Г. Гулиев Ulanbek Zhanbyrbekuly

Positive correlation

10.1007/s00240-023-01511-w

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[Results of open and laparoscopic partial nephrectomy for localized renal cancer].

PubMed (2017)

B. K. Komyakov Б. Г. Гулиев A I Novikov Kh Kh Yagubov

To compare the results of laparoscopic and open partial nephrectomy.From February 2000 to June 2016, 178 patients (mean age 58.2 years) with stage T1 kidney tumors underwent partial nephrectomy. This cohort included 106 (59.5%) men and 72 (40.5%) women. Open partial nephrectomy was performed in 102 (57.3%) patients (group 1) and laparoscopic partial nephrectomy (LPL) - 76 (42.7%, 2nd group). The majority (92.2%) of patients underwent resection for elective and 14 (7.8%) for absolute indications. Preoperatively, 163 (91.6%) and 15 (8.4%) patients had stage T1a stage T1b, respectively. The tumor size ranged from 2.4 to 6.2 cm and from 2 cm to 5.4 cm in group 1 and 2, respectively. A comparative analysis included operative time, warm ischemia time, blood loss, duration of drainage and the length of hospital stay.Open partial nephrectomy was associated with shorter operative time (105 min versus 125 min) and warm ischemia time (14.5 vs. 20.8 min) compared with laparoscopic partial nephrectomy. Laparoscopic partial nephrectomy was characterized by a smaller blood loss (180 ml vs. 365 ml, p<0.05) and a shorter length of hospital stay (2.5 days vs. 5.6 days, p<0.05). One patient from each group was found to have positive surgical margins.Currently, laparoscopic partial nephrectomy is the method of choice for stage T1 kidney tumors. Despite the comparatively longer operative time and warm ischemia time, laparoscopic partial nephrectomy leads to faster patient recovery and fewer complications.

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Percutaneous treatment of purulent kidney formations

Experimental and Сlinical Urology (2020)

Б. Г. Гулиев B. K. Komyakov Zh. P. Avazkhanov

10.29188/2222-8543-2020-12-1-52-56

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Patient Counseling Through the Pelvicalyceal-shaped Labyrinth: In Search of an Easy Understanding of the Upcoming Stone Removal: A Pilot Study

Urology (2020)

Ali Talyshinskii Б. Г. Гулиев B. K. Komyakov Antonio Galfano

10.1016/j.urology.2020.04.114

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Robot-Assisted and Open Radical Cystectomy: Comparative Analysis of Results

Urology Herald (2020)

Б. Г. Гулиев R. R. Bolokotov

Radical cystectomy (RC) remains the main method of surgical treatment of patients with muscle-invasive bladder cancer. Currently, in case of radical cystectomy, along with the open, robot-assisted access is actively used. This review presents an analysis of the main results of a robot-assisted RC (RARC), which are compared with those after an open RC. Perioperative parameters, functional and oncological results of robot-assisted and open RC were evaluated. According to the data obtained, it was found that with robot-assisted access there is a low volume of blood loss and a percentage of blood transfusion, but a high cost and a long operation time. In addition, there was no significant difference in the daytime and nighttime continence, and the quality of life of patients, as well as oncologic results between the two procedures. Further accumulation of experience allows us to improve the oncological and functional results of the robot-assisted RC, as well as to reduce the number of postoperative complications, high degree according to Clavien-Dindo grade especially.

10.21886/2308-6424-2020-8-1-59-68

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PLASTIC SURGERY OF THE PROXIMAL URETER WITH A BUCCAL MUCOSA GRAFT

Medicine theory and practice (2023)

Б. Г. Гулиев Пайзилидинович Авазханов Жалолиддин Шухратович Абдурахманов Ойбек

Введение. При рецидивных протяженных стриктурах пиелоуретерального сегмента (ПУС) и проксимального отдела мочеточника, когда стандартные операции неэффективны или технически не выполнимы, суженный участок можно заменить лоскутом из слизистой щеки. Цель исследования: изучить результаты лапароскопической пластики ПУС и проксимального отдела мочеточника буккальным графтом. Материалы и методы. Малоинвазивная пластика протяженной стриктуры ПУС, верхней и средней трети мочеточника лоскутом из слизистой щеки выполнена 30 больным. Из них мужчин было 18 (60,0%), женщин — 12 (40,0%), средний возраст составил 51 (19–77) год. Причиной сужения у 18 больных была выполненная ранее пиелопластика. У 27 больных использовался лапароскопический, у 3 — робот-ассистированный доступ. У 18 из них проводилось замещение суженного участкапо onlay-методике, у 12 больных выполнялась аугментация анастомоза буккальным графтом. Результаты. Интраоперационных осложнений не было. Длительность операций колебаласьот 115 до 340 мин. Случаев подтекания мочи по дренажу не было. Лихорадка до 38,0 °С наблюдалась у 5 (18,5%) пациентов, у 3 (11,1%) из них проводились антибактериальная терапия(II степень по Клавьену), а у 2 (7,4%) без нефростомического дренажа выполнена пункционная нефростомия (IIIa степень по Клавьену). Осложнений по Клавьену ≥IIIb степени не было.На экскреторных урограммах и компьютерной томограмме участок мочеточника, замещенный буккальным лоскутом, широкий и хорошо проходим. У пациентов со стриктурами ПУСв динамике наблюдалось уменьшение размеров расширенных чашечек и лоханки. Клинически все операции были успешными, так как удалось избавить пациентов от  нефростомического дренажа и симптомов обструкции верхних мочевыводящих путей (ВМП). Заключение. Буккальная уретеропластика может быть методом выбора у больных с протяженными сужениями ПУС и проксимального отдела мочеточника. Она является сравнительно несложной операцией и не требует широкой мобилизации мочеточника и обеспечивает хорошие функциональные результаты. Introduction. With recurrent extended strictures of the pyeloureteral segment (PUS) and the proximal ureter, when standard operations are ineffective or technically impossible, the narrowed area can be replaced with a buccal mucosa graft. The purpose of the study: to study the results of laparoscopic plastic surgery of the PUS and proximal ureter with buccal graft. Materials and methods. Minimally invasive plastic surgery of the extended stricture of the PUS, upper and middle third of the ureter with a flap from the cheek mucosa was performed in 30 patients. Of these, there were men 18 (60.0%), women — 12 (40.0%)., the average age was 51 (19–77) years. The cause of narrowing in 18 patients was previously performed pyeloplasty. Laparoscopic access was used in 27 patients, and robot-assisted access was used in 3 patients. In 18 of them, the narrowed area was replaced by the onlay technique, in 12 patients, anastomosis augmentation was performed with a buccal graft. Results. There were no intraoperative complications. The duration of operations ranged from 115 to 340 minutes. There were no cases of urine leaking through the drainage. Fever up to 38.0 °C was observed in 5 (18.5%) patients, 3 (11.1%) of them underwent antibacterial therapy (grade II according to Clavien), and 2 (7.4%) without nephrostomy drainage, puncture nephrostomy (grade IIIa according to Clavien) was performed. There were no complications according to Clavien ≥IIIb degree. On excretory urograms and computed tomography, the area of the ureter replaced by a buccal flap is wide and well passable. In patients with PUS strictures, a decrease in the size of expanded cups and pelvis was observed in dynamics. Clinically, all operations were successful, as it was possible to relieve patients from nephrostomy drainage and symptoms of upper urinary tract obstruction. Conclusion. Buccal ureteroplasty may be the method of choice in patients with extensive narrowing of the PUS and proximal ureter. It is a relatively simple operation and does not require extensive mobilization of the ureter and provides good functional results.

Buccal mucosa

Mouth mucosa

10.56871/mtp.2023.99.97.011

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