| Abstract [eng] |
The study aim was to evaluate the importance of the preoperative risk rates which allow to predict the result of the treatment and possible complications. To compare effectiveness, the efficiency quotient and economical effect. of ureteroscopy and extracorporeal lithotripsy when the stone is being removed from the upper part of the ureter. Till now, in Lithuania no study have analysed ureteroscopic stone removal results only from the upper part of the ureter. In the researches that have been made up to date the treatment effectiveness has never been evaluated by calculating the efficiency quotient of the methods used. No economic calculations that would indicate which way of treatment is financially cheaper after introducing service coding system according to ACHI classification in Lithuania had been done. Study results showed that comparing with extracorporeal lithotripsy, ureteroscopy with a laser lithotripsy is a more effective and quicker treatment method when seeking to reach a stone free rate in the upper part of the ureter. When performing ureteroscopy with a laser lithotripsy the size of the stone does not influence the treatment results. The localization of the stone at the level of the 3rd lumbar vertebrae is related to its high possibility of migrating to the kidney. Study results allow to state that, when performing ureteroscopy patient‘s age, gender, ASA degree, the fact whether the stone is in the left or in the right ureter, do not influence complication risks. An “impacted” ureter stone is a prognostic factor of the ureter stricture in the stone location. Ureteroscopy single use devices are more expensive than the payment for ureteroscopy and flexible ureteropyeloscopy from the compulsory health insurance fund. in Lithuania nowadays. |
