551
2295579220014562122181
Ces36847930014570127174
Urol38837930014578115180208
2024;41167930014562121178235258
28(3):43997930014562121154212241263
228–23346887930014561121180242297357415
ORIGINÁLNÍ3862200016996181224324367468561635735777
PRÁCE4686200016974156253339415
Aim:77489001357098190215
To1013890013151102
present114089001316092144184237295327
our1491890013159117148
department‘s1663890013160113173223254291381434492523545583
experience2270890013153101161215247269322380428479
with6241040013179101134191
percutaneous8341040013161114145191247280329386438496553592
nephrolithotomy14461040013158110169227258313336357390447504536591680725
in2191104001312379
a22901040013150
modified23591040013189147206228253280332391
supine624119001314197157180237290
position.9381190013161120160182215237295353372
Materials7741340013590145182237275302356383428
and12201340013555117179
Methods:14181340013589146184245306369413438
During18741340013170128158180236295
the2188134001313490142
observed23501340013158117156208238290341400
period6241490013161115147170228288
from945149001312862118208
January1186149001313887145202251282334
1,1553149001315465
2020,16511490013154105155207224
to1908149001313490
May20301490013186136182
31,22451490013154100112
2023,23891490013154106156209226
9326471490013154103
percutaneous6241640013160114145191247280330387439497555593
nephrolithotomies12371640013159111170228259315338359392449507538594683704756796
were20521640013179131162213
performed22851640013160113144176232264353405465
in624179001312382
a7391790013151
modified8231790013191150212234261288342403
supine12591790013142100160183242296
position15881790013162122163185219242301360
on19811790013160119
8021331790013155109
patients.22751790013162113146169222281314356376
A26851790013165
retrospective624194001313386120153210252312367418455478529582
data12391940013161111144195
analysis14671940013151110160183232274296336
was18371940013180131172
conducted.20421940013150108167228287337374426488507
The25831940013152113167
factors624209001312981130167224257298
studied955209001314277136196219272333
included1321209001312482132154212273326388
stone1742209001314176133193247
size,2022209001314163108160177
Guy‘s22322090013170129178200238
stone2503209001314177134193247
score,624224001314291148181233250
operative9072240013159121176208259291314364417
time,1357224001313457147201218
stone-free1608224001314277134193247283312346398453
rate,2094224001313384116168186
complica‑23122240013150107198258282304353404438
tions,624239001313456114172212230
fluoroscopy880239001312753110168200257297345401462509
time,1414239001313457145198215
use1655239001315897151
of1831239001315987
lithotripsy,194423900131234578136194227258281340380430443
and24122390013150108168
the2605239001313492145
need6242540013159112166226
for874254001312986118
blood1016254001316184142201261
transfusion1301254001313466116174213243302341362420479
after1804254001315077115166197
the2026254001313492145
procedure.2195254001316092149198249310367398449467
Result:7742690013563119165227255293319
The11212690013151111164
average1315269001315098149181231290343
size1688269001314162106158
of1876269001315887
the1993269001313492145
treated2168269001313466117165197248309
stone2507269001314175131190243
was6242840013179129169
2618212840013153104149
mm².9982840013190179210225
In1251284001312381
3113602840013153100
cases,1487284001314999139192232251
we17662840013179131
dealt19252840013160113161183216
with21692840013179102135193
multiple23902840013190147169203225284307360
stones,624299001314176132190243283302
partially9572990013161111142179201249271293341
cast1329299001314999138173
stones1533299001314175131190243283
(Guy‘s1847299001312994152201222259
stone2137299001314176132190243
score2411299001314190146178229
3)2671299001315479
in624314001312381
17729314001315498
cases,852314001314998138191231250
and11273140013150108167
completely13193140013149105195254277330363414437485
cast1828314001315099139174
stones2026314001314176132190244284
in2335314001312380
424403140013154
cases2519314001314998138191231
(Guy‘s624329001313096155204226264
stone921329001314277134194248
score1202329001314191148181233
4).146832900131548096
The15973290013152113167
stone-free1797329001314177134193247283312346398453
rate2283329001313384117169
in2485329001312382
our26003290013159118150
cohort6243440013149105164222254291
was9363440013180130169
78%.11273440013154104184205
Lithotripsy1353344001314972105163221254285308368408457
of1831344001315987
the1940344001313492145
stone2107344001314175131190243
was23713440013180129169
nec‑25623440013159112161188
essary624359001315494134184216268
in924359001312381
5910373590013154103
cases11723590013150100140193233
(63%).1438359001312979131210235250
Complications17203590013163120210270293314363413445467525584624
of2376359001315987
grade2496359001316091142201254
II624374001312447
according7063740013152102151209243303327387449
to1190374001313593
the1318374001313595151
Clavien-Dindo1503374001316588139189213268328363439463523585645
classification2183374001315074125166208231258286336388422446506567
were6243890013179132163214
recorded864389001313384134190222279332393
in1282389001312381
213883890013154
cases1468389001314999138191232
(2%),1725389001312981160186201
grade1952389001316091141200253
IIIa223138900131234567116
in2373389001312380
124793890013153
case2558389001314999139192
(1%),624404001312977151177193
and8504040013150108169
grade1051404001316192143203257
IIIb134040400131244668129
in1501404001312382
816154040013155
cases17024040013150100140194235
(9%).1969404001313079162188203
The22054040013151112165
average2403404001315199151183234294347
operative6244190013159119173204254286308358409
time1064419001313456145198
was12934190013179129169
4414924190013154110
minutes,16334190013190112170227260311351370
and20344190013149107167
the2231419001313492145
average2407419001315098150181231290343
fluoroscopy624434001312753110168200257297346401462509
time1161434001313456145198
was13884340013179129168
215854340013154
minutes16674340013190112169226260311351
and20464340013150108168
3322424340013154103
seconds.2374434001314194143199258317356376
Blood624449001315577133191250
transfusion893449001313364113169207236294332352409466
after1378449001314976112162193
the1590449001313390142
procedure1751449001315990146194243302358388439
was22094490013178126165
required2393449001313282141197218248298357
in624464001312381
27294640013153
cases806464001314999139192232
(2%).1062464001312981161186201
Conclusion:7744790013564123185233260321366393453515539
Percutaneous13314790013155104135180237269318375427484541580
nephrolithotomy19304790013158110169226257312334355388445502533588676721
in2671479001312279
a6244940013150
modified7014940013190148208230256283336396
supine1124494001314197157179237290
position14414940013160119159181214236294352
is1820494001312362
a19094940013150
safe1985494001314292120172
and21834940013150108168
effective2377494001315483112164214250272321373
method6245090013188140171227284342
for984509001312984114
treating1117509001313363113159190211267324
nephrolithiasis,14595090013158109167224253308330350382438459505543564601618
with2096509001317899131187
the2301509001313390141
advan‑24605090013149106154202258290
tage624524001313483142194
of838524001315886
reduced944524001313283143200248298358
operative13225240013158118171202252283305354405
time1747524001313456143196
due19635240013160116168
to2151524001313490
the2260524001313492144
station‑2424524001314175124156178235293326
ary624539001315081133
position7815390013161120160181215237294353
of1158539001315987
the1269539001313492145
patient14385390013161111143165218276307
during17695390013160117149171229288
the2081539001313492145
procedure.2250539001316193150199250310367399450467
KEY6255680014770134206
WORDS85856800147105189260345408
Modified6245840013185143203225250277329389
supine1033584001314197156178235288
position,13415840013160119159180213235292350368
nephrolithiasis,17295840013159111170229260316338360393450472520559580619637
percuta‑23865840013160114145192248282331364
neous6245990013159112171229268
nephrolithotomy.9165990013159112172231262318341363396454513545601691737750
………62462800147120240360
ÚVOD6256700018197183286388
Perkutánní6247040013154103133178234267315371427448
nefrolitotomie10907040013158110137168223245266298352383438525546597
je1706704001312374
jednou1799704001312374132188245301
z21197040013144
modalit21817040013189146204251273293325
léčby2525704001312374122179225
nefrolitiázy,6247190013159112140173230253274308330378422474487
první1139719001316193146205227
použití13947190013160119177221244277299
této1721719001313485118174
metody19237190013190144177233293341
je2292719001312477
literárně239771900131234478129160210241300353
zaznamenané624734001314495140198247336389447496554607
v12527340013150
roce1323734001313389139189
1976.1534734001315398148196215
Dle1770734001317195147
doporučení19397340013159118178237269327376426484506
Evrop‑2466734001315199132188249284
ské624749001314185136
urologické779749001315889145167225284305353398448
společnosti1247749001314199157180232281338395434468490
je1756749001312476
metodou18517490013190142175230289346404
první2274749001316092144202223
volby25177490013149105128186233
u6247640013158
nefrolitiázy7027640013158111139171227250271304325373417468
o11907640013158
velikosti12687640013150101123144189245285319341
nad16287640013159107166
2018147640013153104
mm,19377640013189177195
u21527640013158
konkremen‑22307640013146102160205238289377430487520
tů297689001313493
o3102890013159
velikosti3194890013150103126148194252293328351
10–203578890013154102161209262
mm3860890013191181
je407489001312477
perkutánní4184890013162117149196255289340398457479
nefrolito‑4696890013160114143176234257279313370406
tomie2976104001313490180201254
ekvivalentním3262104001315399152175224274296349407438497518607
řešením3901104001313384124177235257345
k42781040013147
endoskopickému43571040013153111171229269314371431454502547599688745
výkonu29761190013150102148205264321
a33201190013150
extrakorporální33931190013153101137169219264321353414473505555577635656
litotrypsi407211900131244579135167199250311351373
rázovou4468119001313282127183232289347
vlnou,4838119001314973130188246264
u29761340013158
konkrementů30531340013146102160204237288375428485516572
s36451340013140
velikostí37051340013149100122143187243282316338
pod40621340013160118178
1042591340013153100
mm43771340013189177
je4573134001312375
provedení4667134001316192147195246305357414435
perkutánní29761490013161115146192250284333391449471
nefrolitotomie34691490013158112140173229252274307363395451541563615
druhou4106149001316091150207266324
volbou44521490013149106130189248306
s47801490013141
prefe‑4843149001316193144172224259
rencí2976164001313386145195218
endoskopických32271640013154114175234275322380442465515561614663722
výkonů39821640013151104152210270329
a43441640013151
extrakorporální44281640013154103141174225272330363425486519570593652674
litotrypse.297617900131234375130161191241301339391407
Výkon34011790013155103148203260
je3680179001312374
možné37731790013188145186243294
provést4086179001315990145192242281314
v44181790013149
pronační4486179001316090145202249296352373
nebo48771790013158110167225
supinační2976194001314299160183242292341400422
poloze.34311940013162122146205248301318
Obě37821940013175137192
metody40071940013191145179236298347
vykazují43871940013151104151203249308331353
stejnou4773194001314277129152210270329
stone2976209001314174129187239
free3234209001312961111164
rate,3417209001313281113163179
supinační3615209001314196155176233281328385406
poloha40402090013160118141198255303
přináší4362209001316091113170217256277
kratší4658209001314679128159200221
ope‑48982090013158117170204
rační2976224001313280127183204
čas.3199224001314896135153
Při3371224001315483105
výkonu3495224001314899144199256311
je3825224001312375
možné39182240013189146187244295
využít4232224001314999156199220253
ultrazvukovou4503224001315879111141190233284341385440487543599
nebo29762390013158111170228
skiaskopickou3224239001314085108156195239295354376424468524582
kontrolu,38252390013146102160191222278301357374
případně4219239001316091113172221280337389
kombinace46282390013146102190249271328376424474
obojího29762540013159119178200222282340
(1).334025400131307797112
MATERIÁL297829500181121215281357438477569641
A36542950018192
METODY378129500181120196275378480557
Provedli2976329001315585142190242302324345
jsme3341329001312463151204
retrospektivní3565329001313384117149205245304358403440462511570591
analýzu41773290013150107156178226272330
perkutánních45283290013160114145191249283332390447469516574
nefroliltotomií29763440013160114142176234257279302336393426483574596618
v36273440013151
modifikované37113440013191150212234261288333391440491550604
supinační4348344001314199159183241291340399421
poloze48023440013162122145204248300
provedených2976359001316295153203256318373432480529588
v35983590013150
období36823590013160122184243305329
od40443590013160122
ledna4200359001312378140199249
202044833590013155108159212
do47293590013161120
květ‑48833590013147102155189219
na29763740013161112
2023.31223740013155109161216235
Většina33913740013158111145189211272322
pacientů37483740013162114165188243304337397
byla41793740013163112137188
hospitalizována44013740013161121163225249284336359382428487538590650701
na29763890013159108
našem31133890013159108148201290
pracovišti,3432389001316193143192248296319358392414432
malá38933890013191139162210
část4133389001314999138173
byla43363890013160108131179
z45453890013145
provozních4619389001316193150198255297356378425483
důvodů29764040013161119169227289347
hospitalizována33564040013160120161221244279329352375419477527578637687
na40764040013160110
jiném4219404001312446105159250
oddělení45024040013160121182236259313372394
naší49304040013160109150172
nemocnice29764190013161116208269320380403453506
například35164190013161112174207231280306356418
při3968419001316396120
plánovaném4122419001316286137197258308360420475567
uzavření47234190013160106159209242296356379
našeho29764340013161112153209269330
lůžkového3342434001312483129178237288342403463
oddělení.38414340013160123186241265320380403423
U43004340013171
všech4407434001315193149201261
pacientů47044340013162115166189244304338398
bylo29764490013161108131189
před3197449001316092143204
výkonem34324490013150102148205264317406
provedené3869449001316193149198249310363420474
standardní4374449001314175125183242291322380438460
před‑4865449001316192144204237
operační29764640013160122178210262312371394
vyšetření,34034640013151105146201235268321381403422
u38594640013159
pacientů39524640013162113163186240300333392
s43784640013142
antikoagulační44534640013151111144167214272324385444467517567626649
či2976479001315072
antiagregační30814790013151110142165214275307360421471520579602
terapií3716479001313486118169230253276
byly40254790013161110134183
preparáty4241479001316194147207258291342375427
vysazeny47014790013150103145196242295354401
s29764940013141
dostatečným30394940013160118158192242274325375432478569
předstihem3630494001316092143204243277300357410499
před4151494001316193144204
výkonem,43774940013150102149205264317406424
převe‑4823494001316193144193244279
dení29765090013160113170192
na31885090013159108
nízkomolekulární3316509001315981125171227317375398451497555577625656715737
heparin40735090013159112172221253275333
proběhlo4426509001316193149209263321343401
podle48475090013161120180202255
indikace2976524001312380139160205255303354
dispenzarizujícího3349524001316081120178232289333383414436479537559580628649708766
internisty.4135524001312380111162193251272311345395409
Profylakticky4564524001315484140168220243291336373394442487538
byl29765390013161109133
nízkomolekulární3141539001315981126172230320379403456503561584633664724746
heparin39195390013160114174224256279337
podáván42895390013161121182231279330388
po47105390013161121
dobu48635390013160119180239
hospitalizace29765540013159117157216239272322344366409460509560
u35605540013158
všech3642554001315090143193250
pacientů.39165540013161111160181234292324381398
Na31265690013170119
našem32775690013159108148201290
pracovišti3599569001316193143191247296319357392414
je4045569001312476
výkon41535690013150102149206264
vždy4449569001315096154203
prováděn4684569001316193149198247307360418
v29765840013151
modifikované30605840013191151213235262289335393443494553607
supinační3701584001314199160183242292342401423
poloze41585840013161122146205248301
s44925840013142
podložením45675840013162123184207267310363422445535
oblasti29765990013160122146196237273296
hrudníku3305599001316092152214273296345404
a37435990013151
pánve38275990013162114173222275
na41355990013161111
ipsilaterální4279599001312485126149171221255307340391414473496
straně,4808599001314278111162222276294
podložení29766140013162122184207266310363422444
provádíme3454614001316194152201253313336427481
5litrovými396861400131557699133166223273326418441
infuzními4442614001312482111171217277299390412
vaky,48886140013150101148201214
osvědčilo29766290013160102155209271322345368429
se3439629001314298
nám35716290013161112204
i38096290013124
podložení38676290013163125188211272316370430453
pacienta43556290013162114165188243304337389
plovací4778629001316387148198250301324
pěnovou29766440013160114171228276333390
tyčí3386644001313484131152
do35586440013160117
vody.36956440013150106166214227
Ipsilaterální3942644001312382121142164212244294325375396453475
horní44376440013158116147206227
končetina46846440013146102160208258291313370418
je2976659001312476
natažena30776590013159107140189234285343392
přes3493659001316193144184
hrudník3702659001315990148208265287335
na40616590013159108
kontralaterální41936590013147104162194226276298347379430461511533591612
stranu4830659001314175107157215272
a29766740013151
fixována,3062674001312754103162213265325376396
ipsilaterální3492674001312486128150174224258311345397420480503
dolní40296740013162123147207230
končetina42936740013148107168219272307330390441
nataže‑47686740013161112146198244298334
na29766890013159109
a31176890013151
kontralaterální32006890013147104163196228278301350383434466516539597619
dolní38516890013161119143201223
končetina41066890013147104164212264297320378427
je4565689001312477
v46756890013150
abdukci47576890013151111172230275323345
a29767040013150
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cystoskopu46117040013149100140175231271316373433491
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katétr3849719001314798130181214246
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dutého45987190013159117150201259317
sys‑4940719001314190131162
tému2976734001313485174231
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následně38627340013159107147169222282340393
fixujeme4283734001312653100157180232321374
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zavede‑4760734001314495142194255307342
nému29767490013159112201258
Foley32637490013150107130183231
katétru.3522749001314797129180214245304322
U38737490013169
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extrahujeme33497640013155104141174226285344367421512567
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