{"id":1065435,"date":"2025-12-15T22:48:37","date_gmt":"2025-12-15T19:48:37","guid":{"rendered":"https:\/\/analyse.optim.biz\/?p=1065435"},"modified":"2025-12-15T22:48:37","modified_gmt":"2025-12-15T19:48:37","slug":"litotritia-laser-tratamentul-minim-invaziv-al-pietrelor-la-rinichi","status":"publish","type":"post","link":"https:\/\/analyse.optim.biz\/?p=1065435","title":{"rendered":"Litotri\u021bia laser: tratamentul minim invaziv al pietrelor la rinichi"},"content":{"rendered":"
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<\/a><\/p>\n

Dr. C\u0103t\u0103li<\/span>n<\/span>C<\/span>onstandache<\/span><\/a>, medic <\/span>primar<\/span>Urologie<\/span>, <\/span>Arc<\/span>a<\/span>dia<\/span><\/a><\/p>\n<\/div>\n

Litiaza<\/span>renal\u0103<\/span> (<\/span>pietrele<\/span> la <\/span>rinichi<\/span>)<\/span>este<\/span> o <\/span>afec\u021biune<\/span> des <\/span>\u00eent\u00e2lnit\u0103<\/span>, care <\/span>afecteaz\u0103<\/span>via\u021ba<\/span>cotidian\u0103<\/span>\u0219i<\/span> care <\/span>poate<\/span> fi <\/span>sursa<\/span>unor<\/span>complica\u021bii<\/span>medicale<\/span>importante<\/span>. <\/span>Ureteroscopia<\/span>retrograd\u0103<\/span>flexibil\u0103<\/span>este<\/span> o <\/span>metod\u0103<\/span> de <\/span>tratament<\/span> minim <\/span>invaziv<\/span>, care <\/span>prezint\u0103<\/span>numeroase<\/span>avantaje<\/span>pentru<\/span>pacient<\/span>\u0219i<\/span> care se <\/span>realizeaz\u0103<\/span> cu <\/span>succes<\/span>\u00een<\/span>Spitalul<\/span> Arcadia<\/span><\/a>.<\/span><\/p>\n

Ce <\/span>este<\/span>ureteroscopia<\/span>\u0219i<\/span> care <\/span>este<\/span>importan\u021ba<\/span>acestei<\/span>metode<\/span>atunci<\/span>c\u00e2nd<\/span>vorbim<\/span>despre<\/span>litiaz\u0103<\/span>renal\u0103<\/span>?<\/span><\/h4>\n

Ureteroscopia<\/span>este<\/span> o <\/span>metod\u0103<\/span> minim <\/span>invaziv\u0103<\/span> de <\/span>endoscopie<\/span> a <\/span>tractului<\/span>urinar<\/span>\u00eenalt<\/span><\/strong>ce<\/span>cuprinde<\/span>investigarea<\/span>ureterului<\/span>\u0219i<\/span> a <\/span>c\u0103ilor<\/span>urinare<\/span>\u00eenalte<\/span>. <\/span>Practic<\/span>, se <\/span>p\u0103trunde<\/span>, cu <\/span>ajutorul<\/span>unui<\/span> instrument, pe cale <\/span>retrograd\u0103<\/span>,<\/span> la <\/span>nivelul<\/span>ureterului<\/span>\u0219i<\/span> a <\/span>c\u0103ilor<\/span>urinare<\/span>\u00eenalte<\/span>, <\/span>unde<\/span>este<\/span>identificat\u0103<\/span>patologia<\/span> de la <\/span>acest<\/span>nivel<\/span>\u0219i<\/span>tratat\u0103<\/span> cu <\/span>ajutorul<\/span>diferitelor<\/span>metode<\/span> care sunt la <\/span>dispozi\u021bia<\/span>noastr\u0103<\/span>. <\/span>Importan\u021ba<\/span>acestei<\/span>metode<\/span>rezid\u0103<\/span> din <\/span>faptul<\/span>c\u0103<\/span> o <\/span>avem<\/span> la <\/span>dispozi\u021bie<\/span>atunci<\/span>c\u00e2nd<\/span>celelalte<\/span>metode<\/span> de <\/span>tratament<\/span> a<\/span>l<\/span>litiazei<\/span>renale<\/span> au <\/span>fost<\/span>utilizate<\/span>\u0219i<\/span> nu au <\/span>avut<\/span>succes<\/span>\u00een<\/span>fragmentarea<\/span>calculilor<\/span>.<\/span><\/p>\n

C\u00e2nd<\/span>este<\/span>indicat\u0103<\/span>ureteroscopia<\/span>retograd\u0103<\/span>flexibil\u0103<\/span>?<\/span><\/h4>\n

Ureteroscopia<\/span>retrograd\u0103<\/span>flexibil\u0103<\/span>este<\/span>indicat\u0103<\/span> cel <\/span>mai<\/span>frecvent<\/span>\u00een<\/span>tratamentul<\/span>litiazei<\/span> de <\/span>c\u0103i<\/span>urinare<\/span>\u00eenalte<\/span>, <\/span>adic\u0103<\/span> calculi <\/span>situa\u021bi<\/span> la <\/span>nivelul<\/span>cavit\u0103\u021bilor<\/span>renale<\/span>\u2013<\/span>bazinet<\/span>, <\/span>calice<\/span>, <\/span>atunci<\/span>c\u00e2nd<\/span>litroti\u021bia<\/span>extracorporeal\u0103<\/span> nu a <\/span>dat<\/span>rezultatele<\/span>scontate<\/span>. <\/span>De <\/span>obicei<\/span>folosim<\/span>aceast\u0103<\/span>tehnic\u0103<\/span>\u0219i<\/span>litotri\u021bie<\/span> tip <\/span>laser<\/span>\u00een<\/span>tratamentul<\/span>calculilor<\/span> de <\/span>p\u00e2n\u0103<\/span> la <\/span>2<\/span>centimetri<\/span><\/strong>.<\/span> Se <\/span>poate<\/span>utiliza<\/span>aceast\u0103<\/span>tehnic\u0103<\/span>\u0219i<\/span>\u00een<\/span>cazul<\/span>calculilor<\/span> de <\/span>dimensiuni<\/span>mai<\/span>crescute<\/span>, <\/span>dar<\/span>efectuarea<\/span>unui<\/span>num\u0103r<\/span>mai<\/span> mare de <\/span>\u0219edin\u021be<\/span>operatorii<\/span>. <\/span>Aceast\u0103<\/span>metod\u0103<\/span> nu <\/span>este<\/span>utilizat\u0103<\/span>doar<\/span>\u00een<\/span>tratamentul<\/span>litiazei<\/span>renale<\/span>, ci <\/span>\u0219i<\/span>\u00een<\/span>tratamentul<\/span>tumorilor<\/span> minim <\/span>agresive<\/span> de <\/span>c\u0103i<\/span>urinare<\/span>superioare<\/span>, <\/span>tratamentul<\/span>hidronefrozei<\/span>congenitale<\/span>asociate<\/span> cu <\/span>litiaza<\/span> de <\/span>c\u0103i<\/span>urinare<\/span>. <\/span><\/p>\n

Este important de <\/span>\u0219tiut<\/span>c\u0103<\/span>aceast\u0103<\/span>procedur\u0103<\/span>trebuie<\/span>limitat\u0103<\/span> la 90 de minute<\/span><\/strong> d<\/span>in <\/span>cauza<\/span>complica\u021biilor<\/span> care pot <\/span>ap\u0103rea<\/span>atunci<\/span>c\u00e2nd<\/span>durata<\/span>este<\/span>prelungit\u0103<\/span>. <\/span>Dup\u0103<\/span>litroti\u021bia<\/span> de tip <\/span>laser<\/span>, <\/span>pacientul<\/span>va<\/span>r\u0103m\u00e2ne<\/span> cu o <\/span>sond\u0103<\/span>\u00een<\/span> interior care face <\/span>leg\u0103tura<\/span>\u00eentre<\/span>rinichi<\/span>\u0219i<\/span>vezica<\/span>urinar\u0103<\/span>\u0219<\/span>i<\/span>ajut<\/span>\u0103<\/span> la <\/span>eliminarea<\/span>fragmentelor<\/span>litiazice<\/span>. <\/span>Aceast\u0103<\/span>sond\u0103<\/span>va<\/span> fi <\/span>extras\u0103<\/span>printr<\/span>-o <\/span>manevr\u0103<\/span>simpl\u0103<\/span> de <\/span>ambulatoriu<\/span>, la <\/span>aproximativ<\/span>6<\/span> s<\/span>\u0103pt\u0103m\u00e2ni<\/span>dup\u0103<\/span>interven\u021bia<\/span>chirurgical\u0103<\/span>, <\/span>dup\u0103<\/span> un control radiologic <\/span>efectuat<\/span>\u00een<\/span>prealabil<\/span>.<\/span><\/p>\n<\/div>\n<\/div>\n

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Care sunt <\/span>avantajele<\/span>acestei<\/span>metode<\/span> de <\/span>tratament<\/span>atunci<\/span>c\u00e2nd<\/span>vorbim<\/span> de <\/span>litiaz\u0103<\/span>renal\u0103<\/span>?<\/span><\/h4>\n

Aceast\u0103<\/span>metod\u0103<\/span>poate<\/span> fi <\/span>folosit\u0103<\/span>\u00een<\/span>scop diagnostic <\/span>\u0219i<\/span>terapeutic<\/span>, <\/span><\/strong>pentru<\/span> a <\/span>trata<\/span>una<\/span>sau<\/span>mai<\/span>multe<\/span>afec\u021biuni<\/span>. <\/span>\u0218i<\/span>aici<\/span>men\u021bionez<\/span>cazul<\/span>\u00een<\/span> care <\/span>avem<\/span> un <\/span>rinichi<\/span> cu <\/span>hidronefroz\u0103<\/span>congenital\u0103<\/span>, <\/span>adic\u0103<\/span> un <\/span>blocaj<\/span> congenital la <\/span>ie\u0219irea<\/span> din <\/span>rinichi<\/span>asociat<\/span> cu <\/span>litiaz\u0103<\/span>secundar\u0103<\/span>, <\/span>iar<\/span>aceast\u0103<\/span>metod\u0103<\/span> ne <\/span>pune<\/span> la <\/span>dispozi\u021bie<\/span>posibilitatea<\/span> de a <\/span>trata<\/span>ambele<\/span>afec\u021biuni<\/span>\u00een<\/span>aceea\u0219i<\/span>\u0219edin\u021b\u0103<\/span>operatorie<\/span>.<\/span><\/p>\n

Marele<\/span>avantaj<\/span> al <\/span>acestei<\/span>proceduri<\/span>este<\/span>determinat<\/span> de <\/span>faptul<\/span>c\u0103<\/span>p<\/span>oate<\/span> fi <\/span>efectuat\u0103<\/span> la <\/span>pacien\u021bi<\/span> cu <\/span>afec\u021biuni<\/span>medicale<\/span>sau<\/span>chirurgicale<\/span>concomitente<\/span>, care nu permit <\/span>interven\u021bii<\/span>mai<\/span>agresive<\/span>. <\/span>Poate<\/span> fi <\/span>efectuat\u0103<\/span> la <\/span>pacien\u021bi<\/span> sub <\/span>tratament<\/span> anticoagulant <\/span>sau<\/span>antiagregant<\/span>plachetar<\/span><\/strong>.<\/span><\/p>\n

Care sunt <\/span>principalele<\/span>contraindica\u021bii<\/span> ale <\/span>utiliz\u0103rii<\/span>acestei<\/span>metode<\/span>?<\/span><\/h4>\n

Sunt <\/span>contraindica\u021bii<\/span>reprezentate<\/span> de <\/span>septicemie<\/span>, <\/span>adic\u0103<\/span>prezen\u021ba<\/span>infec<\/span>\u021b<\/span>iei<\/span> la <\/span>nivelul<\/span>\u00ee<\/span>ntregului<\/span> organism. Sunt <\/span>contraindica\u021bii<\/span>reprezentate<\/span> de <\/span>prezen\u021ba<\/span>unor<\/span>anomalii<\/span>sau<\/span>afec\u021biuni<\/span> care nu permit <\/span>anestezia<\/span>general\u0103<\/span>. O <\/span>alt\u0103<\/span>contraindica\u021bie<\/span>este<\/span>legat\u0103<\/span> de <\/span>dimensiunea<\/span>calculului<\/span>.<\/span>Nu <\/span>putem<\/span>aborda<\/span>prin<\/span>aceast\u0103<\/span>metod\u0103<\/span>litiazele<\/span>renale<\/span> de <\/span>dimensiuni<\/span>foarte<\/span>mari<\/span>, <\/span>a\u0219a-numitul<\/span>calcul<\/span>coraliform<\/span>. De <\/span>asemenea<\/span>, nu <\/span>putem<\/span>aborda<\/span>prin<\/span>aceast<\/span>\u0103<\/span>metod\u0103<\/span>hidronefroza<\/span>congenital\u0103<\/span> a <\/span>c\u0103rei<\/span>cauz<\/span>\u0103<\/span>este<\/span>vasul<\/span> polar inferior, <\/span>deoarece<\/span>incizia<\/span> laser <\/span>poate<\/span>determina<\/span>hemoragie<\/span>abundent\u0103<\/span>\u0219i<\/span>necesitatea<\/span>unei<\/span>interven\u021bii<\/span>chirurgicale<\/span>urgente<\/span>.<\/span><\/p>\n

Care sunt <\/span>recomand\u0103rile<\/span> generale pe care <\/span>pacien\u021bii<\/span>trebuie<\/span>s\u0103<\/span> le <\/span>urmeze<\/span>dup\u0103<\/span>ce<\/span> au <\/span>accesat<\/span>aceast\u0103<\/span>procedur\u0103<\/span>?<\/span><\/h4>\n

Pacientul<\/span>trebuie<\/span>s\u0103<\/span> se <\/span>prezinte<\/span> la <\/span>controale<\/span>periodice<\/span> la <\/span>medicul<\/span>urolog<\/span>, <\/span>pentru<\/span> a <\/span>identifica<\/span>precoce<\/span> o <\/span>recidiv\u0103<\/span>litiazic\u0103<\/span>, <\/span>astfel<\/span>\u00eenc\u00e2t<\/span>aceasta<\/span>s\u0103<\/span>poat\u0103<\/span> fi <\/span>tratat\u0103<\/span>atunci<\/span>c\u00e2nd<\/span>este<\/span> de <\/span>dimensiuni<\/span>mai<\/span>mici<\/span>. Ca <\/span>regul\u0103<\/span>general\u0103<\/span>, <\/span>recomand<\/span>pacien\u021bilor<\/span> un <\/span>consum<\/span>adecvat<\/span> de <\/span>ap\u0103<\/span>. <\/span>\u00cen<\/span> plus, <\/span>profilaxia<\/span>recidivelor<\/span>litiazice<\/span>presupune<\/span>\u0219i<\/span>recoltarea<\/span>unui<\/span> fragment <\/span>litiazic<\/span>, care <\/span>va<\/span> fi <\/span>supus<\/span>unei<\/span>analize<\/span>, <\/span>iar<\/span> pe <\/span>baza<\/span>caracteristicilor<\/span>acelui<\/span>calcul<\/span>putem<\/span> face <\/span>recomand\u0103ri<\/span>specifice<\/span>fiec\u0103rui<\/span>pacient<\/span>, <\/span>\u00een<\/span>func\u021bie<\/span> de <\/span>tipul<\/span> de <\/span>litiaz\u0103<\/span> pe care l-a <\/span>prezentat<\/span>.<\/span><\/p>\n

Pentru<\/span>program\u0103ri<\/span>, <\/span>pacien\u021bii<\/span> au la <\/span>dispozi\u021bie<\/span>num\u0103rul<\/span> de <\/span>telefon<\/span>0232 920, Call <\/span>Center<\/span> Arcadia<\/span><\/strong>.<\/span><\/p>\n

www.arcadiamedical.ro<\/span><\/a><\/p>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Dr. C\u0103t\u0103linConstandache, medic primarUrologie, Arcadia Litiazarenal\u0103 (pietrele la rinichi)este o afec\u021biune des \u00eent\u00e2lnit\u0103, care afecteaz\u0103via\u021bacotidian\u0103\u0219i care poate fi sursaunorcomplica\u021biimedicaleimportante. Ureteroscopiaretrograd\u0103flexibil\u0103este o metod\u0103 de tratament minim invaziv, care prezint\u0103numeroaseavantajepentrupacient\u0219i care se realizeaz\u0103 cu succes\u00eenSpitalul Arcadia. Ce esteureteroscopia\u0219i care esteimportan\u021baacesteimetodeatuncic\u00e2ndvorbimdesprelitiaz\u0103renal\u0103? Ureteroscopiaeste o metod\u0103 minim invaziv\u0103 de endoscopie a tractuluiurinar\u00eenaltcecuprindeinvestigareaureterului\u0219i a c\u0103ilorurinare\u00eenalte. Practic, se p\u0103trunde, cu ajutorulunui instrument, […]<\/p>\n","protected":false},"author":1,"featured_media":1065436,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[89],"tags":[174],"class_list":["post-1065435","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-romania","tag-suceavanews-ro"],"_links":{"self":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts\/1065435","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1065435"}],"version-history":[{"count":0,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts\/1065435\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/media\/1065436"}],"wp:attachment":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1065435"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1065435"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1065435"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}