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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">kaspmed</journal-id><journal-title-group><journal-title xml:lang="ru">Прикаспийский вестник медицины и фармации</journal-title><trans-title-group xml:lang="en"><trans-title>Title</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2712-8164</issn><publisher><publisher-name>ФГБОУ ВО Астраханский ГМУ Минздрава России</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17021/2712-8164-2026-1-15-26</article-id><article-id custom-type="elpub" pub-id-type="custom">kaspmed-129</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL INVESTIGATIONS</subject></subj-group></article-categories><title-group><article-title>Безнефростомная перкутанная нефролитотрипсия в хирургическом лечении мочекаменной болезни</article-title><trans-title-group xml:lang="en"><trans-title>Nephrostomy-Free Percutaneous Nephrolithotripsy in the Surgical Treatment of Urolithiasis</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4324-4139</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Асфандияров</surname><given-names>Ф. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Asfandiyarov</surname><given-names>F. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Фаик Растямович Асфандияров, доктор медицинских наук, профессор, заведующий кафедрой урологии</p><p>Астрахань</p></bio><bio xml:lang="en"><p>Faik R. Asfandiyarov, Dr. Sci. (Med.), Professor, Head of the Department</p><p>Astrakhan</p></bio><email xlink:type="simple">drfa@rambler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1451-008X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Круглов</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kruglov</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владимир Александрович Круглов, кандидат медицинских наук, доцент кафедры урологии</p><p>Астрахань</p></bio><bio xml:lang="en"><p>Vladimir A. Kruglov, Associate Professor of the Department</p><p>Astrakhan</p></bio><email xlink:type="simple">astradoc@rambier.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ляшенко</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Lyashenko</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владимир Владимирович Ляшенко, кандидат медицинских наук, заведующий урологическим отделением</p><p>Астрахань</p></bio><bio xml:lang="en"><p>Vladimir V. Lyashenko, Cand. Sci. (Med.), Head of the Department</p><p>Astrakhan</p></bio><email xlink:type="simple">guzamokb@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3799-9543</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сеидов</surname><given-names>С.-К. С.-С.</given-names></name><name name-style="western" xml:lang="en"><surname>Seidov</surname><given-names>S.-K. S.-S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сеид-Кафлан Сеид-Султанович Сеидов, кандидат медицинских наук, доцент кафедры урологии</p><p>Астрахань</p></bio><bio xml:lang="en"><p>Seid-Kaflan S.-S. Seidov, Cand. Sci. (Med.), Associate Professor of the Department</p><p>Astrakhan</p></bio><email xlink:type="simple">kaflanseidov@ramler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Соколова</surname><given-names>Е. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Sokolova</surname><given-names>E. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Екатерина Николаевна Соколова, врач-уролог урологического отделения; старший лаборант кафедры урологии</p><p>Астрахань</p></bio><bio xml:lang="en"><p>Ekaterina N. Sokolova, Urologist; Senior Laboratory Assistant</p><p>Astrakhan</p></bio><email xlink:type="simple">sokolkato@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Астраханский государственный медицинский университет<country>Россия</country></aff><aff xml:lang="en">Astrakhan State Medical University<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">Александро-Мариинская областная клиническая больница<country>Россия</country></aff><aff xml:lang="en">Alexandro-Mariinsky Regional Clinical Hospital<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru">Астраханский государственный медицинский университет; Клиническая больница «РЖД-Медицина»<country>Россия</country></aff><aff xml:lang="en">Astrakhan State Medical University; Clinical Hospital “RZhD-Medicine”<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>15</day><month>04</month><year>2026</year></pub-date><volume>7</volume><issue>1</issue><fpage>15</fpage><lpage>26</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Асфандияров Ф.Р., Круглов В.А., Ляшенко В.В., Сеидов С.С., Соколова Е.Н., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Асфандияров Ф.Р., Круглов В.А., Ляшенко В.В., Сеидов С.С., Соколова Е.Н.</copyright-holder><copyright-holder xml:lang="en">Asfandiyarov F.R., Kruglov V.A., Lyashenko V.V., Seidov S.S., Sokolova E.N.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.kaspmed.ru/jour/article/view/129">https://www.kaspmed.ru/jour/article/view/129</self-uri><abstract><p>Мочекаменная болезнь – наиболее частая урологическая патология, требующая хирургического лечения. Тенденцией многих десятилетий является отказ от открытого оперирования пациентов с мочекаменной болезнью, поиск и совершенствование наиболее эффективных, безопасных и минимально травматичных методов лечения, позволяющих повысить качество жизни пациентов, сократить сроки лечения и реабилитации. Одним из таковых является перкутанная нефролитотрипсия, выполняемая инструментами малого диаметра без финального наружного дренирования верхних мочевых путей. Ключевым моментом в эффективной и безопасной реализации подобного подхода является надежный гемостаз. В настоящее время единого консенсуса в отношении методов интраоперационного гемостаза перкутанного тракта нет. Цель: оценить безопасность и эффективность использования гемостатического матрикса в перкутанной хирургии мочекаменной болезни. Материалы и методы: в исследование были включены 52 пациента, которым была произведена миниперкутанная нефролитотррипсия в урологическом отделении Александро-Мариинской областной клинической больницы г. Астрахань. Всем пациентам в качестве завершающего этапа оперативного пособия выполнялось заполнение перкутанного тракта гемостатическим материксом отечественного производства без установи нефростомического дренажа. Результаты: послеоперационный период у пациентов, оперированных по описанной методике, характеризуется малой потребностью в назначении анальгетиков, статистически незначимым снижением показателей красной крови, отсутствием признаков экстравазации мочи и формирования паранефральных/забрюшинных урогематом. Заключение: наш опыт применения безнефростомного способа выполнения миниперкутанной нефролитотрипсии свидетельствует о его высокой эффективности и существенном улучшении качества жизни пациентов в ближайшем послеоперационном периоде, в том числе за счет отсутствия нефростомического дренажа. Введение гемостатических агентов в нефростомический тракт является фактором, который способствует его герметизации, снижает вероятность развития геморрагических осложнений и в целом повышает надежность и безопасность данной методики хирургического лечения камней почек.</p></abstract><trans-abstract xml:lang="en"><p>Urolithiasis is the most common urological pathology requiring surgical treatment. For many decades, the trend has been to abandon open surgery for patients with urolithiasis and to seek and refine the most effective, safe, and minimally invasive treatment methods to improve patients' quality of life and reduce treatment and rehabilitation time. One such method is percutaneous nephrolithotripsy, performed with small-diameter instruments without final external drainage of the upper urinary tract. Reliable hemostasis is key to the effective and safe implementation of this approach. Currently, there is no consensus regarding methods for intraoperative hemostasis of the percutaneous tract. This study presents our positive experience using a hemostatic matrix at the final stage of minipercutaneous nephrolithotripsy. Target: to evaluate the safety and efficacy of using hemostatic matrix in percutaneous surgery for urolithiasis. Materials and methods: the study included 52 patients who underwent minipercutaneous nephrolithotripsy in the urology department of the Alexandro-Mariinsky Regional Clinical Hospital in Astrakhan. As a final step in the surgical procedure, all patients underwent percutaneous tract filling with a domestically produced hemostatic matrices without the need for a nephrostomy drain. Results: the postoperative period in patients operated on using the described technique is characterized by a low need for analgesics, a statistically insignificant decrease in red blood counts, the absence of signs of urine extravasation and the formation of paranephric/retroperitoneal urohematomas. Conclusion: our experience with the nephrostomy-free minipercutaneous nephrolithotripsy method demonstrates its high efficacy and significant improvement in patients' quality of life in the immediate postoperative period, in part due to the elimination of nephrostomy drainage. The introduction of hemostatic agents into the nephrostomy tract facilitates its sealing, reduces the risk of hemorrhagic complications, and overall improves the reliability and safety of this surgical technique for kidney stone treatment.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>мочекаменная болезнь</kwd><kwd>безнефростомная перкутанная нефролитотрипсия</kwd><kwd>кровотечение</kwd></kwd-group><kwd-group xml:lang="en"><kwd>urolithiasis</kwd><kwd>non-nephrostomy percutaneous nephrolithotripsy</kwd><kwd>bleeding</kwd></kwd-group><funding-group xml:lang="ru"><funding-statement>Авторы декларируют отсутствие внешнего финансирования для проведения исследования и публикации статьи.</funding-statement></funding-group><funding-group xml:lang="en"><funding-statement>The authors declare that there is no external funding for the exploration and analysis work.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Меринов Д. 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