Optimization of treatment methods of kidneys cysts

Today a lot of approaches exist in management of symptomatic renal cysts. Was held retrospective compared study about outcomes of surgical treatment of cystic renal disease. In the theme were submitted such main problem: indications and contraindications for percutaneous aspiration of cysts with sclerotherapy, evaluation of the efficacy of minimally invasive open retroperitoneoscopy for the treatment of simple and complicated renal cysts. For the decision of this tasks the results of examination and surgical treatment 1755 patients with renal cysts were analysed, moreover, prospectively recorded parameters for the 182 cases dealt with by primary minimally invasive techniques were compared with historical controls dealt with by conventionally surgery. Open retroperitoneoscopy and laparoscopy management for all kidney cysts is a safe, effective and minimally invasive alternative to traditionally surgery for symptomatic renal cysts.В настоящее время существует множество подходов в лечении кист почек. Нами было проведено сравнительное ретроспективное исследование результатов хирургического лечения кистозных заболеваний почек. Были рассмотрены такие основные проблемы: показания и противопоказания для чрескожной аспирационной пункции кист почек со склеротерапией, оценка эффективности минимально инвазивных хирургических методов лечения простых и сложных почечных кист. Для решения этой задачи, были проанализированы результаты обследования и хирургического лечения 1755 пациентов с кистами почек, кроме того, был проведен сравнительный анализ 182 историй болезни пациентов, пролеченных с применением минимально-инвазивных методов, и историй болезни пациентов прооперированных по традиционной методике. Открытое малоинвазивное ретроперитонеоскопическое и лапароскопическое иссечение кист почек являются безопасной, высокоэффективной и минимально травматичной альтернативой традиционной хирургии при симптоматических почечных кистах

The first experience of application of High-intensity focused ultrasound (HIFU) ablation for prostate cancer

In the clinic of urology of the Sverdlovsk regional hospital № 1 organized 32 HIFU therapy. The mean operative time 120 minutes (from 40 to 180 minutes). Intraoperative complications were not. The average time of hospitalization was 7 (6 to 10) days. Postoperative hospital stay from 5 to 7 days. Within 3 months all patients decreased PSA to 0.5 ng/ml and below. In 20 patients after 6 months, there has been a constantly low level of PSA is 0.2 ng/ml to 0.5 ng/ml. Thus, the use of high-intensity focused ultrasound ablation can be successfully treated various stages of prostate cancer with minimal side effects, provides opportunities for early assessment of the effectiveness of treatment.В клинике урологии ГБОУ ВПО УГМУ на базе ГБУЗ СО 'СОКБ1 №1 проведено 32 HIFU терапии. Среднее время операции 120 минут (от 40 до 180 мин.). Интраоперационных осложнений не было. Среднее время госпитализации составило 7 (от 6 до 10) дней. Послеоперационный койко-день от 5 до7 дней. В течение 3 месяцев у всех пациентов произошло снижение PSA до 0,5 нг/мл и ниже. У 20 пациентов после 6 месяцев наблюдается стабильно низкий уровень PSA от 0,2 нг/мл до 0,5 нг/мл. Таким образом, применение высокоинтенсивной фокусированной ультразвуковой абляции позволяет успешно лечить различные стадии рака простаты, с минимальными побочными эффектами, дает возможность ранней оценки эффективности лечения

THE FIRST DOMESTIC IMPLANTABLE AXIAL FLOW PUMP: RESULTS OF EXPERIMENTAL STUDIES IN CALVES

Aim of our experimental study was evaluation of the first domestic implantable axial pump as a left ventricle assist device in calves. Materials and methods. 18 calves 90–120 days of age, weighing 95 ± 5 kg were exposed to implantation of an axial pump under the scheme «left ventricular – aorta» in paracorporeal and implantable in chest cavity versions. Two models of the pump were tested. Model 1 is a pump with cylindrical bearings and elongated straightener, model 2 had ball bearings and modified design of impeller and straightener. Results. In the first series (n = 12) the pump model 1 was tested. The duration of experiments was 4,9 ± 5,3 days, maximal duration was 16 days. The experiments were finalized due to intraoperation cardiac fibrillation (n = 3), uncrop- ped acute bleeding (n = 3), lowering of blood flow through the pump of 60 ± 15% (n = 6) because of thrombo- sis of the pump (n = 5) and outlet line (n = 1), in 3 cases of 5, combined with mechanical wear of bearings. In the second series (n = 6) the pump model 2 was tested. In 4 experiments of 6 the duration was 74,5 ± 29 days. One experiment was finalized due to intraoperation cardiac fibrillation. Another one experiment was finalized on 8 day as planned. In 5 experiments there was absence of either thrombosis or mechanical wear of bearings. Morphological and histological examination of the kidneys, liver and lungs in the 5 experiments of second series did not reveal the presence of zones of ischemia or thromboembolia. Conclusion. The results of the second series can be treaded as preclinical testing of the first domestic implantable axial pump as a left ventricle assist device in calves