528 research outputs found

    TREATMENT OF INVASIVE BLADDER CANCER IN PATIENT AFTER RENAL TRANSPLANTATION

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    There are case report and literature review of the treatment recurrent bladder cancer after kidney transplantation. Radical cystectomy and Bricker ileal conduit was performed. Detailed operative technique is described. Radical cystectomy is an effective curative treatment for recurrent disease. Bricker ileal conduit is safe and feasible in renal transplant patients

    РСцСнзия Π½Π° ΡΡ‚Π°Ρ‚ΡŒΡŽ Β«Π’Π°ΠΊΡ‚ΠΈΠΊΠ° лСчСния Ρ€Π°ΠΊΠ° ΠΌΠΎΠ»ΠΎΡ‡Π½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ‹ Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΊΠΈ с ΠΏΠΎΡ‡Π΅Ρ‡Π½Ρ‹ΠΌ трансплантатом»

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    ΠŸΡ€Π΅Π΄ΡΡ‚Π°Π²Π»Π΅Π½Π½ΠΎΠ΅ Π² ΡΡ‚Π°Ρ‚ΡŒΠ΅ наблюдСниС прСдставляСт большой интСрСс с Ρ‚ΠΎΡ‡ΠΊΠΈ зрСния подтвСрТдСния ΠΎΠ±Ρ‰ΠΈΡ… закономСрностСй ΠΈ Π²Ρ‹Ρ€Π°Π±ΠΎΡ‚ΠΊΠΈ ΠΊΠΎΠ½ΠΊΡ€Π΅Ρ‚Π½Ρ‹Ρ… Ρ€Π΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°Ρ†ΠΈΠΉ ΠΏΠΎ Π»Π΅Ρ‡Π΅Π½ΠΈΡŽ Ρ€Π°ΠΊΠ° ΠΌΠΎΠ»ΠΎΡ‡Π½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ‹ Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² послС трансплантации ΠΎΡ€Π³Π°Π½ΠΎΠ². ΠŸΡ€Π΅Π΄ΡΡ‚Π°Π²Π»Π΅Π½Π½ΠΎΠ΅ наблюдСниС Ρ‚Π°ΠΊΠΆΠ΅ ΠΏΠΎΠ΄Ρ‚Π²Π΅Ρ€ΠΆΠ΄Π°Π΅Ρ‚ Π΄Π°Π½Π½Ρ‹Π΅ Π½Π΅ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Ρ… исслСдований, ΡΠ²ΠΈΠ΄Π΅Ρ‚Π΅Π»ΡŒΡΡ‚Π²ΡƒΡŽΡ‰ΠΈΡ… ΠΎ ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΠΈ риска развития онкологичСских Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ Π΄Π°ΠΆΠ΅ Ρ‡Π΅Ρ€Π΅Π· ΠΌΠ½ΠΎΠ³ΠΎ Π»Π΅Ρ‚ послС примСнСния ΠΏΠΎΠ»ΠΈ- ΠΈΠ»ΠΈ ΠΌΠΎΠ½ΠΎΠΊΠ»ΠΎΠ½Π°Π»ΡŒΠ½Ρ‹Ρ… Π°Π½Ρ‚ΠΈΡ‚Π΅Π» ΠΊΠ°ΠΊ для ΠΈΠ½Π΄ΡƒΠΊΡ†ΠΈΠΈ иммуносупрСссии, Ρ‚Π°ΠΊ ΠΈ для лСчСния острого отторТСния (ΠΊΠ°ΠΊ Π² случаС, ΠΏΡ€ΠΈΠ²Π΅Π΄Π΅Π½Π½ΠΎΠΌ Π² ΡΡ‚Π°Ρ‚ΡŒΠ΅)

    РСцСнзия Π½Π° ΡΡ‚Π°Ρ‚ΡŒΡŽ Β«Π‘Ρ€Π°Π²Π½ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹ΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΈΠ½Ρ‚Ρ€Π°- ΠΈ послСопСрационных ослоТнСний рСтропСритонСоскопичСской ΠΈ лапароскопичСской нСфрэктомии ΠΏΡ€ΠΈ опухолях Π±ΠΎΠ»ΡŒΡˆΠΈΡ… Ρ€Π°Π·ΠΌΠ΅Ρ€ΠΎΠ²Β»

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    .Π‘Ρ‚Π°Ρ‚ΡŒΡ прСдставляСт ΠΎΡΠΎΠ±ΡƒΡŽ Ρ†Π΅Π½Π½ΠΎΡΡ‚ΡŒ хотя Π±Ρ‹ ΠΏΠΎΡ‚ΠΎΠΌΡƒ, Ρ‡Ρ‚ΠΎ Π΅Π΅ ΠΏΠ΅Ρ€Π²Ρ‹ΠΉ Π°Π²Ρ‚ΠΎΡ€ Π—ΠΈΠ΅Ρ€Π°Ρ‚ΡˆΠΎ АбдуллоСвич ΠšΠ°Π΄Ρ‹Ρ€ΠΎΠ² являСтся ΠΎΠ΄Π½ΠΈΠΌ ΠΈΠ· ΠΏΠΈΠΎΠ½Π΅Ρ€ΠΎΠ² рСтропСритонСоскопичСского доступа Π² отСчСствСнной ΡƒΡ€ΠΎΠ»ΠΎΠ³ΠΈΠΈ.Β  Π Π°Π±ΠΎΡ‚Π° содСрТит, Π² Ρ‚ΠΎΠΌ числС Π½Π΅ ΠΎΡ‡Π΅Π½ΡŒ ΡˆΠΈΡ€ΠΎΠΊΠΈΠΉ, Π½ΠΎ Π΅ΠΌΠΊΠΈΠΉ ΠΎΠ±Π·ΠΎΡ€ Π»ΠΈΡ‚Π΅Ρ€Π°Ρ‚ΡƒΡ€Ρ‹, Π²ΠΏΠΎΠ»Π½Π΅ достаточный для освСщСния ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΡ‹ с ΡƒΡ‡Π΅Ρ‚ΠΎΠΌ Π½Π΅ слишком ΡˆΠΈΡ€ΠΎΠΊΠΎΠ³ΠΎ распространСния Ρ€Π΅Ρ‚Ρ€ΠΎΠΏΠ΅Ρ€ΠΈΡ‚ΠΎΠ½Π΅Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ доступа Π² Π•Π²Ρ€ΠΎΠΏΠ΅

    LAPAROSCOPIC RECONSTRUCTION OF THE URINARY TRACT IN PATIENTS WITH URETERAL STRICTURE AFTER KIDNEY TRANSPLANTATION

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    Aim. Ureteral obstruction secondary to ischemia is the most common urologic complication of kidney trans- plantation. Pyeloureteral anastomosis with recipient ureter has shown most satisfactory long-term results in its management. Existing urinary infection and immunosupression determine the high risk of wound complications. We have experience more than 50 reconstructive procedures of urinary tract after kidney transplantation by open surgery during 25 years. Till last time this procedure has been performed through open surgery. Method. We used pyeloureteral anastomosis with recipient ureter in two patients with ureteral stricture after kidney transplantation by laparoscopic approach. The operations lasted 215 and 275 min respectively. In both cases the surgery was per- formed after percutaneous nephrostomy because of deterioration of transplanted kidney function. Internal stent was indwelled laparoscopicaly. No drain tube was left. Results. The nephrostomy tubes were removed after 10 and 7 days respectively. The stents were removed after 27 and 20 days respectively. No complications were seen during the surgery and postoperative period. Now serum creatinine level is 0.12 mmol/l and 0.15 mmol/l after 15 and 12 months after surgery respectively. Conclusion. In spite of some difficulties related with topographic land- marks and severe tissues fibrosis after transplantation laparoscopic pyeloureterostomy in transplanted kidney is safe and feasible procedure. The main advantage is absence of risk of most serious complications related with wound infection in immune compromised patients. Moreover, early recovery to usual activity and diet facilita- tes to prevent pulmonary infections and to normalize intestinal absorbability of the immunosuppressive drugs
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