73 research outputs found
APPLICATION OF COLLAGEN MATRIX β AN INNOVATION IN SURGERY OF POSTRADIATION VESICO-VAGINAL FISTULAS
Purpose: to estimate an influence of the collagen biopolymer (Β«collostΒ») to tissues of a living organism in experimental study.Materials and methods: laboratory rats divided in two comparable experimental groups were underwent to implantation of collost plate thickness of 1.5 mm and 4 mm (the third group was control). Proliferative and secretory activity of fibroblasts were studied at 10 day, 3 and 6 months of postimplantation period by immuno-histochemical method. Process of neovascularization in the area of implantation using a quantitative method of calculating the length of capillaries per unit volume of the granulation tissue, including on a background of artificial immune were studied also.Results: better proliferative and secretory activity of fibroblasts and angiogenesis activity were revealed in the group of implanted 4 mm-collagen plates.Summary: the experimental results allow the use of the collagen plate in the surgical treatment of postradiation urogenital fistulas
Potential algebra approach to position dependent mass Schroedinger equation
It is shown that for a class of position dependent mass Schroedinger equation
the shape invariance condition is equivalent to a potential symmetry algebra.
Explicit realization of such algebras have been obtained for some shape
invariant potentials
ΠΠ΅ΡΡΠΎΠ½ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΡΠΉ ΠΏΠΎΠ΄Ρ ΠΎΠ΄ ΠΊ Ρ ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌΡ Π»Π΅ΡΠ΅Π½ΠΈΡ Π΄ΠΎΠ±ΡΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΠΈ ΠΏΡΠ΅Π΄ΡΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π±ΠΈΠΏΠΎΠ»ΡΡΠ½ΠΎΠΉ ΡΡΠ°Π½ΡΡΡΠ΅ΡΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ΅Π·Π΅ΠΊΡΠΈΠΈ ΠΏΡΠΎΡΡΠ°ΡΡ
Β Β Aim:Β to improve the outcomes of surgical treatment of benign prostatic hyperplasia by bipolar transurethral prostatic resection based on the personalized approach.Β Β Materials and methods.Β Surgical treatment of prostatic hyperplasia by bipolar transurethral resection of the prostate was carried out in 50 patients: the personalized approach, that is extensive preoperative preparation, was adopted in 25 cases, and the standard procedure was implemented in the rest 25 cases. Functional outcomes were assessed in 1, 3 and 6 months aft er surgery, taking into account intra- and postoperative complications.Β Β Results and discussion.Β The use of the personalized approach resulted in the reduction in the duration of surgery (p = 0.019), amount of blood loss (p = 0.027), incidence of hyperthermia in the early postoperative period (p = 0.021), duration of bladder catheterization (p = 0.030) and the duration of hospital stay (p = 0.031). The personalized approach was proved to have a positive eff ect on the functional outcome of bipolar transurethral resection of the prostate: Qmax value in 1, 3 and 6 months (p = 0.037, p = 0.030, p = 0.036), IPSS score in 6 months (p = 0.037), QOL score in 1 and 3 months (p = 0.041, p = 0.030) and residual urine volume in 3 and 6 months (p = 0.035, p = 0.040).Β Β Conclusions.Β Th e personalized approach contributes to improving the functional outcomes of bipolar transurethral resection of the prostate, namely, improving the Qmax value in 1, 3 and 6 months, reducing the IPSS score in 6 months and the QOL score in 1 and 3 months, and decreasing the residual urine volume in 3 and 6 months.Β Β Π¦Π΅Π»Ρ. Π£Π»ΡΡΡΠ΅Π½ΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π΄ΠΎΠ±ΡΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΠΈ ΠΏΡΠ΅Π΄ΡΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π±ΠΈΠΏΠΎΠ»ΡΡΠ½ΠΎΠΉ ΡΡΠ°Π½ΡΡΡΠ΅ΡΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ΅Π·Π΅ΠΊΡΠΈΠΈ ΠΏΡΠΎΡΡΠ°ΡΡ Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ ΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π°.Β Β ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. 50 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΎ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π³ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΠΈ ΠΏΡΠΎΡΡΠ°ΡΡ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π±ΠΈΠΏΠΎΠ»ΡΡΠ½ΠΎΠΉ ΡΡΠ°Π½ΡΡΡΠ΅ΡΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ΅Π·Π΅ΠΊΡΠΈΠΈ ΠΏΡΠΎΡΡΠ°ΡΡ, ΠΈΠ· Π½ΠΈΡ
25 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π°, ΠΏΠΎΠ΄ΡΠ°Π·ΡΠΌΠ΅Π²Π°ΡΡΠ΅Π³ΠΎ ΡΠ°ΡΡΠΈΡΠ΅Π½Π½ΡΡ ΠΏΡΠ΅Π΄ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ ΠΏΠΎΠ΄Π³ΠΎΡΠΎΠ²ΠΊΡ ΠΈ 25 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ β ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΡ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΡΠΉ ΠΎΠ±ΡΠ΅ΠΌ. Π€ΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΠΈΡΡ ΡΠΏΡΡΡΡ 1, 3 ΠΈ 6 ΠΌΠ΅ΡΡΡΠ΅Π² ΠΏΠΎΡΠ»Π΅ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΡΠΈΡΡΠ²Π°Π»ΠΈΡΡ ΠΈΠ½ΡΡΠ°- ΠΈ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΠ΅ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡ.Β Β Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈ ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅. ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π° ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»ΠΎ ΡΠ½ΠΈΠ·ΠΈΡΡ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ (Ρ = 0,019), Π²Π΅Π»ΠΈΡΠΈΠ½Ρ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ (Ρ = 0,027), ΡΠ°ΡΡΠΎΡΡ Π³ΠΈΠΏΠ΅ΡΡΠ΅ΡΠΌΠΈΠΈ Π² ΡΠ°Π½Π½Π΅ΠΌ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ (Ρ = 0,021), Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΊΠ°ΡΠ΅ΡΠ΅ΡΠΈΠ·Π°ΡΠΈΠΈ ΠΌΠΎΡΠ΅Π²ΠΎΠ³ΠΎ ΠΏΡΠ·ΡΡΡ (Ρ = 0,030) ΠΈ ΡΠΎΠΊΡΠ°ΡΠΈΡΡ ΡΠΈΡΠ»ΠΎ Π΄Π½Π΅ΠΉ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ (Ρ = 0,031). ΠΡΠΌΠ΅ΡΠ΅Π½ΠΎ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ Π²Π»ΠΈΡΠ½ΠΈΠ΅ ΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π° Π½Π° ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π±ΠΈΠΏΠΎΠ»ΡΡΠ½ΠΎΠΉ ΡΡΠ°Π½ΡΡΡΠ΅ΡΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ΅Π·Π΅ΠΊΡΠΈΠΈ ΠΏΡΠΎΡΡΠ°ΡΡ: Π½Π° Π²Π΅Π»ΠΈΡΠΈΠ½Ρ Qmax ΡΠ΅ΡΠ΅Π· 1, 3 ΠΈ 6 ΠΌΠ΅ΡΡΡΠ΅Π² (Ρ = 0,037, Ρ = 0,030, Ρ = 0,036), ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ Π±Π°Π»Π»ΠΎΠ² IPSS ΡΠ΅ΡΠ΅Π· 6 ΠΌΠ΅ΡΡΡΠ΅Π² (Ρ = 0,037) ΠΈ QoL ΡΠ΅ΡΠ΅Π· 1 ΠΈ 3 ΠΌΠ΅ΡΡΡΠ° (Ρ = 0,041, Ρ = 0,030) ΠΈ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΠΉ ΠΌΠΎΡΠΈ ΡΠ΅ΡΠ΅Π· 3 ΠΈ 6 ΠΌΠ΅ΡΡΡΠ΅Π² (Ρ = 0,035, Ρ = 0,040).Β Β ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ΅ΡΡΠΎΠ½ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΡΠΉ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΡΠ»ΡΡΡΠΈΡΡ ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π±ΠΈΠΏΠΎΠ»ΡΡΠ½ΠΎΠΉ ΡΡΠ°Π½ΡΡΡΠ΅ΡΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ΅Π·Π΅ΠΊΡΠΈΠΈ ΠΏΡΠΎΡΡΠ°ΡΡ, Π° ΠΈΠΌΠ΅Π½Π½ΠΎ: ΡΠ»ΡΡΡΠΈΡΡ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ Qmax ΡΠ΅ΡΠ΅Π· 1, 3 ΠΈ 6 ΠΌΠ΅ΡΡΡΠ΅Π² ΠΈ ΡΠ½ΠΈΠ·ΠΈΡΡ Π²Π΅Π»ΠΈΡΠΈΠ½Ρ Π±Π°Π»Π»ΠΎΠ² ΡΠΊΠ°Π»Ρ IPSS ΡΠ΅ΡΠ΅Π· 6 ΠΌΠ΅ΡΡΡΠ΅Π², ΡΠΊΠ°Π»Ρ QoL β ΡΠ΅ΡΠ΅Π· 1 ΠΈ 3 ΠΌΠ΅ΡΡΡΠ° ΠΈ ΡΠ½ΠΈΠ·ΠΈΡΡ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΠΉ ΠΌΠΎΡΠΈ ΡΠ΅ΡΠ΅Π· 3 ΠΈ 6 ΠΌΠ΅ΡΡΡΠ΅Π²
A generalized quantum nonlinear oscillator
We examine various generalizations, e.g. exactly solvable, quasi-exactly
solvable and non-Hermitian variants, of a quantum nonlinear oscillator. For all
these cases, the same mass function has been used and it has also been shown
that the new exactly solvable potentials possess shape invariance symmetry. The
solutions are obtained in terms of classical orthogonal polynomials
Possibilities and features of zero-ischemia nephron-sparing surgery in localized kidney cancer
Kidney cancer (KCa) is one of the greatest challenges in oncological urology due to the increase in morbidity and mortality rates annually. In the treatment of KCa, preservation of renal function is an important objective, in addition to achieving oncological results. The article presents the experience of treatment of 175 KCa-patients of pT1a β T2aN0M0 stages, who underwent nephron-saving surgery (NSS) with preventive hemostatic sutures. Functional outcomes of NSS were studied in the groups without cross-linking (group 1; n = 150) and with cross-linking of the renal pedicle (group 2; n = 25). Kidney resection with prophylactic suturing has been shown to allow removal of a tumour of almost any localisation. By avoiding cross-linking of the renal pedicle during surgery, post-ischemic changes in the renal parenchyma are minimised. Thus, one month after surgery, the perfusion indexes in groups 1 & 2 were 45.2 Β± 3.0% vs 35.5 Β± 3.3%; renal indexes were 44.8 Β± 2.4% vs 39.1 Β± 1.4%; areas of the functioning parenchyma were 52.0 Β± 10.0% vs 35.0 Β± 9.0%, respectively
Π€ΠΠΠ’ΠΠ Π« ΠΠ ΠΠΠΠΠΠ ΠΠ«ΠΠΠΠΠΠΠΠ‘Π’Π ΠΠ Π Π ΠΠΠ ΠΠΠ§ΠΠ
The purpose of the study was to reveal the independent anatomic, histological, and clinical factors of cancer-specific survival in patients with renal-cell carcinoma (RCC). For this, the authors retrospectively analyzed their experience with radical surgical treatments in 73 RCC patients operated on at the Department of Urology and Surgical Andrology, Russian Medical Academy of Postgraduate Education, from January 1, 1999 to December 31, 2004; their outcomes have become known by the present time. There was a statistically significant correlation of cancer-specific survival with its parameters, such as pathological stage of a tumor, its maximum pathological size, differentiation grade, involvement of regional lymph nodes, venous tumor thrombosis, level of thrombocytosis, and degree of the clinical symptoms of the disease. Multivariate analysis of survival in RCC in relation to the prognostic factors could reveal odd ratios for the limit values of significant prognostic factors. The statistically significant prognostic values established in the present study, as well as the molecular factors the implication of which is being now investigated can become in future an effective addition to the TNM staging system to define indications for certain treatments and to predict survival in RCC Β Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡβ Π²ΡΡΠ²Π»Π΅Π½ΠΈΠ΅ Π½Π΅Π·Π°Π²ΠΈΡΠΈΠΌΡΡ
Π°Π½Π°ΡΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
, Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΠΏΡΠΎΠ³Π½ΠΎΠ·Π° ΡΠ°ΠΊΠΎΠ²ΠΎ-ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
ΡΠ°ΠΊΠΎΠΌ ΠΏΠΎΡΠΊΠΈ (Π Π). ΠΠ»Ρ ΡΡΠΎΠ³ΠΎ ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎ ΠΏΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½ ΠΎΠΏΡΡ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ 73 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π Π, ΠΎΠΏΠ΅ΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π½Π° Π±Π°Π·Π΅ ΠΊΠ°ΡΠ΅Π΄ΡΡ ΡΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π°Π½Π΄ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ Π ΠΠΠΠ Π² ΠΏΠ΅ΡΠΈΠΎΠ΄ Ρ 01.01.1999 Π³. ΠΏΠΎ 31.12.2004 Π³. c ΠΈΠ·Π²Π΅ΡΡΠ½ΡΠΌ ΠΊ Π½Π°ΡΡΠΎΡΡΠ΅ΠΌΡ ΠΌΠΎΠΌΠ΅Π½ΡΡ ΠΈΡΡ
ΠΎΠ΄ΠΎΠΌ. Π‘ΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠ°Ρ ΠΊΠΎΡΡΠ΅Π»ΡΡΠΈΠΎΠ½Π½Π°Ρ ΡΠ²ΡΠ·Ρ ΡΠ°ΠΊΠΎΠ²ΠΎ-ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
Π Π Π²ΡΡΠ²Π»Π΅Π½Π° Ρ ΡΠ°ΠΊΠΈΠΌΠΈ Π΅Π΅ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠ°ΠΌΠΈ, ΠΊΠ°ΠΊ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΡΠ°Π΄ΠΈΡ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ, ΠΌΠ°ΠΊΡΠΈΠΌΠ°Π»ΡΠ½ΡΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ Π΅Π΅ ΡΠ°Π·ΠΌΠ΅Ρ, ΡΡΠ΅ΠΏΠ΅Π½Ρ Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΡΠΎΠ²ΠΊΠΈ, ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ ΡΠ΅Π³ΠΈΠΎΠ½Π°ΡΠ½ΡΡ
Π»ΠΈΠΌΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ·Π»ΠΎΠ², Π²Π΅Π½ΠΎΠ·Π½ΡΠΉ ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΠΉ ΡΡΠΎΠΌΠ±ΠΎΠ·, ΡΡΠΎΠ²Π΅Π½Ρ ΡΡΠΎΠΌΠ±ΠΎΡΠΈΡΠΎΠ·Π°, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠΎ ΡΡΠ΅ΠΏΠ΅Π½ΡΡ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΡΠΈΠΊΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ. ΠΠ½ΠΎΠ³ΠΎΡΠ°ΠΊΡΠΎΡΠ½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΏΡΠΈ Π Π Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΠΏΡΠΎΠ³Π½ΠΎΠ·Π° ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ» Π²ΡΡΠ²ΠΈΡΡ ΡΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠ΅ ΡΠΈΡΠΊΠΎΠ² Π΄Π»Ρ ΠΏΡΠ΅Π΄Π΅Π»ΡΠ½ΡΡ
Π²Π΅Π»ΠΈΡΠΈΠ½ Π·Π½Π°ΡΠΈΠΌΡΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΠΏΡΠΎΠ³Π½ΠΎΠ·Π°. Π£ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½Π½ΡΠ΅ Π² Π½Π°ΡΡΠΎΡΡΠ΅ΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΡΠ΅ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΡ ΠΏΡΠΎΠ³Π½ΠΎΠ·Π°, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠ΅ ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΡΠ΅ ΡΠ°ΠΊΡΠΎΡΡ, Π·Π½Π°ΡΠΈΠΌΠΎΡΡΡ ΠΊΠΎΡΠΎΡΡΡ
Π² Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΡΡΡ, Π² Π±ΡΠ΄ΡΡΠ΅ΠΌ ΠΌΠΎΠ³ΡΡ ΡΡΠ°ΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ Π΄ΠΎΠΏΠΎΠ»Π½Π΅Π½ΠΈΠ΅ΠΌ ΡΠΈΡΡΠ΅ΠΌΠ΅ ΡΡΠ°Π΄ΠΈΡΠΎΠ²Π°Π½ΠΈΡ TNM Π² ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠΈ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΠΉ ΠΊ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄Π°ΠΌ Π»Π΅ΡΠ΅Π½ΠΈΡ, Π° ΡΠ°ΠΊΠΆΠ΅ Π² ΠΏΡΠ΅Π΄ΡΠΊΠ°Π·Π°Π½ΠΈΠΈ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ².
Π£Π»ΡΡΡΠ΅Π½ΠΈΠ΅ Π±Π΅Π·ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π½ΠΎΠΉ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΏΠΎΡΠ»Π΅ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΡΠΎΡΡΠ°ΡΡΠΊΡΠΎΠΌΠΈΠΈ ΠΏΡΠΈ ΠΌΠ΅ΡΡΠ½ΠΎ-ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΠΌ ΡΠ°ΠΊΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΡΡΠΎΠΊΠ° ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π°
Objective: to comparatively estimate the frequency of a positive surgical margin and 5-year biochemical recurrent-free survival (BRFS) rates in patients with locally advanced prostate cancer in relation to the time of radical retropubic prostatectomy.Subjects and methods. The investigation enrolled 274 patients with prostate cancer (pT3-4N0-1M0) who were divided into 2 groups of 68 and 20 patients operated on in 1997 to 2006 and 2007 to 2012, respectively. Two surgeons made surgical interventions by the standardized procedure. The 5-year BRFS rates were estimated using the Kaplan-Meier method and log-rank test. A biochemical recurrence was defined as a prostatespecific antigen level of t 0.2 ng / ml in 2 consecutive measurements or as the initiation of adjuvant therapy.Results. The detection rate of a positive surgical margin decreased from 55.9 % in 1997β2006 to 37.9 % in 2007β2012 (p = 0.01); the 5-year recurrence-free survival rates were 38.8 % versus 66.2 % (p < 0.001).Conclusion. These changes would probably be a result of surgeonsΒ» better experience and improved surgical techniques in the course of time.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½Π°Ρ ΠΎΡΠ΅Π½ΠΊΠ° ΡΠ°ΡΡΠΎΡΡ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΊΡΠ°Ρ ΠΈ 5-Π»Π΅ΡΠ½Π΅ΠΉ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ Π±Π΅Π· Π±ΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π° Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΌΠ΅ΡΡΠ½ΠΎ-ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ ΠΏΡΠ΅Π΄ΡΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ Π²ΡΠ΅ΠΌΠ΅Π½ΠΈ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ ΠΏΠΎΠ·Π°Π΄ΠΈΠ»ΠΎΠ½Π½ΠΎΠΉ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΡΠΎΡΡΠ°ΡΡΠΊΡΠΎΠΌΠΈΠΈ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ 274 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° (pT3β4N0β1M0), ΠΊΠΎΡΠΎΡΡΠ΅ Π±ΡΠ»ΠΈ ΡΠ°Π·Π΄Π΅Π»Π΅Π½Ρ Π½Π° 2 Π³ΡΡΠΏΠΏΡ: 68 Π±ΠΎΠ»ΡΠ½ΡΡ
, ΠΎΠΏΠ΅ΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π² ΠΏΠ΅ΡΠΈΠΎΠ΄ Ρ 1997 ΠΏΠΎ 2006 Π³., ΠΈ 206 β Π² ΠΏΠ΅ΡΠΈΠΎΠ΄ Ρ 2007 ΠΏΠΎ 2012 Π³. ΠΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΡΠ΅ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π° Π²ΡΠΏΠΎΠ»Π½ΡΠ»ΠΈΡΡ Π΄Π²ΡΠΌΡ Ρ
ΠΈΡΡΡΠ³Π°ΠΌΠΈ ΠΏΠΎ ΡΡΠ°Π½Π΄Π°ΡΡΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ΅. ΠΡΡΠΈΠ»Π΅ΡΠ½ΡΡ Π±Π΅Π·ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π½ΡΡ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΠΈ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΌΠ΅ΡΠΎΠ΄Π° ΠΠ°ΠΏΠ»Π°Π½Π°βΠΠ°ΠΉΠ΅ΡΠ° ΠΈ log-rank-ΡΠ΅ΡΡΠ°. ΠΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ΅ΡΠΈΠ΄ΠΈΠ² ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΠΈ ΠΊΠ°ΠΊ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ ΡΡΠΎΠ²Π½Ρ ΠΏΡΠΎΡΡΠ°ΡΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π½ΡΠΈΠ³Π΅Π½Π° t 0,2 Π½Π³ / ΠΌΠ» Π² 2 ΠΏΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΈΠ·ΠΌΠ΅ΡΠ΅Π½ΠΈΡΡ
ΠΈΠ»ΠΈ ΠΊΠ°ΠΊ Π½Π°ΡΠ°Π»ΠΎ Π°Π΄ΡΡΠ²Π°Π½ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π§Π°ΡΡΠΎΡΠ° ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΊΡΠ°Ρ ΡΠ½ΠΈΠ·ΠΈΠ»Π°ΡΡ Ρ 55,9 % Π² 1997β2006 Π³Π³. Π΄ΠΎ 37,9 % Π² 2007β 2012 Π³Π³. (p = 0,01); Π±Π΅Π·ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π½Π°Ρ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ ΡΠ΅ΡΠ΅Π· 5 Π»Π΅Ρ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 38,8 % ΠΏΡΠΎΡΠΈΠ² 66,2 % (p < 0,001).ΠΡΠ²ΠΎΠ΄Ρ. ΠΠ°Π½Π½ΡΠ΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ, Π²Π΅ΡΠΎΡΡΠ½ΠΎ, ΠΌΠΎΠ³ΡΡ ΡΠ²Π»ΡΡΡΡΡ ΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠ΅ΠΌ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΠΎΠΏΡΡΠ° Ρ
ΠΈΡΡΡΠ³ΠΎΠ² ΠΈ ΡΡΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°Π½ΠΈΡ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅Ρ
Π½ΠΈΠΊΠΈ Ρ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ Π²ΡΠ΅ΠΌΠ΅Π½
- β¦