ОПЫТ ЛАПАРОСКОПИЧЕСКОЙ ХИРУРГИИ ПРИ ЛЕЧЕНИИ ПОЧЕЧНО-КЛЕТОЧНОГО РАКА НА БАЗЕ РЕСПУБЛИКАНСКОГО КЛИНИЧЕСКОГО ОНКОЛОГИЧЕСКОГО ДИСПАНСЕРА

Purpose of the study. Study of the nearest results of laparoscopic operations in patients with localized renal cell carcinoma.Materials and methods. The results of treatment of 92 patients who underwent operative treatment in the period from 2015 to 2017 with the help of laparoscopic technique for kidney carcinoma were analyzed and evaluated. Of these, 57 men (62%) and 35 women (38%), the average age is 50.5 ± 2.25 years (min. 26 and not more than 75 years). Results. The duration of the operation was influenced by various factors, such as the features of the vascular anatomy of the kidneys, the presence of the adhesive process of the abdominal cavity, the state of paranephalic fat. When improving the technique of performing laparoscopic interventions, the operation time was reduced. In the period of mastering the technique of laparoscopic interventions on the kidney, the operation time averaged 210.0 ± 20.2 min (min 120 and max 300 min); subsequently it decreased on average to 130.00 ± 10.5 min (min 70 and max 190 min). After accumulation of experience, the technique of laparoscopic resection of the kidney without total ischemia with selective clamping of segmental arteries, or without compression of the renal artery was mastered.The conclusion. An analysis of the immediate results of laparoscopic interventions in patients with renal cell carcinoma showed their high efficacy and safety. The results of laparoscopic nephrectomies and kidney resections significantly improve with the improvement of technology and the accumulation of surgical experience. Введение. Цель исследования - изучение ближайших результатов лапароскопических операций у пациентов с локализованным почечно-клеточным раком.Материалы и методы. Проанализированы и оценены результаты лечения 92 пациентов, прооперированных с 2015 по 2017 гг. с помощью лапароскопической техники по поводу почечно-клеточного рака. Из них 57 мужчин (62%) и 35 женщин (38%), средний возраст 50,5±2,25 года (min 26 и max 75 лет).Результаты. На продолжительность операции влияли различные факторы, такие как особенности сосудистой анатомии почек, наличие спаечного процесса брюшной полости, состояние паранефральной жировой клетчатки. При совершенствовании техники выполнения лапароскопических вмешательств время операции значительно сократилось. В период освоения методики лапароскопических вмешательств на почке время операции в среднем составляло 210,0±20,2 мин (min 120 и max 300 мин), в последующем оно уменьшалось в среднем до 130,00±10,5 мин (min 70 и max 190 мин). После накопления опыта была освоена методика лапароскопической резекции почки без тотальной ишемии с селективным пережатием сегментарных артерий или без компрессии почечной артерии.Заключение. Анализ ближайших результатов лапароскопических вмешательств у пациентов с почечно-клеточным раком показал их высокую эффективность и безопасность. Результаты лапароскопических нефрэктомий и резекций почки существенно улучшаются с совершенствованием технологий и накоплением хирургического опыта.

EXPERIENCE OF LAPAROSCOPIC SURGERY IN THE TREATMENT OF RENAL CELL CANCER ON THE BASIS OF THE REPUBLICAN CLINICAL ONCOLOGICAL DISPENSARY

Purpose of the study. Study of the nearest results of laparoscopic operations in patients with localized renal cell carcinoma.Materials and methods. The results of treatment of 92 patients who underwent operative treatment in the period from 2015 to 2017 with the help of laparoscopic technique for kidney carcinoma were analyzed and evaluated. Of these, 57 men (62%) and 35 women (38%), the average age is 50.5 ± 2.25 years (min. 26 and not more than 75 years). Results. The duration of the operation was influenced by various factors, such as the features of the vascular anatomy of the kidneys, the presence of the adhesive process of the abdominal cavity, the state of paranephalic fat. When improving the technique of performing laparoscopic interventions, the operation time was reduced. In the period of mastering the technique of laparoscopic interventions on the kidney, the operation time averaged 210.0 ± 20.2 min (min 120 and max 300 min); subsequently it decreased on average to 130.00 ± 10.5 min (min 70 and max 190 min). After accumulation of experience, the technique of laparoscopic resection of the kidney without total ischemia with selective clamping of segmental arteries, or without compression of the renal artery was mastered.The conclusion. An analysis of the immediate results of laparoscopic interventions in patients with renal cell carcinoma showed their high efficacy and safety. The results of laparoscopic nephrectomies and kidney resections significantly improve with the improvement of technology and the accumulation of surgical experience