Abstract
There is proposed to refuse from the sealing of the parenchyma since the ligature method of hemostasis is an additional factor damaging the parenchyma of the kidney. In our opinion it is sufficient to perform electrohemostasis with the addition of local adhesive compositions. In the analysis of data from 2015 to 2016 on the basis of the Department of Urology of the N.N. Petrov Research Institute of Oncology there were performed 90 laparoscopic resections without ischemia and without a hemostatic suture applied to the resection area. The volume of blood loss, the duration of the operation, the volume of the functioning parenchyma of the kidney, before and after surgery, postoperative complications were estimated. With a comparative evaluation of the volume of the functioning parenchyma of the kidney before and after the operation, according to data of CT and CT-perfusion, the volume of functioning parenchyma of the resected kidney decreased only by the volume of the removed tumor. Resection of the kidney without applying a hemostatic suture to the area of resection, in conditions of hypotension, allowed improving the results of surgery relatively to kidney function in comparison with resection with the classical ligature method of hemostasis.References
Петров С.Б., Шпиленя Е.С., Кукушкин А.В. и др. Усовершенствованная техника достижения гемостаза при резекции почки с новообразованием // Онкоурология. - 2009. - № 1. - С.14-19.
Попков В.М., Потапов Д.Ю., Понукалин А.Н. Способы гемостаза при резекции почки, 2012.
Bellomi M., Petralia G., Sonzogni A. et al. CT perfusion for the monitoring of neoadjuvant chemotherapy and radiation therapy in rectal carcinoma: initial experience // Radiology. - 2007. - Vol. 244. - P. 486-493.
Fujimoto K., Tanaka N., Hirao Y Partial nephrectomy for renal cell carcinoma using a microwave tissue coagulator-postoperative recurrence and renal function // Hinyokika Kiyo. - 2005. - Vol. 51. - № 8. - P. 511-515.
Hamasaki T et al. Laparoscopic partial nephrectomy using microwave tissue coagulator for treating small peripheral renal tumors // J. Nippon Med. Sch. - 2004. - Vol. 71. - № 6. - P. 392-397.
Matsui Y, Fujikawa K., Iwamura H. et al. Application of the microwave tissue coagulator: is it beneficial to partial nephrectomy? // Urol. Int. - 2002. - Vol. 69. - № 1. -P. 27-32.
Nanri M. et al. Microwave tissue coagulator induces renal apoptotic damage to preserved normal renal tissue following partial nephrectomy // Clin. Exp. Nephrol. - 2009. - Vol. 13. - № 5. - P. 424-429.
Ong A.M., Bhayani S.B., Hsu T H. Pinto Bipolar needle electrocautery for laparoscopic partial nephrectomy without renal vascular occlusion in a porcine model // Urology. - 2003. - Vol. 62. - № 6. - P. 1144-1148.
Satoh Y et al. Renal-tissue damage induced by laparoscopic partial nephrectomy using microwave tissue coagulator // J. Endourol. - 2005. - Vol. 19. - № 7. - P. 818-822.
Wirestam R. Using contrast agents to obtain maps of regional perfusion and capillary wall permeability // Imaging Med. - 2012. - Vol. 4(4). - P. 423-442.
Zima A. Can Pretreatment CT Perfusion Predict Response of Advanced Squamous Cell Carcinoma of the Upper Aerodigestive Tract Treated with Induction Chemotherapy? / Annual Meeting of the American Society of Head and Neck Radiology, September 21-25, 2005.
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