[Experience in performing robot-assisted radical prostatectomy in patients after heart transplan- tation].

INTRODUCTION: Prostate cancer (PCa) occupies a leading position in the structure of oncological morbidity and mortality and is an urgent problem of modern oncourology. In recipients after organ transplantation, due to the intake of immunosuppressants, the risk of aggressive forms of cancer increases, which necessitates active treatment. In the world, there is not enough data on the radical treatment of PCa in patients after heart transplantation (HT), especially on surgical treatment. We present the first experience in Russia and Eastern Europe of 3 robot-assisted radical prostatectomy for localized PCa in patients after HT. MATERIALS AND METHODS: The procedures were performed from February 2021 to November 2021 at the FGBU NMRC named after V.A. Almazov. Preoperative preparation, as well as postoperative management of patients was carried out jointly by urologists and transplant cardiologists. RESULTS: The main demographic, perioperative indicators, as well as oncological and non-oncological outcomes are presented. All patients were discharged from the hospital in a satisfactory condition. During the follow-up period, there were no biochemical recurrences of PCa. Early urinary continence in all three patients was satisfactory. CONCLUSION: Thus, robot-assisted radical prostatectomy in patients after HT is a technically feasible, effective, and safe treatment for PCa. The comparative studies with prolonged follow-up are needed.

[Embolization of arteriovenous malformation of the scrotum]. / Embolizatsiya arteriovenoznoi mal'formatsii moshonki.

The authors report a rare disease at the junction of urology and cardiovascular surgery (arteriovenous malformation (AVM) of the scrotum). The options for correction of this disease are discussed. The authors describe the complications of natural course of disease and their treatment. Treatment strategy with AVM embolization is substantiated. Postoperative regression of symptoms is emphasized. The authors concluded safety and effectiveness of interventional correction of this disease.

EXPERIENCE OF 424 ROBOT-ASSISTED OPERATIONS IN ST-PETERSBURG: RADICAL PROSTATECTOMY, PARTIAL AND RADICAL NEPHRECTOMY.

The article presents the results of 257 robot-assisted radical prostatectomies, 135 partial nephrectomies and 32 radical nephrectomies at the period from 2010 to 2016. The operations were performed on robotic complex da Vinci S. The mean operative time was 170±50 min, 158,4±72,2 min and 143,3±67,3 min, the mean blood loss was 130±35 ml, 213,0±102,2 ml and 141,4±49,0 ml for robotic radical prostatectomy, partial and radical nephrectomy, respectively. The mean time of warm ischemia consisted of 13,1±2,7 min. Five-year cancer-specific survival rate was 100%, 100% and 98%. The overall survival rate was 97,5%, 87% and 92% for robotic radical prostatectomy, partial and radical nephrectomy, respectively.

[NEW METHOD OF PARTIAL NEPHRECTOMY WITH SELECTIVE PARENCHYMA CLAMPING].

The authors suggested a new method of performance of open, laparoscopic and robot-assisted partial nephrectomy using specially developed instruments for selective parenchyma clamping in order to improve the functional results of renal cell carcinoma treatment. The operation with clamping of renal vessels was carried out in 86 cases and clamping of renal parenchyma was used in 24 cases. It was shown, that the open, laparoscopic and robot-assisted partial nephrectomy could be safely performed in conditions of selective ischemia of the renal parenchyma without clamping of renal vessels.