[Laparoscopic transperitoneal and retroperitoneal partial nephrectomy].

The article presents a modern approach to partial nephrectomy, and evaluation of individual results of laparoscopic partial nephrectomies. The study included 38 patients who underwent laparoscopic partial nephrectomy in the period from 2006 to 2011. Kidney cancer was diagnosed in 30 patients, other diseases--in 8. Mean duration of surgery was 225 min. Warm ischemia time was less than 36 minutes. The average postoperative period was 8,7 days. Despite the technical difficulties in the development and implementation of laparoscopic partial nephrectomy, the benefits of minimally invasive techniques are obvious, and the operation can comply with all the principles of oncology and become an alternative to open surgery.

[Laparoscopic transperitoneal and extraperitoneal reconstructive plastic surgery on the ureter].

The results of laparoscopic reconstructive operations on ureter distal of ureteropelvic junction are analyzed. The study included 19 patients with different obstructive lesions of the ureter who underwent surgery in the period from 2003 to 2012. According to the method of surgical treatment, the patients were divided into three groups. Ureteroureteroanastomosis was formed in 6 patients, ureterocystoanastomosis--in 5 patients, and ureterolysis was performed in 8 patients. Mean duration of operations ranged from 113 to 210 minutes. There were no requirements of conversion to open surgery in any case. Significant blood loss and other intraoperative complications were not observed. It is concluded that laparoscopic reconstructive plastic surgery in these patients can be performed with good effect equal to open surgery.

[Endoscopic ureterolithotomy in large concrements of the upper third of the ureter].

Endoscopic ureterolithotomy was made in 38 patients who had concrements in the upper third of the ureter more than 1 cm in size. Operations were retroperitoneoscopic and laparoscopic in 20 and 18 cases, respectively. Five patients had recurrent stones, 7 patients had prior extracorporeal shock-wave lithotripsy, 2 patients failed contact ureterolithotripsy. In the rest cases endoscopic ureterolithotomy was a first-line treatment. A complete elimination of the stone was achieved in all the cases. Mean time of the operation in a retroperitoneoscopic approach was 149 min, in laparoscopic - 125 min. Mean blood loss was the same. Conversion was performed in one case in the group of retroperitoneal approach. Postoperative stay in hospital in retroperitoneo- and laparoscopic ureterolithotomy was 3 - 16 days. Laparoscopic ureterolithotomy produced a complication in one case - an insignificant injury of the colon. Urinous infiltration and pneumonia developed after retroperitoneoscopic ureterolithotomy in one and one case, respectively. Thus, endoscopic ureterolithotomy in large stones of the upper third of the ureter via retroperitoneal and transperitoneal approach is a safe, low-invasive and effective operation which provides complete stones elimination. Endoscopic ureterolithotomy should be done in uneffective first-line treatment. It is a leading method in the treatment of large and long-standing stones of the upper third of the ureter.