[Laparoscopic radical cystectomy: innovations and classics].

INTRODUCTION: Radical cystectomy remains the gold-standard treatment for muscle-invasive bladder cancer. To combine the advantages of minimally invasive interventions and the well-established open surgery, we attempted to reproduce as accurately as possible the technique of open radical cystectomy using a laparoscopic procedure. MATERIALS AND METHODS: The study comprised 35 patients (27 men and 8 women) with invasive bladder cancer who underwent laparoscopic radical cystectomy (LRC) between April 2013 and March 2016. The study included only patients with fully intra-corporal ileum conduits. RESULTS: The operating time averaged 378 min., the mean blood loss was 285 ml, the mean postoperative hospital stay was 12.4 days. Only 20% of patients needed postoperative opioid analgesia. Postoperative complications occurred in 11.4% of patients. The vast majority of them were successfully managed by minimally invasive methods. CONCLUSION: Laparoscopic radical cystectomy is a safe and effective treatment modality for invasive bladder cancer. However, more patients and a longer observation period are needed to recommend the method as a standard of care.

[RADICAL LAPAROSCOPIC NEPHRECTOMY WITH INFERIOR VENA CAVA THROMBECTOMY].

Laparoscopic radical nephrectomy has proven itself as the "gold standard" treatment of renal cell carcinoma. Inferior vena cava (IVC) tumor thrombus is a complicating factor that occurs in 5% to 10% of patients with renal cell carcinoma. In world literature, there are only anecdotal reports on using laparoscopic approach for IVC thrombectomy in patients with renal cell carcinoma. Herein we report our experience of laparoscopic radical nephrectomy and thrombectomy of the level II tumor thrombus in the IVC. Two patients (79-year-old female and 48-year-old male) underwent radical nephrectomy with thrombectomy from IVC for renal cell carcinoma T3bNxM0 complicated by the formation of a tumor thrombus in the IVC. To do this, IVC was isolated, the right gonadal and lumbar veins were ligated and transected. The IVC and the left renal vein blood flow were controlled with a plastic clip and Satinski clamp. After thrombectomy and resection of the IVC, the wall the defect was sutured with continuous Prolene suture. Laparoscopic radical nephrectomy with thrombectomy without conversion to open surgery was successfully carried out in both patients. During 6-18 months follow-up no local recurrence or distant metastasis were observed. Laparoscopic radical nephrectomy with thrombectomy for renal cell carcinoma complicated with tumor thrombus level II is a safe and reproducible method, which can be applied to a specific population of patients.

[Laparoscopic partial nephrectomy using local ischemia].

Oncological outcomes of laparoscopic partial nephrectomy are no worse than those after open sparing operation for kidney cancer. However, laparoscopic procedures are accompanied by a longer warm ischemia. In order to reduce the ischemic injury, local ischemia by isolation and temporary clamping of the individual branches of the renal artery was used. From January 2009 to June 2012, 60 laparoscopic partial nephrectomies were performed in the clinic, including 34 resections with temporary clipping of renal artery and 26 resections with temporary clipping of secondary and tertiary segmental and subsegmental branches. Functions of affected kidney were evaluated before and after surgery in both groups of patients. At 3 months after surgery, significantly lower decline of the function of affected kidney was observed in patients who underwent resection with the use of local ischemia compared with patients who received the intervention accompanied by a temporary clamping the renal artery. Partial nephrectomy using local ischemia can significantly expand the indications for laparoscopic and retroperitoneoscopic sparing operation for renal cell cancer.

[Clinical efficacy of reamberin in drug-addicts with hepatic lesions].

Infusion of 1.5% reamberin solution was shown to be a safe tool for combined therapy of severe viral hepatitis in drug addicts with signs of polyorganic lesions. Reamberin had detoxicating, antioxidative, hepato- and nephroprotective effects associated with clinical improvement, reduced hospital stay and normalized biochemical characteristics. Moreover, it increased the serum antioxidative potential and non-specific resistance of the patients.

[Stages of the development of new biologically active suture materials and using them in the emergency abdominal surgery].

After experimental investigations the antimicrobial suture materials Nikant and Nikant P were used in clinical practice (in operations on 985 patients). It was shown that the frequency of local complications after surgery using the antimicrobial suture materials decreased from 34.1% to 18.6%. Lethality from local postoperative complications proved to be reliably less.

[Treatment of ureteral vast obliteration after kidney transplantation]. / Lechenie protiazhennykh oblitertsii mochetochnika posle transplantatsii pochki.

Ureteral ischemia is one of the causes of obliterations arising after kidney transplantation. Reureterocystoanastomosis does not solve the problem of ischemia. Ureteropyelostomy with the recipient's ureter is the most effective open surgical intervention. Choice of operation is made with consideration of specific features of blood supply. If the use of own recipient's ureters is impossible, pyelocystostomy with Boari flap is indicated for allograft's rescue.

[Status of the upper parts of the digestive tract and Helicobacter pylori infections in patients with chronic kidney failure after kidney transplantation]. / Sostoianie verkhnikh otdelov pishchevaritel'nogo trakta i Helicobacter pylori-infektsiia u bol'nykh khronicheskoi pochechnoi nedostatochnost'iu posle transplantatstii pochki.

The purpose of the study was to examine the state of upper parts of the digestive tract, prevalence of Helicobacter pylori infection and its relation to the pathology revealed in patients with chronic renal insufficiency after kidney transplantation.

[Use of pyelo-cystic anastomosis in ureteral obliteration after kidney transplantation]. / Primenenie pielotsistoanastomoza pri obliteratsii mochetochnika posle transplantatsii pochki.

Reconstruction of the urinary tract because of ureteral stricture after kidney transplantation is a serious problem. In development of obliteration of the recipient's ureter near anastomosis and in the absence of own ureters reconstruction is made by pyelocystoanastomosis. A case is reported of a successful use of this method in reconstruction of the urinary tract. Preoperative preparation includes transcutaneous nephrostomy. Sometimes Boary flap is used. The arising reflux had insignificant effect on the transplant's function.

[Oscillation spectra of metal-porphyrin dication spectra]. / Kolebatel'nye spektry dikationov metall-porfirinov.

Spectra of resonance spontaneous combination scattering (RSCS) of dications of metal--derivatives of tetraphenyl and ethioporphyrine (Ni-TPhP, Cu-TPhP, Cu-EP and VO-EP0 and IR-spectra of absorption of Ni-TPhP and Cu-EP dications were obtained. It was found that transformation of porphyrine neutral molecules into dications is accompanied with the appearance of new absorption bands in IR-spectra analogs of which are in RSCS spectra of dications. In some cases it points to the disturbance of alternative prohibition to oscillative transitions and to structural changes which result in the loss of symmetry centre by the molecule when it is transformed into the dication. A comparison of RSCS spectra of dications and dianions of VO-EP suggests that they have different structure.