Registration Number
0223U002496,
0121U110084
, R & D reports
Title
To study the effectiveness of organ-preserving surgical tactics for the treatment of kidney cancer, to optimize the indications and medical rehabilitation of patients.
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Head
Stakhovsky Eduard O., Доктор медичних наук
Registration Date
21-02-2023
Organization
National Cancer Institute
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The object of the study is patients with localized renal cell cancer. The purpose of the work is to improve the results of treatment of patients with localized renal cell cancer by studying the effectiveness of local ischemia during kidney resection based on dynamic renoscintigraphy and to study morpho-functional changes in the kidneys depending on the size, spread of the tumor and accompanying pathology. Research methods: clinical, laboratory, radiation, pathomorphological, statistical. On the basis of a prospective non-randomized study evaluating the impact of central and local thermal ischemia on the functional state of the kidney during resection based on dynamic renoscintigraphy, which included 557 patients with localized renal cell carcinoma, it was found that the size of renal cell carcinoma did not affect the choice of central or local thermal ischemia. Nephrometric indicators that indicated the placement of renal cell carcinoma closer to the renal portal (p<0.05) and a smaller volume of functioning kidney parenchyma (p<0.001) are the main parameters that influenced the choice of surgeons in favor of central thermal ischemia for the purpose of better visualization and adequate control of hemostasis. It was established that kidney resection with central thermal ischemia leads to irreversible changes in the parenchyma and a significant progressive decrease in both the total glomerular filtration rate by 10% and the glomerular filtration rate on the affected side by 23.2% (p<0.05). Local ischemia does not cause a significant decrease in the filtration function of the kidneys. It has been proven that reducing the duration of central thermal ischemia to less than 15 minutes preserves the progressive decrease in glomerular filtration rate of the operated kidney during the 1-year follow-up period (ANOVA: η2=0.16; power=0.96; p=0.0005).
Product Description
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Vitruk Iurii V.
Voylenko Oleg А.
Pikulʹ Maksym V.
Semko Sofiya L.
Stakhovsky Olexander E.
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2023-02-21
