Кафедра урології, нефрології та андрології імені професора А.Г. Подрєза
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Browsing Кафедра урології, нефрології та андрології імені професора А.Г. Подрєза by Author "Lisovyi, Volodymyr"
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Item A new surgical technique of the renal artery control during nephrectomy with tumor thrombus removal(2018-05) Lisovyi, Volodymyr; Shchukin, Dmytro; Khareba, Gennadiy; Garagatiy, Igor; Polyakov, Nikolay; Mozzakov, P.The nephrectomy safety during removal of kidney tumors with intravenous extension mostly depends on control of the renal arterу. But in certain situations control of the renal artery is a very complicated and dangerous stage of the operation due to presence of the venous collaterals and massive size of the tumor thrombus. Search of the renal artery often accompanied the displacement of the renal vein, inferior vena cava or kidney, which can lead to thrombus fragmentation and pulmonary embolism in the presence of fragile or soft tumor thrombus. We present a novel method of control of the renal artery after performing thrombectomy. Our experience has demonstrated the feasibility and safety of a new surgical technique, including anterior ligation of the renal artery after thrombectomy. This approach decreases the blood loss from the venous collaterals during kidney mobilization and reduces the risk of pulmonary embolism.Item Control of the renal artery after removal of tumor thrombus from the inferior vena cava: Analysis of the efficacy and safety of a new surgical approach(2016-03-13) Лісовий, Володимир Миколайович; Щукін, Дмитро Володимирович; Гарагатий, Ігор Анатолійович; Хареба, Геннадій Геннадійович; Поляков, Микола Миколайович; Shchukin, Dmytro; Lisovyi, Volodymyr; Garagatiy, Igor; Khareba, Gennadiy; Polyakov, M.The nephrectomy safety during removal of kidney tumors with intravenous extension mostly depends on control of the renal artery. We focused on efficacy and safety of a novel renal artery ligation technique after thrombectomy in comparison to the standard surgical techniques. Our study has demonstrated feasibility and safety of thrombectomy without prior ligation of the renal artery. The results of this technique were not related to the level of spread of intravenous tumor, and were significantly better than those with the use of the standard approaches to the renal artery in terms of technical feasibility and safety, due to the lower frequency of bleeding, and the absence of embolic complications.Item Improvement in sexual function and fertility in patients with ejaculatory disorders(2014) Knigavko, Oleksandr; Lisovyi, Volodymyr; Arkatov, AndriyEjaculatory disorders occupy a place of sexual disharmony couple and are the most common physiological cause of divorce. Among ejaculatory disorders the most common are the syndrome premature ejaculation ( SPE), retrograde ejaculation. (ER ) and anorgasmia. The aim of the study was to develop an algorithm treatment of dizorgazmia and improving sexual function of men with ejaculatory disorders.Item Infections of the urinary system at pregnancy(2015) Лісовий, Володимир Миколайович; Андон'єва, Ніна Михайлівна; Lisovyi, Volodymyr; Andonieva, NinaFor the last decades the traditional perception of etiology and pathogenesis of infections of the urinary system (IUS) has considerably changed. Among factors which stipulate the development of IUS, the biological characteristics of microorganisms which colonize urinary tract are especially important. Urinary pathogenic features of some microorganisms explain the origin of infection in the normal urinary system. On the other hand, the non-urinary pathogenic cultures of bacteria cause inflammation in the presence of innate anomalies or due to the decline of protective forces of the organism, specifically at pregnancy.Item Male androgen defict and chronic infections as factors chronic replaced urolithiasis(2014) Knigavko, Oleksandr; Lisovyi, Volodymyr; Arkatov, AndriyChronic replaced urolithiasis (CRU) development dependence on the age. The wide use preservatives, stabilizators and increased amounts of flour products in meal leads to the decrease of urine pH and alter of the physical and chemical urine content that rises lithogenesis. Urolithias and its clinical symptoms become one of the most recurring problems in modern urology. Anomalies of urosexual path, infravesical obstruction, damaged exchange of microelements, hormonal disbalans, hypopolyvitaminosis, heritaged problems, hypodynamia, living in endemic areas are the anatomo-physiological factors which traditionally contribute to appear of concrements. But some of European people who suffer from chronic replaced urolithias don’t have such factors. In our previous clinical studies it have been proved that one of the most common reasons of CRU development was the presence of chronic urine tract infection mostly Ureaplasma Urealitycum. Target of current research is to investigate the pathogenetic factors of CRU in patients without anatomo-physiological variations of urosexual path depending on their age.Item Nephron sparing surgery in patients with intravenous extension of renal cell carcinoma(2016-03-14) Стаховський, Е.О.; Щукін, Дмитро Володимирович; Лісовий, Володимир Миколайович; Вітрук, І.; Войленко, О.А.; Стаховський, О.Е.; Гарагатий, Ігор Анатолійович; Поляков, Микола Миколайович; Антонян, Ігор Михайлович; Хареба, Геннадій Геннадійович; Stakhovsky, E.; Shchukin, Dmytro; Lisovyi, Volodymyr; Vitruk, I.; Voylenko, O.; Stakhovskyi, O.; Garagatiy, Igor; Polyakov, M.; Antonyan, I.; Khareba, GennadiyWe have conducted a retrospective evaluation of the results of open nephron sparing surgery in patients with macroscopic intravenous extension of RCC found either during operation or at final pathomorphological study. The study included 32 patients with renal tumours and intravenous extension who underwent NSS from 2007 to 2015 in two urological centers. Their charts were reviewed to identify clinical, operative, and pathology details, as well as oncological outcomes of these patients. Nephron sparing surgery may be used to treat patients with kidney tumours and neoplastic venous thrombosis. Elective indications for this surgical approach are still to be developed.Item Sources of bleeding during IVC tumour thrombi removal: MDCT examination(2016-03-23) Лісовий, Володимир Миколайович; Щукін, Дмитро Володимирович; Алтухов, Олексій Олександрович; Савенков, Володимир Ілліч; Ілюхін, І.; Хареба, Геннадій Геннадійович; Єрмоленко, Тамара Іванівна; Lisovyi, Volodymyr; Shchukin, Dmytro; Altukhov, Oleksiy; Savenkov, V.; Ilyukhin, I.; Khareba, Gennadiy; Yermolenko, T.The purpose of this study was to investigate the sources of bleeding from the lumen of the inferior vena cava (IVC) during removal of the tumour thrombus. We have studied the MDCT anatomy of the posterior tributaries of the IVC, including variant lumbar veins and lumbar veins of the infrarenal IVC. The variant lumbar veins rarely are the main source of bleeding during thrombectomy. The right upper lumbar veins of the infrarenal IVC draining into the inferior vena cava in close proximity to the mouths of the renal veins played the leading role in this matter. Before the operation a surgeon must carefully plan the stage of vascular thrombus isolation and evaluate the anatomy of the upper lumbar veins with the use of the data of medical imaging.Item Surgical Approaches to Supradiaphragmatic Segment of IVC and Right Atrium through Abdominal Cavity during Intravenous Tumor Thrombus Removal(Surgical Approaches to Supradiaphragmatic Segment of IVC and Right Atrium through Abdominal Cavity during Intravenous Tumor Thrombus Removal / D. Shchukin, V. Lesovoy, I. Garagatiy, G. Khareba,R. Hsaine // Advances in Urology. – 2014. – Vol. 2014. – Article ID 924269. – Mode of access : http://dx.doi.org/10.1155/2014/924269., 2013-07) Shchukin, Dmytro; Lisovyi, Volodymyr; Garagatiy, Igor; Khareba, Gennadiy; Hsaine, RedouaneObjective.The purpose of this study was to investigate safety and feasibility of some surgical approaches to the supradiaphragmatic inferior vena cava (IVC) and the right atrium through the diaphragm from the abdominal cavity. Materials and Methods. The material of the anatomical study included 35 fresh cadavers. Several options of surgical access to the supradiaphragmatic IVC were successively performed. Feasibility and risk level of each of the approaches were evaluated with the use of a special scale. Results. The isolation of the supradiaphragmatic IVC and cavoatrial junction was most easily performed via T-shaped or circular diaphragmotomy (grade “easy” was registered in 74.3% and 80% of patients, resp., compared to 31.4% for transverse diaphragmotomy and 40% for isolation of the IVC in the pericardial cavity). The risk analysis has demonstrated the highest safety level for T-shaped diaphragmotomy (grade “safe” was registered in 60% of cases).The intervention via transverse diaphragmotomy, circular diaphragmotomy, and IVC isolation in the pericardial cavity was graded as “risky” in 80%, 62.9%, and 82.9% of cases, respectively. Conclusions. In our opinion, T-shaped diaphragmotomy is the most safe and easy-to-perform access for mobilization of the supradiaphragmatic IVC through the abdominal cavity.Item The reducing edge fibrosis graft after surgical corporoplastic(2014) Lisovyi, Volodymyr; Arkatov, Andriy; Knigavko, OleksandrApplication corporoplasty using geometric principles in a dense ossified plaque is a common method. However, after such operations often arises fibrosis in graft-linking with the tunica of the corpora cavernosa. This complication reduces the size of the penis, may cause distortion, compression, deterioration of sexuality and even urethral stricture. The aim of our study was to explore the process of fibrosis edge of the graft and reduce fibrosis of graft.Item Transurethral catheterization of the ejaculatory ducts as a method of improving sexual and reproductive functions of men.(2016) Knigavko, Oleksandr; Lisovyi, Volodymyr; Arkatov, Andriy; Panasovskiy, MykolaThe woork is devoted effectivness of using new method - transurethral catetherisation of ejaculatory ducts for treatment prostatic azoospermia and premature ejaculationItem Мультидисциплинарный подход к коррекции уремического синдрома у пациентки с ангиомиолипомой почки(2017-06) Lisovyi, Volodymyr; Polyakov, Nikolay; Andonieva, NinaAbstract Patients with uremic syndrome are at high risk of developing various complications that can lead to fatal consequences. Uremic syndrome usually develops on the background of chronic kidney disease, especially its later stages. However, uremia may also occur as a result of tumor, surgical treatment of which can lead the patient to renoprival state. According to various au- thors, the development of uremic syndrome occurs in 7-10% of patients suffering from kidney tumors. Renal angiomyolipoma is a benign mesenchymal tumor, which accounts for 3% of all tumors of renal parenchyma and 90% of all benign tumors of the kidney. It is known that angiomyoli- poma is characterized by slow growth and the associated asymptomatic course. Present study describes a case of uremic syndrome developed as a result of kidney angiomyo- lipoma in a 32-year-old female patient, who earlier underwent nephrectomy in connection with angiomyolipoma of the contralateral kidney. The computer tomography allowed to reveal a large retroperitoneal space-occupying lesion and to detect a spontaneous rupture of this formation, in connection with which the patient underwent a revision of the retroperitoneal space. While mak- ing the revision of the tumor no kidney authentic tissues were clearly detected. That was the reason for performing the nephrectomy. The patient has begun renal replacement therapy using haemodialysis. The mother of the patient expressed a desire to become a kidney donor for the daughter. As a result of examination in the potential donor a renal artery aneurism was revealed. After examination of the donor and recipient, the patient has successfully undergone living- related kidney transplantation, and the kidney donor – renal artery plasty. Thus, the specialized urological management, haemodialysis as a method of renal replace- ment therapy and the living-related kidney transplantation, concentrated in one center, have given the chance to provide maximal rehabilitation of the patient with the uremic syndrome as well as to prevent fatal complications in the kidney donor.