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 "Polyakov, Nikolay"
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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 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.