The aim: to evaluate the own direct results of the RFA of kidney tumors in A.V. Vishnevsky National Medical Research Center of Surgery.Materials and methods. The study included the results of examination and treatment of 22 patients with kidney tumors treated at A.V. Vishnevsky National Medical Center of Surgery (16 men and 6 women aged 40 to 81, mean age 61.5 years). All patients underwent preoperative ultrasound, MSCT with contrast enhancement., Patients underwent RFA of kidney tumors using the Radionics Cool-Tip ® Ablation System (USA) at various stages of treatment In the postoperative period, all patients underwent MSCT monitoring with contrast enhancement and ultrasound with duplex scanning, as well as ultrasound with contrast enhancement – in 7 patients and MRI with contrast enhancement on the first day after the intervention – in 5 patients. Dynamic follow-up was performed in the postoperative period from 3 to 60 months (median 17.8 months).Results. Depending on the surgical tactics, the patients were divided into two groups: the first (16 patients) – RFA was performed as the first independent stage of treatment; the second (6 patients) – RFA was performed as a staged treatment for kidney resection. The tumor was solitary in 19 patients of both groups, multiple – in 3. In tumors of the first group, with sizes exceeding 30.0 mm in diameter, a positive effect was obtained from the manipulation: no progression of the tumor was detected during dynamic observation. These patients underwent 2 to 3 RFA sessions. In tumors of the second group, the size did not exceed 30.0 mm, 2 to 4 sessions (on average 3 sessions) of RFA were performed, which was due to multiple lesions in 3 cases. The use of RFA in the treatment of patients with small kidney cancer in patients with concomitant diseases that do not allow for radical treatment, made it possible to obtain a relapse-free period of an average of 16.5 months. The use of RFA, as a stage in the treatment of primary multiple kidney cancer, showed a relapse-free period of an average of 21.2 months.Conclusion. The use of radiofrequency ablation in the treatment of kidney cancer patients can significantly expand the scope of surgical care, both in the case of patients with concomitant diseases that do not allow a significant amount of surgical intervention, and in the treatment of patients with primary multiple cancer of both kidneys as a stage treatment.
Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр хирургии имени А.В. Вишневского» Министерства здравоохранения Российской Федерации, 115093, г. Москва, Российская Федерация ДЛЯ КОРРЕСПОНДЕНЦИИ Степанова Юлия Александровнадоктор медицинских наук, ученый секретарь ФГБУ «НМИЦ хирургии им. А.В. Вишневского» Минздрава России
Introduction. Venous invasion and tumor thrombus formation are rare, but life-threatening complications of renal cell carcinoma (RCC), especially in combination with metastases, are considered significant adverse prognostic factors. Aim. To systematize the existing knowledge and summarize the clinical experience of surgical treatment (open and robot-assisted surgery) of RCC with inferior vena cava (IVC) tumor thrombus. Materials and methods. A literature search in the period 2000-2022 was performed in core databases MEDLINE, Scopus, Clinicaltrials.gov, Google Scholar and Web of Science. The PICO framework (Population-Intervention-Comparison-Outcome) was used to develop a literature search strategy. The following keywords were used to search databases: «renal cell carcinoma», «venous invasion», «inferior vena cava tumor thrombus», «surgical treatment», «robot-assisted», «clinical outcomes». Results. A total of 65 publications were identified. Various classifications of tumor thrombus level are considered, their inferiority and superiority in terms of selecting optimal surgical treatment, both open or robot-assisted surgeries, are discussed. Independent predictors of severe perioperative complications are determined. Optimal surgical treatment of RCC with tumor thrombus is highlighted. Functional and oncological outcomes of patients with RCC with IVC tumor thrombus, who underwent open surgical intervention and robot-assisted ones, are presented. Conclusion. Open surgery in patients with RCC and IVC tumor thrombus above the hepatic veins is associated with prolonged surgery duration, higher intraoperative blood loss, and prolonged in-hospital stay. Prolonged in-hospital stay, the need for blood transfusion, metastasis, sarcomatoid differentiation, and Clavien-Dindo grade 3-5 postoperative complications are predictors of poor outcomes.
Testicular cancer is a rare oncourological disease. Of great significance is the fact of the disease onset precisely at the age when men are planning their future life: education, family, etc. According to current clinical guidelines, the treatment of this disease should be complex, including surgical treatment, polychemotherapy and external beam radiation therapy, which leads to a cure in 90% of cases.In the presented clinical case, a 25-year-old patient was diagnosed with right testicular cancer stage III, T2N3M1S0 [PUL]. However, despite the significant initial prevalence of the pathological process, as well as the detection of a single retroperitoneal metastasis in the pancreas two years after the last stage of surgical treatment, the applied multi-stage tactics of complex treatment of the patient allowed not only removing the tumor and metastases, but also rehabilitating the patient socially.
Cystic echinococcosis is a chronically severe parasitic disease of humans and animals caused by parasitism of the larval stage of Echinococcus unicameral.Ultrasound (ultrasound) being the most widely used option of visual diagnostics is the leading method of radiological diagnosis of echinococcosis of the liver and other organs. The technique is generally available and allows diagnosing echinococcosis at a stage when parasitic cysts are still small in size, starting from 1.5-2 cm. However, with the high accuracy and specificity of ultrasound in the differential diagnosis of echinococcosis cysts, there are certain disadvantages of the approach.Due to constant study and, accordingly, changes in knowledge about the course of the disease, methods for its diagnosis and treatment, there is no unified and stable ultrasound classification of liver echinococcosis. The paper analyzes the criteria that justify various classifications of echinococcus, substantiates forming trends. The standardized ultrasound classification of hydatid echinococcosis of the liver, which was adopted by the World Health Organization in 2003 and revised in 2010, is discussed.The potential and advantages of dynamic ultrasound monitoring of echinococcal cysts and postoperative characteristics of the residual cavity after echinococcectomy are demonstrated.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.