V.N. Dubrovin, A.V. Egoshin, A.V. Tabakov, R.R. Shakirov, O.V. Mikhayliovskiy
Republican Clinical Hospital of the Republic of Mari El, Yoshkar-Ola
Dubrovin Vasily N. ― MD, Head of the Urology Department of the Republican Clinical Hospital of the Republic of Mari El, ORCID ― 0000-0001-5579-554X, RSCI ― 173041
33Osipenko Str., Republic of Mari El, Yoshkar-Ola, Russian Federation, 424037, tel. (836) 246-80-14, e-mail: firstname.lastname@example.org
Introduction. Laser partial nephrectomy in patients with superficial tumors allows to perform the procedure without warm ischemia. The purpose of the work is to reduce smoke generation during laser thulium partial nephrectomy using an irrigation-aspiration system and to improve the visualization of the resection zone.
Material and methods. 22 operations were performed for 10 men (45.5%) and 12 women (54.5%), middle-aged 50.0 (34 – 72) years old, using an irrigator-aspirator and a system for supplying physiological saline to the thulium laser resection area for surface treatment located kidney tumors, in 6 cases used open, in 16 ― laparoscopic access.
Results. Tumors of the right kidney were found in 9 (40.9%), left ― in 13 (59.1%) patients. The size of the kidney tumor was 29.0 (15-60) mm with an average RENAL score of 5.6 (3-8). The average time of operations was 107.1 (50 – 250) minutes, the time of direct resection of the kidney using laser energy was 20.5 (10 – 40) minutes. Blood loss amounted to 102.9 (50 – 300) ml, there was no blood transfusion. Complications were observed in G1 in 3 (13.6%) and G2 in 3 (13.6%) patients, kidney angiolipoma was detected in 4 (18.2%) patients, and renal cell carcinoma in 18 (81.8%) cases there was no positive surgical margin. The time of hospitalization was 7.5 (5 – 10) days.
Conclusion. The use of the instrument for the irrigation-aspiration system allowed to reduce smoke generation during laser thulium resection of the kidney and to improve visualization in the resection zone.
Key words: kidney tumor, laser partial nephrectomy, thulium laser, irrigation-aspiration system.