ALGORITHM OF PREOPERATIVE EXAMINATION AND METHODS OF SURGICAL TREATMENT OF PATIENTS WITH LOCALIZED KIDNEY CANCER

Abstract

Summary. Aim: to improve the effectiveness of surgical treatment of patients with localized renal cell carcinoma by improving the assessment of the location of the tumor at the preoperative stage, a thorough study of the vascular anatomy of the kidney and its relation to the tumor, and performing more effective and functionally sparing organ-preserving surgery. Results: based on a multifactorial comparative analysis of the studied criteria that influenced the effectiveness of treatment of patients with localized renal cell carcinoma (RCC) (T1-2vN0M0) we developed an algorithm for preoperative examination and a method of surgical treatment of tumorous lesions of the kidney, which provides a clear understanding of the vascular anatomy of the kidney, taking into account the possible variability of the organ’s angioarchitecture; rational surgical access; close proximity to the area of surgical interest; no need for lateral mobilization of the colon, which is impossible with transabdominal access absence of intraoperative renal ischemia; minimal probability of positive surgical margins; reliable hemostasis; no probability of postoperative trocar circles; satisfactory postoperative cosmetic effect.