References

urovest

Вестник урологии

Urology Herald

2308-6424

Rostov State Medical University

10.21886/2308-6424-2021-9-2-111-124

urovest-441

Research Article

ОБЗОРЫ ЛИТЕРАТУРЫ

REVIEWS ARTICLE

Мочевые свищи после парциальной нефрэктомии при почечно-клеточном раке

Urinary fistulas after partial nephrectomy in renal cell carcinoma

https://orcid.org/0000-0002-2359-6973

Гулиев

Б. Г.

Guliev

B. G.

Гулиев Бахман Гидаятович — доктор медицинских наук, профессор; профессор кафедры урологии Северо-Западного ГМУ имени Мечникова; руководитель центра урологии с робот-ассистированной хирургией Мариинской больницы.

191015, Санкт-Петербург, ул. Кирочная, д. 41; 191014, Санкт-Петербург, пр-т Литейный, д. 56.

Тел.: +7 (921) 945-34-80

Bakhman G. Guliev — M.D., Dr. Sc. (M), Full Prof.; Prof., Dept. of Urology, Mechnikov North-West State Medical University; Head, Urology Centre with Robot-assisted Surgery, St. Petersburg Mariinsky Hospital.

191015, St. Petersburg, 41 Kirochnaya st.; 191014, St. Petersburg, 56 Liteiny ave.

Tel.: +7 (921) 945-34-80

gulievbg@mail.ru

Северо-Западный государственный медицинский университет им. И.И. Мечникова Минздрава России; Центр урологии с робот-ассистированной хирургией Мариинской больницыРоссияMechnikov North-Western State Medical University; Urology Centre with Robot-assisted Surgery, St. Petersburg Mariinsky HospitalRussian Federation

2021

08072021

92111124

2021

Гулиев Б.Г.

Guliev B.G.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.urovest.ru/jour/article/view/441

Мочевые фистулы после парциальной нефрэктомии (ПН) являются редкими осложнениями данной операции. Существуют различные причины их развития, профилактики и лечения. В обзоре проведён анализ результатов распространённости случаев подтекания мочи после ПН различными доступами, предикторы их возникновения, возможные способы профилактики и лечения. Данные показывают, что размеры опухолей, их эндофитность и близость к полостной системе почки, а также ушивание её дефекта могут быть прогностическими факторами развития мочевых свищей (МС). Некоторые авторы также указывают на влияние длительного времени тепловой ишемии (ВТИ) и высокого объёма кровопотери на возникновение МС. Основным методом лечения МС является стентирование мочеточника или перкутанное дренирование полостной системы почки. При длительных стойких МС методом выбора может быть одновременная установка двух стентов, ретроградное или перкутанное введение фибринового клея, перкутанная криоабляция свищевого хода.

Urinary fistulas after partial nephrectomy are rare complications of this operation. There are various reasons for their development, prevention and treatment. This review analyzes the results of the cases' prevalence of urine leakage after partial nephrectomy with various approaches, occurrence's predictors of urinary fistulas, possible ways of their intraoperative prevention and treatment methods. The obtained data show that the size of tumors, their endophytic nature and proximity to the kidney pelvicalyceal system, as well as suturing of its defect, can be predictors of the development of urinary fistulas (UFs). Some authors point to the influence of long ischemia time and high blood loss on the occurrence of UFs. The main method of treating UFs is ureteral stenting or percutaneous drainage of the kidney pelvicalyceal system. For long-term persistent UFs, the method of choice can be simultaneous introduction of 2 stents, retrograde or percutaneous injection of fibrin glue, percutaneous cryoablation of the UFs.

рак почкипочечно-клеточный ракрезекция почкипарциальная нефрэктомияосложнениямочевые свищипрофилактикалечение

kidney cancerrenal cell carcinomakidney resectionpartial nephrectomycomplicationsurinary fistulaspreventiontreatment

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The authors declare that there are no conflicts of interest present.