urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2022-10-3-122-132urovest-587Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWS ARTICLEБесшовная резекция почкиSutureless partial nephrectomyhttps://orcid.org/0000-0003-2495-5760ШкодкинС. В.ShkodkinS. V.

Сергей Валентинович Шкодкин — доктор медицинских наук, доцент; профессор кафедры госпитальной хирургии Медицинского института; врач-уролог урологического отделения

308015, Россия, г. Белгород, ул. Победы, д. 85

308007, Россия, г. Белгород, ул. Некрасова, д. 8/9

Sergey V. Shkodkin — M.D., Dr.Sc.(Med), Assoc.Prof.(Docent); Prof., Dept. of Advanced Surgery, Medical Institute; Urologist

85 Victory St., Belgorod, 308015, Russian Federation

8/9 Nekrasova St., Belgorod, 308007, Russian Federation

shkodkin-s@mail.ruhttps://orcid.org/0000-0003-2318-9494ИдашкинЮ. Б.IdashkinYu. B.

Юрий Борисович Идашкин — врач-уролог урологического отделения

308007, Россия, г. Белгород, ул. Некрасова, д. 8/9

Yury B. Idashkin — M.D.; Urologist

8/9 Nekrasova St., Belgorod, 308007, Russian Federation

shkodkin-s@mail.ruhttps://orcid.org/0000-0003-4048-3986ЗубайдиМ. З. А. А.ZubaidiM. Z. A. A.

Мохаммедейн Захран Абед Альфаттах Зубаиди — аспирант кафедры госпитальной хирургии Медицинского института

308015, Россия, г. Белгород, ул. Победы, д. 85

Mohammedain Z. A. A. Zubaydi — M.D.; Postgraduate student, Dept. of Advanced Surgery, Medical Institute

85 Victory St., Belgorod, 308015, Russian Federation

zubaydi@mail.ruhttps://orcid.org/0000-0002-9813-9523КравецА. Д.KravetsA. D.

Анатолий Дмитриевич Кравец — кандидат медицинских наук; врач-уролог урологического отделения

450071, Россия, г. Уфа, Лесной проезд, д. 3

Аnatoly D. Kravets — M.D., Cand.Sc.(Med); Urologist, Urology Division

3 Lesnoy Dr., Ufa, 450071, Russian Federation

kranatolius@mail.ruhttps://orcid.org/0000-0001-9869-7376ХусейнзодаА. Ф.KhuseinzodaA. F.

Абдуллои Файзали Хусейнзода — аспирант кафедры госпитальной хирургии Медицинского института

308015, Россия, г. Белгород, ул. Победы, д. 85

Abdulloi F. Huseynzoda — M.D.; Postgraduate student, Dept. of Advanced Surgery, Medical Institute

85 Victory St., Belgorod, 308015, Russian Federation

husenzoda.abdullo@mail.ruhttps://orcid.org/0000-0002-0686-9693АскариЖ. К.AskariZh. K.

Жехад Кхалил Аскари — аспирант кафедры госпитальной хирургии Медицинского института

308015, Россия, г. Белгород, ул. Победы, д. 85

Jehad K. Askari — M.D.; Postgraduate student, Dept. of Advanced Surgery

85 Victory St., Belgorod, 308015, Russian Federation

dr_askari@mail.ruhttps://orcid.org/0000-0003-0811-681XПономаревЕ. Г.PonomarevE. G.

Евгений Геннадьевич Пономарев — ординатор кафедры госпитальной хирургии Медицинского института

308015, Россия, г. Белгород, ул. Победы, д. 85

Evgeniy G. Ponomarev — Resident, Dept. of Advanced Surgery, Medical Institute

85 Victory St., Belgorod, 308015, Russian Federation

dr.ponomarev95@mail.ruhttps://orcid.org/0000-0002-5726-5945НечипоренкоВ. Ю.NechiporenkoV. Y.

Владислав Юрьевич Нечипоренко — ординатор кафедры госпитальной хирургии Медицинского института

308015, Россия, г. Белгород, ул. Победы, д. 85

Vladislav Y. Nechiporenko — Resident, Dept. of Advanced Surgery, Medical Institute

85 Victory St., Belgorod, 308015, Russian Federation

nechiporenko@bsu.edu.ruhttps://orcid.org/0000-0003-4270-165XШкодкинК. С.ShkodkinK. S.

Кирилл Сергеевич Шкодкин — ординатор кафедры госпитальной хирургии Медицинского института

308015, Россия, г. Белгород, ул. Победы, д. 85

Kirill S. Shkodkin — Resident, Dept. of Advanced Surgery, Medical Institute

85 Victory St., Belgorod, 308015, Russian Federation

kirill_shkodkin@mail.ruФГАОУ ВО «Белгородский государственный национальный исследовательский университет» Минобрнауки России; ОГБУЗ «Белгородская областная клиническая больница Святителя Иоасафа»РоссияBelgorod State National Research University; St. Joasaph Belgorod Regional Clinical HospitalRussian FederationОГБУЗ «Белгородская областная клиническая больница Святителя Иоасафа»РоссияSt. Joasaph Belgorod Regional Clinical HospitalRussian FederationФГАОУ ВО «Белгородский государственный национальный исследовательский университет» Минобрнауки РоссииРоссияBelgorod State National Research UniversityRussian FederationГБУЗ РБ «Городская клиническая больница №21 г. Уфы»РоссияUfa City Clinical Hospital No. 21Russian Federation202201102022103122132Copyright © Шкодкин С.В., Идашкин Ю.Б., Зубайди М.З., Кравец А.Д., Хусейнзода А.Ф., Аскари Ж.К., Пономарев Е.Г., Нечипоренко В.Ю., Шкодкин К.С., 20222022Шкодкин С.В., Идашкин Ю.Б., Зубайди М.З., Кравец А.Д., Хусейнзода А.Ф., Аскари Ж.К., Пономарев Е.Г., Нечипоренко В.Ю., Шкодкин К.С.Shkodkin S.V., Idashkin Y.B., Zubaidi M.Z., Kravets A.D., Khuseinzoda A.F., Askari Z.K., Ponomarev E.G., Nechiporenko V.Y., Shkodkin K.S.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/587Введение

Введение. Опыт почечной хирургии показал клиническую целесообразность сохранения функционирующей почечной паренхимы и патогенетическую обоснованность органосохраняющих операций при почечно-клеточном раке (ПКР).

Цель исследования

Цель исследования. Провести анализ доступных научных публикаций, посвящённых нефронсберегающей хирургии (НСХ) без использования хирургического шва почки или так называемой ренораффии.

Материалы и методы

Материалы и методы. Нами проведён поиск в базах данных eLibrary, PubMed, Сochrane Library и Scopus без временных ограничений. Всего в базах данных обнаружено 19365 публикаций, включая 71 рандомизированное контролируемое клиническое исследование, 987 обзоров, из которых 168 имели систематический характер, а 2 были выполнены на основании Cochrane Library. В данный обзор включены публикации, посвящённые технике НСХ пациентов с ПКР без наложения хирургического шва, при формальном анализе публикаций исключены клинические наблюдения и материалы тезисов. Таким образом, в анализ отобраны 132 публикации, которые представлены ниже самостоятельно либо включёнными в ранее проведённые литературные обзоры. Имеющиеся для анализа исследования были достаточно разнородны по группам пациентов, критериям включения и контрольным точкам, что не позволило провести метаанализ представленных данных.

Результаты

Результаты. Попытка отказа от принципа ушивания почки после резекции была реализована с помощью способов гемостаза, основанных на действии физических факторов. Вместе с тем кажущаяся на первый взгляд ценность какого-либо одного из способов не показала в НСХ очевидных однозначных преимуществ, достижение которых однозначно снизило бы остроту проблематичности вопроса на современном этапе. Значимыми предпосылками подобного состояния проблемы следует считать моноцентровой характер большинства исследований и сравнительно небольшой опыт применения тех или иных способов или их сочетаний. С учётом вышесказанного трудно не согласиться с утверждением  о том, что большое число различных способов гемостаза, применяемых в НСХ, представляется не только следствием неустанных поисков клиницистами новых возможностей, но и реального отсутствия универсальных технологий.

Заключение

Заключение. Анализ преимуществ и недостатков способов окончательного гемостаза при НСХ у больных локализованными формами ПКР свидетельствует о нерешённости этой проблемы и необходимости дальнейших исследований.

Introduction

Introduction. A century and a half of experience in renal surgery has shown the clinical feasibility of preserving a functioning renal parenchyma and the pathogenetic validity of nephron-sparing surgery (NSS) in renal cell carcinoma (RCC).

Objective

Objective. To analyze the available scientific publications on nephron-sparing sutureless kidney surgery or without  so-called renorrhaphy.

Materials and methods

Materials and methods. We have searched the eLibrary, PubMed, Сochrane Library and Scopus databases without time limits. A total of 19365 publications were found in the databases, including 71 randomized controlled clinical trials, 987 reviews of which 168 were systematic and 2 were performed based on data from the Cochrane Library. This review includes publications on the sutureless NSS technique in patients with RCC; clinical cases and abstracts were excluded from the formal analysis of publications. Thus, 132 publications were selected for the analysis, which are presented in the following independently or included in previous literature reviews. The studies available for analysis were quite heterogeneous in terms of patient groups, inclusion criteria, and control points, which did not allow for a meta-analysis of the data presented.

Results

Results. An attempt to abandon the principle of kidney suturing after partial nephrectomy was implemented using methods of hemostasis based on the action of physical factors. At the same time, the value of any one of the methods that seemed at first glance did not show obvious unequivocal advantages in the NSS, the achievement of which would unequivocally reduce the severity of the problematic issue at the present stage. Significant prerequisites for such a state of the problem should be considered the monocentric nature of most studies and relatively little experience in the application of certain methods or their combinations. In the aspect of the foregoing, it is difficult to disagree with the statement that many different methods of hemostasis used during NSS appear not only to be the result of the tireless search for new opportunities by clinicians, but also the real lack of universal technologies.

Conclusion

Conclusion. An analysis of the advantages and disadvantages of the final hemostasis methods during NSS in patients with localized RCC indicates that this problem has not been solved and requires further research.

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