urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2024-12-4-82-90urovest-923Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESПервый опыт применения хирургического средства Лимфоблок для профилактики развития лимфогенных осложнений при робот-ассистированной радикальной простатэктомии и тазовой лимфаденэктомииLymphoblock surgical solution for the prevention of lymphogenic complications during robot-assisted radical prostatectomy and pelvic lymphadenectomy: first-use experiencehttps://orcid.org/0000-0001-6651-8142СкрупскийК. С.SkrupskiyK. S.

Скрупский Константин Сергеевич.

Москва

Konstantin S. Skrupskiy.

Moscow

89_sks@mail.ruhttps://orcid.org/0000-0003-4511-5998КолонтаревК. Б.KolontarevK. B.

Колонтарев Константин Борисович — д-р мед. наук, профессор.

Москва

Konstantin B. Kolontarev — Dr.Sc.(Med), Full Prof.

Moscow

kb80@yandex.ruhttps://orcid.org/0000-0003-3299-0574ГоворовА. В.GovorovA. V.

Говоров Александр Викторович — д-р мед. наук, профессор.

Москва

Aleksandr V. Govorov — Dr.Sc.(Med), Full Prof.

Moscow

dr.govorov@gmail.comhttps://orcid.org/0009-0008-2961-1688ДьяковВ. В.DyakovV. V.

Дьяков Владимир Валентинович — канд. мед. наук.

Москва

Vladimir V. Dyakov — Cand.Sc.(Med).

Moscow

dr.diakov@gmail.comhttps://orcid.org/0000-0001-5115-0234ЛукинА. М.LukinA. M.

Лукин Андрей Михайлович.

Москва

Andrey M. Lukin.

Moscow

look7in@yandex.ruhttps://orcid.org/0009-0002-9820-9365ДжумабаевБ. И.DzhumabaevB. I.

Джумабаев Бекзод Искандарович.

Москва

Bekzod I. Dzhumabaev.

Moscow

djumabaev_bek@mail.ruhttps://orcid.org/0000-0002-6096-5723ПушкарьД. Ю.PushkarD. Yu.

Пушкарь Дмитрий Юрьевич — д-р мед. наук, профессор, акад. РАН.

Москва

Dmitry Yu. Pushkar — Dr.Sc.(Med), Full Prof., Acad. of the RAS.

Moscow

pushkardm@mail.ruГородская клиническая больница им. С.П. БоткинаРоссияBotkin City Clinical HospitalRussian FederationРоссийский университет медицины; Городская клиническая больница им. С.П. БоткинаРоссияRussian University of Medicine (RosUniMed); Botkin City Clinical HospitalRussian FederationМосковский областной центр кровиРоссияMoscow Region Blood Research CentreRussian FederationРоссийский университет медициныРоссияRussian University of Medicine (RosUniMed)Russian Federation2024060920241248290Copyright © Скрупский К.С., Колонтарев К.Б., Говоров А.В., Дьяков В.В., Лукин А.М., Джумабаев Б.И., Пушкарь Д.Ю., 20242024Скрупский К.С., Колонтарев К.Б., Говоров А.В., Дьяков В.В., Лукин А.М., Джумабаев Б.И., Пушкарь Д.Ю.Skrupskiy K.S., Kolontarev K.B., Govorov A.V., Dyakov V.V., Lukin A.M., Dzhumabaev B.I., Pushkar D.Y.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/923Введение

Введение. Согласно клиническим рекомендациям, при проведении радикального лечения у пациентов с раком предстательной железы (РПЖ) промежуточного и высокого риска выполняется тазовая лимфаденэктомия (ТЛ). При этом частота развития лимфоцеле достигает 10,3%.

Цель исследования

Цель исследования. Оценить эффективность применения хирургического средства Лимфоблок в профилактике образования лимфоцеле у пациентов, перенёсших робот-ассистированную радикальную простатэктомию (РАРП) и тазовую лимфаденэктомию (ТЛ).

Материалы и методы

Материалы и методы. В исследование включены 79 пациентов, перенёсших РАРП и ТЛ. Пациенты были рандомизированы на 3 группы: группа 1 — пациенты с фиксацией свободного лоскута брюшины к лонной кости (n = 26); группа 2 — пациенты с применением инвазивного хирургического средства Лимфоблок (n = 26); группа 3 — контрольная группа (n = 27). Период наблюдения за каждым пациентом составлял 180 дней.

Результаты

Результаты. В послеоперационном периоде лимфоцеле имело место у 8 (10,1%) больных: группа 1 — 2 (7,7%) пациента, группа 2 — 1 (3,8%) пациент, группа 3 — 5 (18,5%) пациентов. Следует отметить, что выявленное образование в группе применения лимфостатического препарата не имело клинических проявлений.

Заключение

Заключение. Предварительные результаты применения Лимфоблока свидетельствуют о том, что использование препарата может уменьшить частоту развития лимфогенных осложнений в послеоперационном периоде у пациентов, перенёсших РАРП и ТЛ.

Introduction

Introduction. The clinical guidelines recommend performing extended pelvic lymph node dissection for patients with intermediateor high-risk cancer prostate. The incidence of lymphocele development reaches 10.3%.

Objective

Objective. The aim of this study was to evaluate the efficiency of the drug Lymphoblock after radical prostatectomy with pelvic lymphadenectomy.

Materials & methods

Materials & methods. The study involved 79 patients with prostate cancer who underwent robot-assisted radical prostatectomy with pelvic lymphadenectomy, that were randomized into three treatment groups: 1. Patients with free peritoneal flap fixed to the pubic bone (n = 26); 2. Patients who received Lymphoblock: during the surgery (n = 26); 3. Control group (n = 27). The median follow-up was 180 d.

Results

Results. In postoperative period lymphocele was diagnosed in 8 (10.1%) patients: group 1 — 2 (7.7%) patients, group 2 — 1 (3.8%), group 3 — 5 (18.5%). Lymphocele had no clinical manifestation in group patients who received Lymphoblock.

Conclusions

Conclusions. Preliminary results of Lymphobloc use indicate that it can reduce the incidence of lymphogenic complications in the postoperative period in patients undergoing robot-assisted radical prostatectomy with pelvic lymphadenectomy.

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