Повторные операции после эксплоративных лапаротомий при раке почки

Abstract

The available literature contains isolated information about the immediate and long-term results of repeated operations after exploratory laparotomy, as well as the quality of life of patients with stage III-IV kidney cancer. Purpose: to make a comparative analysis of the results (immediate and long-term) and quality of life in patients with stage III-IV kidney cancer, re-operated after exploratory laparotomy, with similar criteria for the effectiveness of treatment in patients with similar diagnoses after primary radical surgery. Material and methods. The control group consisted of 15 patients with advanced forms of cancer of the kidney and renal pelvis III and IV stages of the disease, aged 41 to 71 years. The main group included 12 patients with similar diagnoses from 25 to 85 years old. Type of study - observational, prospective. Quality of life was assessed using the EORTC QLQ C-30 questionnaire. Information-analytical, quantitative and qualitative methods of statistical analysis (Statistica 6). Results. Significantly prevailed nephrectomy with thrombectomy of cases of kidney cancer complicated by venous thrombosis, in the control group it was 66.7%, in the main group - 83.3%. Average terms of inpatient treatment: in the control group - 17.9±1.0 days, in the main group - 18.30±1.25 days (p>0.05). Postoperative complications were observed in 2 (13.3%) patients in the control group and in the same number of operated patients in the main group (2–16.7%) (p>0.05). Postoperative mortality was 6.7% in the control group and 8.3% in the main group (p>0.05). There are no statistically significant differences in all quality of life scales between patients in the control and main groups. There were 3 patients in the control group who were alive at the time of the study (21.4%); in the main one - also 3 (27.3%) (р>0.05). Conclusion. In 80% of cases, patients with stage III-IV kidney cancer who have undergone exploratory surgery can perform a repeated full-fledged surgical intervention in highly specialized oncology centers. Immediate and long-term results of repeated surgeries for stage III-IV kidney cancer, not significantly different from those after primary surgeries.