Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press11810.17650/1726-9776-2011-7-1-95-100DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORSДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫPOSSIBILITIES OF URINARY TRACT RECONSTRUCTION AFTER TOTAL SMALL PELVIC EXENTERATIONS IN PATIENTS WITH LOCALLY ADVANCED PRIMARY AND RECURRENT RECTAL TUMORSВОЗМОЖНОСТИ РЕКОНСТРУКЦИИ МОЧЕВЫДЕЛИТЕЛЬНОЙ СИСТЕМЫ ПОСЛЕ ТОТАЛЬНЫХ ЭКЗЕНТЕРАЦИЙ МАЛОГО ТАЗА У ПАЦИЕНТОВ С МЕСТНО-РАСПРОСТРАНЕННЫМИ ПЕРВИЧНЫМИ И РЕЦИДИВНЫМИ ОПУХОЛЯМИ ПРЯМОЙ КИШКИPetrovL. O.ПетровЛ. О.
Russian Federation
byalekseev@mail.ruAlekseevB. Ya.АлексеевБ. Я.
Russian Federation
byalekseev@mail.ruSidorovD. V.СидоровД. В.
Russian Federation
byalekseev@mail.ruButenkoA. V.БутенкоА. В.
Russian Federation
byalekseev@mail.ruGrishinN. A.ГришинН. А.
Russian Federation
byalekseev@mail.ruLozhkinM. V.ЛожкинМ. В.
Russian Federation
byalekseev@mail.ruTroitskiyA. A.ТроицкийА. А.
Russian Federation
byalekseev@mail.ruMainovskayaO. A.МайновскаяО. А.
Russian Federation
byalekseev@mail.ruChissovV. I.ЧиссовВ. И.
Russian Federation
byalekseev@mail.ruP.A. Herzen Moscow Oncology Research Institute, Russian Agency for Health CareФГУ МНИОИ им. П.А. Герцена Минздравсоцразвития РФ3003201171951002707201427072014https://oncourology.abvpress.ru/oncur/article/view/118

The investigators analyzed the world literature on and the immediate and late results of 14 total small pelvic exenterations with different urinary tract reconstruction modalities. Postoperative complications occurred in 57.1 % of patients; postoperative mortality was 7.1 %. Late results were followed up in 12 patients. Overall survival at 10 to 48 months after surgery (median 26 months) was 83.3 %; relapse-free survival was 75 %. Urine derivation was made via orthotopic bladder plasty in 5 patients, Bricker operation in 6, and bilateral ureterocutaneostomy in 3. Functional results were regarded as good in all the patients after orthotopic bladder plasty. Thus, adequate urinary tract reconstruction allows one to expect the quality of life to be better without a negative impact on oncological results.

Проведен обзор мировой литературы и проанализированы непосредственные и отдаленные результаты 14 тотальных экзентераций малого таза с различными вариантами реконструкции мочевыделительной системы. Послеоперационные осложнения имели место у 57,1 % больных, послеоперационная летальность составила 7,1 %. Отдаленные результаты прослежены у 12 пациентов. Общая выживаемость в сроки от 10 до 48 мес после операции (медиана 26 мес) составила 83,3 %, безрецидивная выживаемость — 75 %. Деривация мочи была обеспечена путем выполнения ортотопической пластики мочевого пузыря у 5 больных, операции Брикера – у 6, билатеральной уретерокутанеостомии – у 3 пациентов. Функциональные результаты оцениваются как хорошие у всех пациентов после ортотопической пластики мочевого пузыря. Таким образом, выполнение полноценной реконструкции мочевыделительной системы позволяет рассчитывать на улучшение качества жизни больных без отрицательного влияния на онкологические результаты.

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