Vol 7, No 3 (2011)

Background. Retropubic radical prostatectomy (RPE) is now the gold standard of treatment for locally advanced prostate cancer (PC). However, robot-assisted RPE procedures using the da Vinci system are finding increasing acceptance.

Materials and methods. The authors conducted a prospective study of 60 robot-assisted prostatectomies made at the Clinic of Urology, N.I. Pirogov National Medical Surgical Center, in the period January 2009 to December 2010.

Results. The duration of an operation averaged 230 min; the average amount of blood loss was 200 ml. The mean duration of postoperative analgesia was 2,7 days. That of urinary catheterization was 8.5 days. A normal postoperative course was noted in most cases (88,4 %). Seven patients were found to have 8 (13,3 %) mild and moderate complications. A pathohistological study revealed a positive surgical margin of resection in 21,7 % of the patients, extracapsular tumor growth in 21,7 %, and seminal vesicle invasion in 23,3 %. Tumor-affected regional lymph nodes were detected in 1 (1,7 %) patient. In our observed series, 82 and 93 % of the subjects completely retained urine after 6 and 12 moths, respectively. Throughout the follow-up, erectile function recovered in 7 of the 15 patients undergoing a nerve-sparing surgical procedure.

Conclusion. Postoperative results in our series of interventions are comparable to those obtained in the studies by Russian and foreign colleagues at the early stage of mastering this procedure. By considering a few observations, it is today difficult to say that our study is valid in the context of evidence-based medicine. Estimation of the benefits of robot-assisted laparoscopic prostatectomy calls for long-term multicenter randomized trials.

Objective. The developing and introduction the quality of life (QL) automatized assessment in oncourological patients in clinical practice.

Subjects and methods. General questionnaire EORTC QLQ-C30 and modules (QLQ-PR25 and QLQ-BLM30) were selected for QL assessment. The software tools of hospital information system were used for development. There were surveyed 236 oncourological patients.

Results. Forms of unitary and dynamic researches were developed for result visualization, interactive modules were developed for data complex analysis. The first results of QL assessment were received. The highest values were in role and social functions (medians were equal 100 points). Fatigue, pain and sleeplessness were disturbed patients most of all (medians — 33,3, 16,7 and 33,3 points respectively). The median of Global health status was not high, only 50 points. There were analyzed three nosological groups of patients: urinary bladder cancer, renal cancer, prostate cancer. And the lowest values of functioning scales were in patients with urinary bladder cancer; also these patients complained of dyspnea reliably more often.

Conclusions. The developed technology of quality of life study can be used as a good methodological base for assessment of cure efficiency not only in early postoperational period, but during treatment, and in late time after termination of course of treatment.

Bladder cancer (BC) is one of the most common malignancies. More than 90 % of the notified cases are morphologically diagnosed as transitional cell carcinoma; moreover, over 70 % of them are the early stages (Ta, Tis, and T1) of the disease. Patients with diagnosed T1 tumor are deemed to be the most difficult group of patients with early-stage BC. Despite the generally good prognosis of the course of this stage of BC after performed therapy, the tumor recurs in most patients and progresses to a more disseminated stage in 15–20 %. In this connection, there is a continuous search for the prognostic markers associated with the poor prognosis of the disease. A number of morphological, immunohistochemical, and molecular signs that, according to the investigators’ data, correlate with the risk for BC recurrence and progression have been identified. Nonetheless, a diagnostic testing algorithm that permits the prediction of the course of the disease from primary histological data remains to be elaborated. There should be further investigations that enable one to develop an informative panel of diagnostic and prognostic markers that allow a pathologist to correctly define the stage and prognosis of the disease and a clinician to choose an optimal treatment policy for each patient.