This paper reviews the strategies for correcting ischemia-reperfusion injury (IRI) in kidneys during surgeries and transplantation, discussed and proposed in the current literature. The pathophysiological mechanisms of IRI and a wide range of proposed methods for reducing the severity of injury are considered. The use of such techniques as the combination of ischemic, pharmacological pre- and postconditioning is still being studied. It was observed that researchers were very interested in immunological and biological (stem cell) therapeutic strategies as a potential avenue to lessen the severity of IRI.

Currently, renal cell carcinoma is one of the most common malignant neoplasms, the main treatment method of which is surgery. However, surgical treatment in some cases may be accompanied by deterioration of renal function, which dictates the need to search for alternative treatment methods. This review examines the possibilities of a minimally invasive, radiosurgical procedure - transarterial embolization of the renal arteries in the treatment of renal cell carcinoma. Options for performing this procedure and indications for them are given, the results of using transarterial embolization of the renal arteries for renal cell carcinoma are analyzed, and possible complications are described. The advantages of the method are indicated. The need for further large-scale scientific research devoted to studying the effectiveness and safety of transarterial embolization of the renal artery for renal cell carcinoma is urgent.

The article presents a review of the literature on the current problem of modern transplantology – BK viral nephropathy after nephrotransplantation. Risk factors for BK virus reactivation in immunocompromised patients are reflected. The issues of screening and diagnosis of BK viral infection in people with a transplanted kidney are considered. The role of BK viral nephropathy in renal graft loss is emphasized. The clinical manifestations and treatment strategies of BK viral nephropathy in kidney transplantation are discussed.

Numerous studies indicate a decrease in overall survival among cancer patients who have developed thromboembolic complications. The article presents a review of literature on thromboembolic complications in patients with kidney, bladder, and prostate cancer. The analysis of publications indicates a variety of risk factors and heterogeneous frequency of thromboembolism in patients with malignant neoplasms of the genitourinary system. Prevention of thromboembolism is carried out at all stages of treatment: outpatient, after surgery, during chemotherapy, but is accompanied by a fairly high risk of hemorrhagic complications and recurrences. Direct oral anticoagulants are an alternative to low-molecular-weight heparin for prevention of cancer-associated thromboembolism due to their convenience, efficacy and safety for most patients. An important task is to select patients for primary thromboprophylaxis based on stratification of the risk of thromboembolic complications using prognostic scales.

Introduction. The gold standard of treatment for intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC) is transurethral resection of the bladder (TURB) in combination with intravesical therapy. However, this procedure may cause serious complications. At the same time, studies of various lasers for the treatment of NMIBC have demonstrated their safety and efficacy. Despite this, the topic has not yet been fully explored and is not widely practiced in clinical oncology, making further research necessary.Objective. To compare thulium and holmium lasers with conventional TURB for management of non-muscle-invasive bladder cancer (NMIBC).Materials & methods. In our study, depending on the treatment approach, 84 NMIBC-patients were divided into three groups. Group 1 included 27 patients (34.14%), who underwent laser thulium bladder resection; group 2 included 25 patients (29.76%), who underwent laser holmium bladder resection, and group 3 included 32 patients (38.1%), who underwent standard TURB. Prior to surgery, all patients received a standard set of preoperative general clinical and instrumental examinations for bladder cancer, and the choice of surgical approach was based on informed patient consent, taking into account the benefits and risks of the three treatment options. All surgeries were performed in accordance with established protocols.Results. In the TURB group, the surgery time was the longest and totalled in 20.5 ± 7.4 min. Laser technologies reduce the surgery time to 16.3 ± 5.3 min for a holmium laser and to 14.7 ± 5.2 min for a thulium laser. Also, in groups 1 and 2, a shorter duration of postoperative bladder irrigation was noted (4.4 ± 1.8 and 4.7 ± 1.6 hours) and shorter periods of postoperative bladder catheterisation (1.5 ± 0.08 and 1.6 ± 0.08 days) compared to group 3, where these indicators were 16.4 ± 2.5 hours and 2.5 ± 0.13 days, respectively. Among patients undergoing either holmium or thulium surgery, a higher rate of disease-free survival has been noted. Independent prognostic factors that influence the prognosis of NMIBC in all groups include the type of surgery, history of bladder tumors, and pathological stage.Conclusion. The use of laser technology, such as thulium and holmium laser, in bladder wall resection for NMIBC shows promising results and provides a good clinical outcome that is comparable to (and in some cases, superior to) standard TURB.

AIM:To compare thulium and holmium lasers in the treatment of non-muscle invasive bladder cancer (NMIBC). MATERIALS AND METHODS:In our work, patients were divided into 3 groups, depending on the treatment method. In the group 1 (n=27, 32.14% of the cohort), thulium laser resection of the bladder was done, while in the group 2 (n=25, 29.76% of the cohort) and group 3 (n=32, 38.10 % of the cohort) holmium laser resection and standard transurethral resection (TUR) were performed, respectively. In the preoperative period, all patients underwent a standard clinical examinations and imaging studies (computed tomography of the thorax, abdomen and retroperitoneal space, magnetic resonance imaging of the pelvis, cystoscopy, cytological examination of urine sediment). RESULTS:The duration of the procedure was 14.7+/-5.2 minutes for a thulium laser and 16.3+/-5.3 minutes for a holmium laser, compared to 20.5+/-7.4 minutes for standard TUR. The duration of postoperative irrigation after laser resection was lower (4.4+/-1.8, 4.7+/-1.6 and 16.4+/-2.5 hours, respectively) (p<0.001). The period of postoperative catheterization in groups 1 and 2 was 1.5+/-0.08 and 1.6+/-0.08 days, respectively, compared to 2.5+/- 0.13 days in the group 3 (p=0.002). In the group of thulium and holmium laser resection, a higher disease-free survival was demonstrated compared with TUR throughout the entire follow-up period. CONCLUSION:When performing laser resection of the bladder wall for NMIBC, a significant lower number of complications and better survival were documented compared to patients who underwent TUR.

The effects of the interaction of optical radiation and biological tissues underlie various optical diagnostics technologies, including laser Doppler flowmetry, diffuse reflection spectroscopy, fluorescent spectroscopy, photodynamic diagnostics (fluorescent cystoscopy), confocal microscopy, optical coherence tomography, etc. The efficiency of these technologies is the subject of study in various fields of medicine, such as dermatology and ophthalmology, anesthesiology and cardiac surgery, in the diagnosis of malignant tumors and others. In the first part of our review, the available data on the feasibility of using laser Doppler flowmetry and diffuse reflection spectroscopy as a diagnostic tool in urological practice are reviewed and systematized.

Lung transplantation (LT) is the only treatment for many end-stage lung diseases. Despite significant progress in transplantology and surgery, LT remains a high-tech surgical procedure performed at select research centers. Primary graft dysfunction, acute rejection, and chronic lung allograft dysfunction are serious problems that can worsen lung transplant outcomes significantly. Using animal models in experimental studies to investigate these pathologic conditions is one of the more rational approaches. A literature review was conducted in order to select a suitable model that reproduces pathologic processes developing after LT. The literature was searched and ana- lyzed in MEDLINE and Elibrary databases, and the US National Institute of Health guidelines for the period up to December 2023 were reviewed. It was found that the most frequently used models are small laboratory animal models (without LT) and large animal models (with LT).

Nephrolithiasis in a transplanted kidney is an important medical and social problem. The presence of renal calculi may not manifest clinically for a long time due to the peculiarities of the surgical intervention during organ transplantation. Development of chronic urinary tract infection and deterioration of the functional ability of the renal transplant in the presence of kidney stones can lead to graft death, which is an immediate threat to the patient's life. Existing Russian guidelines on the treatment of urolithiasis currently lack a clear strategy for the management of kidney transplant recipients. Objective: to systematize literature data on analysis of the outcomes of extracorporeal shock wave lithotripsy (ESWL) and other methods in patients with post-transplant kidney stones. Results. Thirty-five publications on the research topic were selected. We summarized the information on various therapy options for patients with stones in transplanted kidney: endourological approach, ESWL, percutaneous nephrolithotripsy (PCNL), open surgical treatment (nephrostomy, pyelolithotomy). A modern foreign algorithm for the management of patients with post-transplant kidney stones depending on the severity of obstruction with sepsis and the size of the renal calculi is presented. Conclusion. 1. The presence of stones in a kidney graft is a clinical situation that requires surgical treatment. 2. In clinical practice, different methods of treatment can be used, such as open intervention, ESWL, PCNL, retrograde transurethral manipulations. 3. In most cases, patient management tactics depend on the clinical picture (presence/absence of obstruction) and the size of the calculi. 4. The use of ESWL, as the most frequently used method, testifies to its efficiency and low-traumatic effect.

Единовременные эндовидеохирургические вмешательства при лечении урологических заболеваний, в случае достаточной отработки методики, являются эффективным методом лечения. При этом они выполняются только у 2,0 – 6,4% пациентов, нуждающихся в таких вмешательствах. Цель настоящего исследования: анализ периоперационных результатов симультанных вмешательств и соответствующих изолированных операций при урологических заболеваниях. Материал и методы проведен ретроспективный анализ периоперационных результатов хирургического лечения 5748 пациентов, прооперированных в период с 01.09.2018 по 30.12.2019. При этом анализировали следующие периоперационные показатели: продолжительность вмешательства, объем интраоперационной кровопотери, время дренирования мочевого пузыря уретральным катетером, частота встречаемости инфекционно-воспалительных осложнений со стороны органов мочеполовой системы в ближайшем послеоперационном периоде, количество койко-дней в стационаре в послеоперационном периоде, продолжительность анестезии. Результаты: выявлены преимущества единовременных эндовидеохирургических вмешательств перед двух- и более этапными вмешательствами урологического профиля по продолжительности, объему интраоперационной кровопотери, частоте развития инфекционно-воспалительных осложнений со стороны урологических органов в раннем послеоперационном периоде и другим изучаемым показателям. Заключение: результаты проведенного исследования полностью подтверждают целесообразность и необходимость более широкого использования единовременных эндовидеохирургических вмешательств при плановом хирургическом лечении сочетанных заболеваний урологического профиля.

Background . Currently, kidney cancer remains one of the most common oncourological diseases with relatively high mortality rate. Aim . To study the main epidemiological indicators of malignant neoplasms of the kidney in various regions of Russia and Saint Petersburg. Materials and methods . Based on the data from the Department of Medical Statistics of Tumor Diseases of the Medical Information and Analytical Center, the epidemiological indicators of malignant neoplasms of the kidney for the period between 2016 and 2021 in Russia, individual Federal Districts of the country and Saint Petersburg were analyzed. Results . Despite the increase in the prevalence of malignant neoplasms of the kidney, medical oncological care for the population is at an appropriate level. Most cases of the disease are diagnosed at early stages, there is a decrease in patient mortality rates and an increase in 5-year survival, which indicates the effectiveness of ongoing anticancer measures. In a number of Federal Districts, a number of indicators showed a negative trend compared to the all-Russia data, which requires close attention. Conclusion . The analysis of statistical data of patients with malignant neoplasms of the kidney can be used to optimize the algorithms for diagnosing and treating this category of patients, as well as to improve oncological care for the population.

Objective. The objective of the study was to investigate the results of operative endoscopic treatment of patients with urological profile depending on the duration of hospitalization.. Patients and methods. The study examined the treatment results of 1647 urological patients aged from 41 to 69 years (mean age 57.1 years), including 791 (48.03 %) males and 856 (51.97 %) females. A comparative analysis of the results of operative endoscopic treatment of patients in two groups was conducted. The interventions were comparable in volume. The first group consisted of patients who were observed in a hospital setting for 3-4 days; the second group consisted of patients who were discharged home within the first day. The visual analog scale (VAS) was used to assess pain. Quality of life was determined using the SF-36 questionnaire. Results. The average pain score on the VAS scale in the first day after surgery in both patient groups was 5.45±0.3 and 5.16±0.2 points, respectively, which was considered «tolerable» pain. The quality of life of patients in the two groups during the first day of the postoperative period indicated comparability of data on the PR, PF, BP, and GH scales. Better parameters were recorded in the second group of patients, compared to the first, on the SF, RE, and MH scales. Analysis of the quality of life questionnaire three days after surgery showed improvement in all scales; better results were achieved in the second group of patients, compared to the first, on the VT, SF, RE, and MH scales, which characterized better social functioning and higher vitality. Conclusion. Endoscopic interventions in urology allow for better pain tolerance, especially in the first day after surgery, which has a positive impact on the quality of life of patients. Shortening the length of hospital stay to one day without increasing the pain syndrome increases the socio-economic significance of endoscopic techniques and emphasizes the prospects for further research.

St. Petersburg, Russian Federation The paper presents a comparative assessment of different methods of treating symptomatic bladder outlet obstruction (BOO) in patients with benign prostatic hyperplasia (BPH) who underwent kidney transplantation (KT).

Worldwide, prostate cancer has remained one of the most common malignant neoplasms among men and it is accompanied by high mortality rates. Standard methods for diagnosing prostate cancer have limited sensitivity and specificity, unnecessary biopsies are often performed, and the risk of overdiagnosis of the disease and overtreatment of patients is high. The review considers diagnostic and prognostic biological markers of prostate cancer proposed in recent years. Theoretical foundations for the use of new biomarkers are analyzed. The characteristics and practical significance of biomarkers of various groups (immunohistochemical, molecular and genetic, prostate specific antigen-associated, volatile organic metabolites) are presented. The need for further large-scale scientific research in the field of biomarker application in prostate cancer, criteria for their selection and evaluation are described. The introduction of modern diagnostic and prognostic markers into real clinical practice opens up new opportunities for improvement of prostate cancer diagnosis, individual prognosis, and rationalization of treatment strategy.

Introduction. Currently, the question of the need for perioperative antibiotic prophylaxis (PAP) during urological operations remains debatable due to the insufficiency of the database that would prove the expediency of mandatory use of PAP to prevent the development of infectious complications in the surgical treatment of urological diseases. The aim of this study was to assess the effect of perioperative antibiotic prophylaxis on the frequency of febrile temperature, leukocytosis, increased serum levels of C-reactive protein, and bacteriuria after various urological interventions. Patients and methods. Method of the study was the analysis of the occurrence of febrile temperature, leukocytosis, increased serum concentration of C-reactive protein, and bacteriuria in the early period after various urological interventions (n=1518) performed in men and women from group 1 (n=753) using perioperative antibiotic prophylaxis (ceftriaxone administered intravenously one hour before the beginning of the intervention (before the incision) at the usual therapeutic dose, equal to 2 g) or without the use of PAP in patients from group 2 (n=765) at the Department of Urology of the St. Petersburg State Budgetary Healthcare Institution St. Luke’s Clinical Hospital. Results. In urological patients treated surgically, the appearance in the early postoperative period of bacteriuria, febrile temperature, leukocytosis, and elevated serum CRP levels was observed only in isolated cases with a frequency of occurrence that did not statistically significantly differ between group 1, where patients were injected intravenously with 2 grams of ceftriaxone 1 hour before the operation, and group 2, the participants of which did not receive PAP. In both groups, the results of the study were not affected by the duration of the intervention and the history of diseases contributing to the development of infectious complications (diabetes mellitus, chronic heart failure, COPD, obesity). Conclusion. Apparently, the question of indications for perioperative antibiotic prophylaxis in the surgical treatment of patients with various diseases of the urological profile remains open, and further research in this direction is relevant.

Background . Prostate cancer is one of the most common malignant neoplasms in the male population worldwide with high morbidity and mortality rates. Aim . To study the main medial statistical indicators of prostate cancer in Saint Petersburg and other regions of the Russian Federation. Materials and methods . The epidemiological indicators of prostate cancer for 2012-2021 in the Russian Federation, individual federal districts and Saint Petersburg were analyzed. Results . The prevalence of malignant neoplasms of the prostate has increased in recent years. At the same time, the number of cases of early-stage disease diagnosis has increased, one-year mortality has decreased, and 5-year survival has increased, which indicates proper quality of oncological care for the population. In some federal districts, unstable or negative dynamics of indicators compared to the average Russian data are observed, which requires further analysis. Conclusion . Evaluation of statistical measures of morbidity and mortality from malignant neoplasms of the prostate gland can be used to improve diagnostic algorithms and therapeutic tactics for this pathology.

Background. Bladder cancer is the most common malignancy of the urinary tract and one of the most common neoplasias in this group. The incidence and mortality rates of the population from bladder cancer differ significantly in different geographical regions of Russia. Aim. To assess the main epidemiological indicators of malignant neoplasms of the bladder in residents of Saint Petersburg and the regions of Russia. Materials and methods. The main epidemiological indicators of malignant bladder neoplasms in Saint Petersburg, Russia and individual federal districts for the period 2012–2021 were studied: crude and standardized rates of morbidity, mortality, prevalence, age structure of patients, the number of cases of diagnosis of the disease at various stages, indicators of one-year mortality and 5-year survival, data on completed cases of treatment of bladder neoplasms. Sources of information: Form No. 7 “Information on cases of malignant diseases” and the database of the Medical Information and Analytical Center (Saint Petersburg). Results. During the period 2012–2021 in Russia, there was an increase in the incidence and prevalence of malignant neoplasms of the bladder. At the same time, mortality rates decreased, and 5-year survival rates increased. This fact indicates the effectiveness of the treatment of patients in this category. In more than 50 % of cases, the disease was detected at stage I of the pathological process, which is due to the proper level of diagnosis. The main medical and statistical indicators in patients with malignant bladder neoplasms in Saint Petersburg are comparable to the average Russian data, and in a number of parameters they exceed them. Conclusion. Oncourological assistance to the population with malignant neoplasms of the bladder in Saint Petersburg is provided properly. The study of medical and statistical indicators in dynamics can be used to improve the algorithms of medical and diagnostic care for cancer patients.

The development of acute renal injury is due to a number of factors both on the part of the patient (age, concomitant pathology, objective status) and the oncological process (stage of the disease, localization, volume of surgical intervention, access, etc.). Acute renal injury in patients with kidney cancer after surgical treatment may be accompanied by the development of early (hyperhydration, electrolyte balance disorders, hyperkalemia, acid‑base condition disorders, uremic intoxication) and late chronic kidney disease complications. The incidence of these complications increases with an increase in the volume of kidney resection, as a result of which it is important to take into account risk factors, timely diagnosis of the degree of kidney damage and medical measures aimed at restoring kidney function. Currently, the possibility of using various molecules as early markers of kidney damage, which help not only assess the presence of kidney damage, but also localize it, is being studied. For example, albumin, serum cystatin C, alpha 1‑microglobulin, P2‑microglobulin – markers of glomerular damage, NGAL, KIM‑1; L‑FABP, urine cystatin‑C, IL‑18 – reflect damage to the proximal tubule, GST, NGAL – distal tubule, calibindin D28 ‑ characterizes damage to the collecting duct, osteopontin, NHE‑3 – are associated with damage to the loop of Henle. Measures of a curative and preventive nature (infusion therapy, anti‑ischemic protection, modulation of ferroptosis, renal replacement therapy), as well as dynamic monitoring of the main biomarkers of renal damage are aimed at preventing the persistence of the pathological process with a possible outcome into chronic kidney disease, which is especially undesirable in patients with single kidney cancer. The main directions of medical and preventive measures in patients with acute kidney injury should be considered: 1) the fastest possible elimination or minimization of the effect of tumor tissue; 2) control and correction of life‑threatening complications of renal dysfunction (hyperhydration, electrolyte balance disorders (hyperkalemia), acid‑base state, uremic intoxication). Methods of anti‑ischemic protection include a number of surgical techniques aimed at 1) minimizing ischemia time, 2) reducing the intensity of volatile metabolic processes in the kidney, 3) training renal parenchyma for hypoxic conditions (receiving ischemic preconditioning). Duration of renal ischemia represents an important modifiable factor affecting early and distant renal function in surgically exposed patients. The article analyzes modern scientific data on the problem of postoperative acute kidney injury in renal cancer surgery.

Открытая или лапароскопическая резекция почки при хирургическом лечении локализованной формы почечноклеточного рака часто сопряжена с введением почки в условия тепловой ишемии. Применение ТИП позволяет предотвратить развитие паренхиматозного кровотечения, оптимизировать условия оперирования, существенно повысить эффективность гемостаза. Однако вероятность ишемически-гипоксического повреждения сохраняемой части почечной ткани и нарушения почечной функции в послеоперационном периоде являются важными проблемами тепловой ишемии почки. Цель исследования: оценка результатов применения фумарата натрия, фуросемида и маннитола на начало и исход тепловой ишемии почек на экспериментальной модели 30- или 60-минутной тепловой ишемии почки у кроликов. Материалы и методы. Экспериментальное исследование выполнено на 360 конвенциональных кроликах-самцах породы «Шиншилла» массой тела 2,6±0,3 кг, которые были разделены на 10 групп. Контрольная группа №1 состояла из интактных животных, в контрольную группу №2 входили кролики, которых оперировали без пережатия почечной артерии. Животным из рабочих групп (№3-№10) создавали экспериментальную модель 30- или 60-минутной ТИП. В группах №3 и №4 медикаментозное сопровождение не предусматривалось. Остальные кролики тепловое обескровливание почки переносили на фоне действия фумарата натрия (группы №5 и №6 - 1,5 мл/кг в/в), лазикса (группы №7 и №8 - 3,0 мг/кг в/в) и маннитола (№9 и №10 - 1,0 г/кг в/в). Изучалось влияние ТИП на ультраструктуру почечной ткани и уровни содержания в крови и в моче NGAL, цистатина-С и креатинина. Результаты. После экспериментальной некорригированной 30-минутной ТИП у подопытных животных выявляются набухание и отек конечной части микроворсин эпителия проксимальных канальцев, увеличение в гиалоплазме эпителиоцитов численности лизосом, появление в просветах дистальных канальцев и собирательных трубочек хлопьевидного содержимого средней электронной плотности, а также резкое (пикообразное) повышение содержания в крови и в моче NGAL и цистатина-С. Увеличение продолжительности обескровливания до 60 минут сопровождается возрастанием степени тяжести и масштабов отмеченных нарушений. В группах, где применялись фумарат натрия, лазикс и маннитол, отмеченные ультраструктурные нарушения были выражены в меньшей степени, однако лучшую нефропротективную активность проявлял фумарат натрия. На фоне действия маннитола выраженность отмеченных расстройств была меньшей, чем в группе, где применение маннитола, лазикса или фумарата натрия не предусматривалось. Лазикс и натриевая соль фумаровой кислоты проявляли более высокую нефропротекторную активность. Наилучшие результаты были получены у животных, защищенных фумаратом натрия. Выводы. Фумарат натрия оказал наибольщее нефропротекторное действие в отношении ишемии почки у кроликов, затем фуросемид, в то время как маннитол – наименьшее. Применение фумарата натрия позволяет максимально эффективно защищать и стимулировать почечную ткань во время тепловой ишемии почки. While performing surgical treatment of the localized form of renal cell cancer by means of open or laparoscopic kidney resection, renal warm ischemia (RWI) is becoming the necessary aspect of the intervention. Using RWI allows to prevent parenchymal bleeding, to optimize operative conditions, to increase significantly the efficiency of hemostasis. However, an important problem is the probability of ischemic hypoxic damage of the secured part of the kidney tissue during RWI and renal functional impairment in the postoperative period. Aim of the study – comparative study of nephroprotective activity of sodium fumarate, mannitole and furosemide using experimental model of 30- and 60-minute renal warm ischemia in rabbits. Materials and methods. The experiments were carried out on 360 conventional male-rabbits of the “Chinchilla” breed weighed 2,6±0,3 kg which were allocated into 10 groups. The control group №1 included intact animals, the control group №2 included the rabbits that were operated without clamping the renal artery. For the animals from the trial groups (№3-№10) the experimental model of 30- and 60-minute RWI was developed. In groups №3 and №4 medication was not provided. Other rabbits endured renal warm exsanguination against the background of sodium fumarate (groups №5 and №6 - 1,5 ml/kg IV), lasix (groups №7 and №8 - 3,0 mg/kg IV) and mannitole (№9 and №10 - 1,0 g/kg IV). The influence of RWI on the renal tissue ultrastructure and the levels of NGAL, Cystatin-C and creatinine in blood and urine were studied. Results. Experimental pharmacologically non-corrected 30-minute RWI in trial animals induced swelling and edema of the final part of microvilli of the proximal tubules epithelium, increase of lysosome number in the hyaloplasm of epithelial cells, appearance of flaky content of medium electronic density in the lumens of distal tubules and collecting tubes, as well as sharp peak-like increase of NGAL and cystatin-C in blood and urine. Increasing the time of exsanguination up to 60 minutes was accompanied by the growth of severity and range of the observed disorder. In groups where sodium fumarate, lasix and mannitole were used the observed ultrastructural disturbances were expressed to lesser extent, whereas sodium fumarate demonstrated the best nephroprotective activity. In case of using mannitole the intensity of the observed disturbances was less than in the groups where mannitole, lasix or sodium fumarate were not provided. Lasix and sodium salt of fumaric acid showed a higher nephroprotective activity. The best results were received in the animals protected by sodium fumarate. Conclusions. The studied medications provided a nephroprotective effect regarding renal ischemia of rabbits, sodium fumarate in the greatest degree, furosemide – less and mannitole – the least. Use of sodium fumarate allows to protect and stimulate the kidney tissue maximum effectively during oxygen deprivation of the ischemized organ.

BACKGROUND: Renal cell cancer is accompanied by the development of a disorder of renal function. The parameters of homeostasis after nephrectomy in renal cell cancer are not well understood. AIM: The aim of the study is to compare the kidney functional status and parameters of homeostasis in patients with RCC after nephrectomy performed by open and laparoscopic surgery. MATERIALS AND METHODS: Eighty patients with renal cell cancer Т3N0M0 were randomized according to the surgery into the comparison group with open nephrectomy (n = 40; 50,1 3,4 years old; 18 males, 22 females) and the main group with laparoscopic nephrectomy (n = 40; 52,4 5,1 years old; 16 males, 24 females). The control group was comprises from twenty subjects without urological pathology, 2258 years old, 10 males, 10 females. Laboratory parameters of endotoxicosis, lipid peroxidation, kidney functional status, partial kidney functions, and urinary syndrome were assessed on the 1st, 3rd, 6th and 10th days after the surgery. RESULTS: The early postoperative period of nephrectomy in renal cell cancer is accompanied by the development of endotoxicosis, activation of lipid peroxidation, deterioration of the functional state of the remaining kidney, and the formation of chronic kidney disease. At the same time, both systemic indicators (toxicity index, as well as concentrations of medium-weight molecules, diene conjugates, malondialdehyde), and renal parameters (glomerular filtration rate, albumin-creatinine ratio) are associated with the method of surgery: with a laparoscopic approach, changes in these indicators are reversible and less pronounced than with open nephrectomy. CONCLUSIONS: The present study demonstrates the advantage of laparoscopic nephrectomy compared to open nephrectomy in patients with renal cell cancer.