Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC880910.15690/vramn8809ONCOLOGY: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ ОНКОЛОГИИResearch ArticleComparative Evaluation of the Results of Radical Surgical Treatment of Patients with Muscle-Invasive Bladder CancerСравнительная оценка результатов радикального хирургического лечения пациентов с мышечно-инвазивным раком мочевого пузыряhttps://orcid.org/0000-0003-1243-743XStartsevVladimir Yu.СтарцевВладимир Юрьевич
Russian Federation

MD, PhD, Professor

д.м.н., профессор

doc.urolog@gmail.comhttps://orcid.org/0009-0001-6822-5869SarychevSergey V.СарычевСергей Владимирович
Switzerland

MD, PhD, Department of Urology

д.м.н., профессор

sergey.sarychev@gmx.chhttps://orcid.org/0000-0002-2479-0436TyapkinNikolay I.ТяпкинНиколай Иванович
Russian Federation

MD

врач

nikt1982@gmail.comhttps://orcid.org/0000-0002-1462-6907KondratievGleb V.КондратьевГлеб Валентинович
Russian Federation

MD

врач

spbgvk@mail.ruSt. Petersburg State Pediatric Medical UniversityСанкт-Петербургский государственный педиатрический медицинский университетSpital Thurgau AGГоспиталь Тургау АГLeningrad Regional Clinical HospitalЛенинградская областная клиническая больница231220237865685742104202301122023Copyright ©; 2023, "Paediatrician" Publishers LLCCopyright ©; 2023, Издательство "Педиатръ"2023"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/article/view/8809

Malignant neoplasms of the bladder with invasion into the muscle layer of the organ wall (MIBC) are recognized as a highly aggressive pathology with a poorly predicted outcome, a high mortality rate, involving patients of any age without gender differences. Radical surgery’s in patients with MIBC has long and highly established itself as one of the main methods of treatment. However, the results of open surgical interventions are still accompanied by a high level of complications. The materials of medical literature (PubMed, CrossRef) for 2000–2023 were studied, with the issues of comparative evaluation of the results of surgical treatment of patients with MIBC, complications of the postoperative period. The search was conducted on the key phrases “bladder cancer”, “open cystectomy”, “robot-assisted cystectomy”, “cancer-specific survival”. The widespread introduction of video-endoscopic methods of treating patients with this disease into clinical practice has made it possible to speak about a decrease in the volume of intraoperative blood loss, the frequency of infectious complications of the wound and inpatient stay. The development of robot-assisted bladder surgery (RARC) demonstrates a number of advantages of using the daVinci robot in terms of reducing the number of postoperative complications during the traditional to study the 30–60–90-day follow-up periods. The issues of rehabilitation of patients after various methods of urine diversion, the medical-economic aspects for RARC in expert urological centers and the feasibility of the widespread introduction of this technique in medical institutions remain unclear. The coverage of these issues in the medical scientific literature is ambiguous, and therefore requires additional analysis.

Злокачественные новообразования мочевого пузыря с инвазией в мышечный слой стенки органа (МИРМП) признаны высокоагрессивной патологией с плохо прогнозируемым исходом, высоким показателем смертности и вовлечением пациентов любого возраста без гендерных различий. Радикальная хирургия у пациентов с МИРМП давно зарекомендовала себя как один из основных методов лечения, однако результаты открытых оперативных вмешательств до сих пор сопровождаются высоким уровнем осложнений. Изучены материалы публикаций отечественной и иностранной медицинской литературы (PubMed, CrossRef) за 2000–2023 гг. по вопросам сравнительной оценки результатов хирургического лечения пациентов с МИРМП, осложнений ближайшего и отдаленного послеоперационного периодов. Поиск проведен по ключевым фразам «рак мочевого пузыря», «открытая цистэктомия», «робот-ассистированная цистэктомия», «раково-специфическая выживаемость». Широкое внедрение в клиническую практику видеоэндоскопических методов лечения пациентов с этим заболеванием позволило говорить о снижении объема интраоперационной кровопотери, частоты инфекционных раневых осложнений и стационарного койко-дня. Развитие робот-ассистированной хирургии мочевого пузыря (РАРЦ) свидетельствует о ряде преимуществ использования робота daVinci в плане снижения числа послеоперационных осложнений в течение ставших традиционными 30–60–90-дневных периодов наблюдения. Остаются неясными вопросы реабилитации пациентов после различных методик деривации мочи, медико-экономическое обоснование использования РАРЦ в условиях экспертных урологических центров, целесообразность широкого внедрения данной методики в лечебных учреждениях. Освещение этих вопросов в медицинской научной литературе неоднозначно и потому требует дополнительного анализа.

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