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Tactics of treatment of patients with a kidney tumour on the one hand and at a lesion not oncologic disease from the opposite.

Number patsmientov by which concerning a kidney tumour the nephrectomy is carried out, a considerable quantity. And thus all functional load lays down on an opposite organ. Can develop hyperfiltrational glomerulopatija with an outcome in a nephrosclerosis and HBP is a principal cause of mors of patients with a unique kidney.

Besides it, among causes of death of one-renal patients diseases of a unique kidney have great value. Possibility of a lesion of a unique kidney a chronic pyelonephritis, MKB, tumoral process causes that «only conditionally it is possible to consider one-renal patients healthy» (Pytel A.J., Grishin M. A, 1973). Thus, in spite of the fact that the radical nephrectomy is one of methods of treatment sick of a tumour of a kidney, indications to it are necessary for choosing carefully.

Earlier revealing of a tumour of a kidney was the absolute indication to a nephrectomy. Last years there were many reports in the literature that results OSO are not worse organounosjashchej, and even better (Lah - motko A.A., 1999; Licht M R Novick A.S., 1993; Lerner S.E. And co-workers 1996 Lopatkin N.A., 1999). In communication by it pressing question of a choice of medical tactics and now - a nephrectomy or a resection (Lopatkin N.A. and co-workers., 1992).

Definition of medical tactics at a kidney tumour is based on full complex studying by the amazed tumour of a kidney, and also on careful research of an opposite organ. For correct formation of medical tactics it is necessary to estimate not only the present functional condition of both kidneys, but also their potential possibilities. The incorrect estimation of reserve possibilities of an opposite organ can lead to inevitable consequences at performance OSO.

Especially the great value is given to reserve possibilities of an opposite kidney as the critical estimation of an opposite organ with revealing of its latent functional insufficiency defines expediency OSO.

Besides it, the asynchronous lesion of an opposite kidney oncologic or not oncologic disease after operative treatment of a neoplasm is possible after a while also. If concerning a kidney tumour it is executed OSO the situation is not so critical as at one-renal patients. Possibility of a lesion of an opposite organ after sometimes long enough time after an oncotomy is argument in favour of expansion of indications to OSO (J.G.Aljaev, 2005).

Whether at a tumour of one kidney another can be absent to be amazed oncologic (a bilateral synchronous tumour of kidneys) or not oncologic disease (cysts, concrements, etc.) and also to remain intact. J.G.Aljaeeva's carried out analysis (2005) has shown, that the lesion of an opposite kidney was observed by oncologic or not oncologic process at 24,8 % of patients.

At a tumour of one kidney and a lesion it is necessary to define another (J.G.Aljaev, 2005):

• sequence of performance of operative grants at a tumour of a kidney and disease of an opposite organ;

• an operation kind (organosohranjajushchaja or organounosjashchaja) depending on a condition of an opposite kidney.

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A source: Hamitov Denis Dinarovich. Tactics of surgical treatment of patients with bilateral tumors of the kidneys, a tumor of a single kidney and patients with a kidney tumor in combination with chronic kidney diseases on the opposite side. Thesis for the degree of candidate of medical sciences. Kazan 2014. 2014

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