Yu.A. Korelov

Introduction. Prostate cancer (PCa) is one of the most common oncological diseases, the tactics of its treatment directly depends on the stage. According to statistics, prostate cancer (prostate cancer) accounts for more than 1.4 million new cases annually. The «gold» standard at the moment for localized prostate cancer is surgical intervention in the volume of radical robot-assisted prostatectomy. The aim was to development technologies for calculating the trajectory of movements of the traveled path of surgical instruments during robot-assisted radical prostatectomy; devalopment and implementation of an «active» robot system into the learning process, and later into the workflow; devalopment of a self-monitoring system for a surgeon in self-study. Materials and methods. On the basis of the Bashkir State Medical University clinic, 30 surgical robot-assisted radical prostatectomies performed by two surgeons were analyzed, of which surgeon 1 performed 14 surgical interventions and surgeon 2 performed 16 surgical interventions. Results. During the analysis, data were obtained on the average duration of the operation of robot-assisted radical prostatectomies, the movement time of robotic instruments. Conclusion. The study of the analysis of the time of movement of instruments is an important step towards optimizing resources and improving the efficiency of the medical process.

Bladder cancer is the 2nd most common urological oncological disease in the worlds. Tumors can be muscle invasive and non-muscle invasive. Recently, tumor microenvironment (TME) became a focus of investigation in malignant tumors of the bladder. According to the currently available data, TME is a specific environment crating optimal conditions for carcinogenesis in the neoplastic lesion. The main parts of TME are extracellular matrix and stroma including vasculature, stromal, and immune cells. Additionally, TME includes cytokines, chemokines, and other compounds activating signal pathways necessary for tumor cells. Tumor-associated macrophages (TAMs) are being extensively studied as representatives of TME in solid tumors of varying locations. These macrophages can be classified into 2 phenotypes: M1 (pro-inflammatory and antitumor) and M2 (anti-inflammatory and protumor). The phenotypes perform different roles, and M2 macrophages regulate the most important processes of oncogenesis (invasion, proliferation, neoangiogenesis, etc.). In the context of bladder cancer, M2 macrophages are the most significant as they are the most numerous TAMs in TME.Aim. To study the role of tumor-associated macrophages in development of bladder tumors, as well as prognostic value of these macrophages.

Introduction. Prostate cancer remains the most common urological malignancy, and robot-assisted radical prostatectomy (RARP) is the most effective treatment option. Special conditions for operation (Trendelenburg position and pneumoperitoneum) increase the airway pressure and reduce functional residual capacity of the lungs. Objectives. Review of risk factors for disorders and various interventions to improve pulmonary function and reduce the adverse physiological effects of RARP under general anesthesia. Materials and methods. This review of literature was conducted using the PubMed search engine in electronic databases Medline, Embase, the Cochrane Library and others up to May 2019. Results. A total of 22 studies were searched, including 9 randomized controlled trials. The factor that could worsen gas exchange during RARP was the body mass index < 30 kg/m2. It is possible to improve gas exchange by means of recruitment maneuvers. Positive end-expiratory pressure of 5–10 cm H2O improves oxygenation but requires alertness in patients with chronic heart failure and chronic obstructive pulmonary disease. Conclusions. The main risk factors for perioperative respiratory and oxygenation disorders in RARP are pneumoperitoneum and steep Trendelenburg position. The effectiveness of ventilation regimes for the prevention of gas exchange disorders has not been proven. Using the recruitment maneuver and increasing the positive end-expiratory pressure does not improve the respiratory function of the lungs. Further studies with a longer follow-up period are needed to determine the clinical efficacy and safety of RARP.