Сулейманов Сулейман Исрафилович

BACKGROUND: Bladder cancer is the most common urinary tract cancer. Transurethral resection of the bladder wall tumor is the gold standard for non-muscle-invasive bladder cancer. In recent years, laser technologies have been actively implemented into clinical practice, including the surgical treatment of bladder cancer, but there are still many questions regarding their use. AIM: To evaluate the efficacy and safety of bladder wall tumor resection followed by neodymium (Nd:YAG) laser ablation of the tumor. MATERIALS AND METHODS: Surgical treatment outcomes in 97 patients with non-muscle-invasive bladder cancer were analyzed for the period between 2012 and 2023. Group 1 (n = 49) underwent classical transurethral resection of the bladder wall. Group 2 (n = 47) underwent the same procedure followed by Nd:YAG laser ablation of the tumor bed. Treatment outcomes were evaluated at 3, 6, and 12 months after surgery. RESULTS: Analysis of complications using the Clavien–Dindo classification system showed a more favorable postoperative course in group 2. Within 1 year after surgery, the rate of bladder cancer recurrence was significantly lower in group 2 compared to group 1, with 4 and 13 cases, respectively (p 0.05). In addition, no patient in group 2 had a recurrence in the area of the resected tumor bed, whereas 9 patients in group 1 had such recurrence during the specified period. CONCLUSIONS: The study demonstrates the potential of using laser technologies in the treatment of bladder cancer. Its clinical implementation will facilitate personalized surgical treatment options for patients with urological cancers and reduce the risk of tumor recurrence.

BACKGROUND: Benign prostatic hyperplasia (BPH) is common middle-aged and elderly men. In modern urology, transurethral resection and its modifications are used in surgical treatment of BPH. In the last decades, an active tendency of laser technologies development in urology was noted. The search for the most appropriate techniques of transurethral removal of prostate adenoma by comparing the results of treatment of patients with the use of different technologies remains relevant. AIM: This study aimed to evaluate the clinical effectiveness of transurethral bipolar surgery and laser technologies in the treatment of BPH. MATERIALS AND METHODS: Transurethral enucleation of the prostate using various technologies was performed in 273 patients with BPH between 2021 and 2023: 94 patients underwent bipolar transurethral enucleation of the prostate, 87 underwent thulium enucleation of the prostate (ThuLEP), and 92 underwent holmium enucleation of the prostate (HoLEP). RESULTS: Clinical evaluation showed the absence of intraoperative complications. For ThuLEP, a trend toward shorter operative times compared to other techniques was observed. In the early postoperative period, significant bleeding was noted in six cases of using bipolar technology, three cases of using a thulium laser, and five cases of using a holmium laser. An examination of patients 6 months postsurgery showed pronounced positive dynamics in all three groups. No significant differences were found in clinical parameters 6 months postsurgery in patients of different groups. CONCLUSIONS: Bipolar enucleation of the prostate, ThuLEP, and HoLEP are comparable in effectiveness and the number of complications in the surgical treatment of BPH. Study results indicated that it is advisable to actively use these methods in wide clinical practice.

BACKGROUND: Studying the clinical features of different surgical approaches in patients with urolithiasis with stones localized in the kidney and the upper third of the ureter is an important practical issue in modern urology. AIM: The aim of the study is a clinical evaluation of the results of percutaneous surgery for urolithiasis with the patient in the supine position. MATERIALS AND METHODS: The results of surgical treatment of 316 patients with urolithiasis with stones localized in the kidney (more than 10 mm) and the upper third of the ureter (more than 8 mm) are presented. All patients underwent percutaneous nephrolithotripsy in the supine position. RESULTS: Complete elimination of stones was achieved in 91.3% of patients with stones of the upper third of the ureter and 96.2% of patients with kidney stones. Clinical evaluation of the surgical results showed that the frequency of intraoperative complications of traumatic origin is about 10%, the most common complication being bleeding. At the same time, complications of grades IV and V according to the Clavien–Dindo classification were noted. Performing percutaneous nephrolithotripsy in the supine position reduces the time required to position the patient, allows for the combination of transurethral and percutaneous interventions, is more effective for patients with increased weight and concomitant diseases, and also provides a significant advantage in the need for ventilation and possible resuscitation. CONCLUSIONS: It is advisable to introduce a personalized approach to the choice of surgical access when performing invasive interventions on the upper urinary tract.