Objective: to identify the role simultaneous use of the Vesical Imaging-Reporting and Data System (VI-RADS) and the assessment of serum levels of several mediators and growth factors for the evaluation of metastatic process and disease stage in patients with bladder cancer.Materials and methods. This retrospective study included 85 patients with histologically verified transitional cell (urothelial) bladder carcinoma (stages рТа—TINOMO. [)T2NOMO, рТ3—4NN0M0, and [)T2—4N1—3M1) and 20 healthy controls. In addition to general clinical examinations, all patients have undergone preoperative diffusion-weighted magnetic resonance imaging of the pelvis with background suppression. We calculated the diffusion coefficient and included it into the VI-RADS protocol. All study participants were also tested for their serum levels of vascular endothelial growth factor (VEGF), interleukin-8 (IL-8), monocyte chemoattractant protein 1 (MSP-1), interferon γ (IFN-γ), transforming growth factor β1 (TGF- β1), granulocyte colony-stimulating factor (G-CSF), and granulocyte-macrophage colonystimulating factor (GM-CSF) using enzyme-linked immunosorbent assay (ELISA).Results and conclusion. We found that the preoperative use of VI-RADS together with the assessment of serum levels of pro-inflammatory mediators, colony-stimulating factors, and growth factors in patients with muscle-invasive bladder cancer provide additional information about the activity of malignant transformation in tumor tissue and tumor spread. Their simultaneous use during the examination of patients with muscle-invasive bladder cancer is a promising diagnostic approach to monitor treatment response.
Aim: to improve the outcomes o f surgical treatment o f benign prostatic hyperplasia by bipolar transurethral prostatic resection based on the personalized approach. Materials and methods. Surgical treatment of prostatic hyperplasia by bipolar transurethral resection of the prostate was carried out in 50 patients: the personalized approach, that is extensive preoperative preparation, was adopted in 25 cases, and the standard procedure was implemented in the rest 25 cases. Functional outcomes were assessed in 1, 3 and 6 months after surgery, taking into account intra-and postoperative complications. Results and discussion. The use of the personalized approach resulted in the reduction in the duration of surgery (p = 0.019), amount of blood loss (p = 0.027), incidence o f hyperthermia in the early postoperative period (p = 0.021), duration of bladder catheterization (p = 0.030) and the duration o f hospital stay (p = 0.031). The personalized approach was proved to have a positive effect on the functional outcome o f bipolar transurethral resection of the pros tate: Qmax value in 1, 3 and 6 months (p = 0.037, p = 0.030, p = 0.036), IPSS score in 6 months (p = 0.037), QOL score in 1 and 3 months (p = 0.041, p = 0.030) and residual urine volume in 3 and 6 months (p = 0.035, p = 0.040). Conclusions. The personalized approach contributes to improving the functional outcomes of bipolar transurethral resection of the prostate, namely, improving the Qmax value in 1, 3 and 6 months, reducing the IPSS score in 6 months and the QOL score in 1 and 3 months, and decreasing the residual urine volume in 3 and 6 months. Keywords: prostatic hyperplasia, bipolar transurethral resection of the prostate, preoperative management, postopera tive complications, personalized approach, persistent irritative symptoms, alpha-blockers, anticholinergics For citation: Chekhonatskii I.A., Loran O.B. Personalized approach to the surgical treatment of benign prostatic hyper plasia by bipolar transurethral resection of the prostate. Creative Surgery and Oncology. 2023;13(2):125-130.
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