Incidence of ICD in the Russian Federation (2005-2016)
Screening for prostate cancer: modern presentation and organization
Primary multiple transitional cell epithelium
Androgenic screening in men over 50 years
The role of stem cells in the treatment of urinary incontinence
Percutaneous nephrolithotripsy in infected urine
Testicular Prosthesis in Children and Adolescents: Results from a Multicenter Study
Premature ejaculation is the current state of the problem.
The prevalence of symptoms of impairment of the function of the lower urinary tract in men according to the results of a population study
Patient-centered system of organization of medical care in urology using...
Principles of «4P Medicine» in the organization of health care in the context of urological diseases
Changes in the electrolyte composition of urine under the influence of sodium hypochlorite. The possibility
of reducing the risk of recurrence of nephrolithiasis
Popov S.V. – Dr. Sc., assistant professor; Head Doctor of St. Petersburg Clinical Hospital of St. Luke, Head of the Center for Endoscopic Urology and New Technologies, email@example.com, ORCID 0000-0003-2767-7153
Guseynov R.G. – Head of the Urology Department №2 of St. Petersburg Clinical Hospital of St. Luke, firstname.lastname@example.org, ORCID 0000-0001-9935-0243
SkryabinO.N. – Dr. Sc., Professor, Chief Oncologist of St. Petersburg Clinical Hospital of St. Luke, Scientific Director of the Center for Endoscopic Urology and New Technologies, email@example.com, ORCID 0000-0002-6664-2861
Koryachkin V.A. – Dr. Sc., Professor of the Department of Anesthesiology, Intensive Care and Emergency Pediatrics named aer V.I. Gordeev St. Petersburg State Pediatric Medical University, firstname.lastname@example.org, ORCID 0000-0002-3400-8989
Kritskiy A.V. – anestesiologist of St. Petersburg Clinical Hospital of St. Luke, email@example.com, ORCID 0000-0002-1626-1040
Davydov A.V. – PhD, urologist of St. Petersburg Clinical Hospital of St. Luke, firstname.lastname@example.org, ORCID 0000-0003-3062-5119
Barchitdinov R.S.– urologist of St. Petersburg Clinical Hospital of St. Luke, email@example.com, ORCID 0000-0001-7580-6197
Lozhkin A.A. – urologist of St. Petersburg Clinical Hospital of St. Luke, firstname.lastname@example.org, ORCID 0000-0002-0487-013Х
Katunin A.S. – urologist of St. Petersburg Clinical Hospital of St. Luke, email@example.com, ORCID 0000-0003-3676-6246
Mirzabekov M.M.– urologist of St. Petersburg Clinical Hospital of St. Luke, firstname.lastname@example.org, ORCID 0000-0001-5792-1589
Nikolaev N.M. – urologist of St. Petersburg Clinical Hospital of St. Luke, email@example.com, ORCID 0000-0002-6364-7296
Trufanov G.S. – urologist of St. Petersburg Clinical Hospital of St. Luke, firstname.lastname@example.org, ORCID 0000-0001-5792-1589
Hozrevanidze D.D. – urologist of St. Petersburg Clinical Hospital of St. Luke, email@example.com, ORCID 0000-0003-1306-5244
Introduction. The safety of anesthetic management in endovascular surgery for cancer and prostate adenoma is an important factor for the successful surgery and postoperative period.
The purpose of this study is the comparative study of perioperative hemodynamic changes and the probability of developing postoperative cognitive dysfunction in the surgical treatment of prostate cancer and BPH using laparoscopic radical prostatectomy and laparoscopic adenomectomy, respectively, under conditions of general endotracheal and epidural anesthesia.
The research method was the analysis of perioperative changes in central hemodynamics and the results of neuropsychological testing during the prostate cancer and BPH treatment using laparoscopic surgery in 166 patients of the St. Petersburg State Budgetary Healthcare Institution Clinical Hospital of St. Luke.
Results. A key negative consequence of general endotracheal anesthesia and carboxyperitoneum in laparoscopic interventions is stroke volume decrease, that leads to myocardial ischemia, total peripheral vascular resistance and blood pressure increase – factors that form pressure overload and left ventricular heart failure. Hemodynamic instability, as well as the neurotoxic effects of general anesthetics, can cause postoperative cognitive deficits.
Conclusion. The use of epidural anesthesia in the considered situations allows to increase the safety degree of surgical interventions in urology due to, first of all, preventing marked disorders in central hemodynamics through blocking autonomic effects on the vascular walls, reducing TPR (total peripheral resistance) and increasing venous return to the right heart departments, and the absence of pharmacological suppression of myocardial contractility. Secondly owing to the reduction of postoperative cognitive dysfunction probability in conditions with stable hemodynamics and the absence of neurotoxic effects of general anesthetics.
Conflict of interest. The authors declare no conflict of interest.
laparoscopic radical prostatectomy, laparoscopic adenomectomy, general endotracheal anesthesia, decrease in stroke volume of the heart, increase in total peripheral vascular resistance, postoperative cognitive dysfunction, epidural anesthesia