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Concurrent possibilities of minimallyinvasive surgical treatment of kidney tumours
Eret, Viktor ; Hora, Milan (advisor) ; Zachoval, Roman (referee) ; Minčík, Ivan (referee)
Minimally invasive surgery in the treatment of kidney tumours has developed since the beginning of the nineties. A lot of specialized or top laparoscopic urological centres so-called "centres of excellence" have been created since the first laparoscopic radical nephrectomy (LRN). These centres have thanks to the centralization of kidney tumour patients sufficient cohorts for evaluation of operative data, operative technique and oncological results. A lot of large studies have been published so far, showing comparable oncological results with open nephrectomy and advantages of miniinvasivity ( shorter hospitalization time, less analgesia requirements, better recovery and cosmetics). LRN is considered a standard of care in the treatment of cT1-2 (≤ 8cm) renal tumours in patients who are not candidates for nephron- sparing surgery. In our department in Plzeň, we have been performing LRN since January 2003. The majority of procedures has been performed by transperitoneal approach. The first LRN in the Czech Republic was done in April 1998 within XII. Conference of Czech Urologic Society by guesting prof. Clayman. We prefer transperitoneal to extraperitoneal approach in our department. The transperitoneal approach provides a larger working space, better anatomical and topographical orientation.We perform...
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Molecular mechanism of renal cell carcinogenesis
Chocholatý, Matúš ; Babjuk, Marek (advisor) ; Soukup, Viktor (referee) ; Eret, Viktor (referee)
The receptor for advanced glycation end products (RAGE), soluble RAGE (sRAGE) and its ligands are involved in the pathogenesis of cancer. Glyoxalase I (GLO1) is an enzyme which detoxifies advanced glycation end product (AGE) precursors. Four polymorphisms of RAGE (rs1800625 RAGE -429T/C, rs1800624 -374T/A, rs3134940 2184A/G, rs2070600 557G/A (G82S), and GLO1 rs4746 419A/C(E111A)) were determined by PCR-RFLP in 214 patients with ccRCC. A group of 154 healthy subjects was used as control. We found significant differences in the allelic and genotype frequencies of GLO1 E111A (419A/C) SNP between patients and controls-higher frequency of the C allele in ccRCC-58.6 vs. 44.5 % in controls, OR (95 % CI) 1.77 (1.32-2.38), p=0.0002 (corrected p=0.001); OR (95 % CI) CC vs. AA 2.76 (1.5-4.80), p=0.0004 (corrected p= 0.002); and AC+CC vs. AA 2.03 (1.23-3.30), p=0.0034 (corrected p=0.017). The values of sRAGE in a subgroup of 132 patients were evaluated before and three weeks, three and six months after surgery and in cancer relapse. According to relapse of the cancer, the patients were divided into two groups. The postoperative elevation of sRAGE was seen in group of ccRCC without relapse. Stable postoperative sRAGE were in group with relapse. We have not detected the difference between sRAGE in ccRCC group...
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Concurrent possibilities of minimallyinvasive surgical treatment of kidney tumours
Eret, Viktor ; Hora, Milan (advisor) ; Zachoval, Roman (referee) ; Minčík, Ivan (referee)
Minimally invasive surgery in the treatment of kidney tumours has developed since the beginning of the nineties. A lot of specialized or top laparoscopic urological centres so-called "centres of excellence" have been created since the first laparoscopic radical nephrectomy (LRN). These centres have thanks to the centralization of kidney tumour patients sufficient cohorts for evaluation of operative data, operative technique and oncological results. A lot of large studies have been published so far, showing comparable oncological results with open nephrectomy and advantages of miniinvasivity ( shorter hospitalization time, less analgesia requirements, better recovery and cosmetics). LRN is considered a standard of care in the treatment of cT1-2 (≤ 8cm) renal tumours in patients who are not candidates for nephron- sparing surgery. In our department in Plzeň, we have been performing LRN since January 2003. The majority of procedures has been performed by transperitoneal approach. The first LRN in the Czech Republic was done in April 1998 within XII. Conference of Czech Urologic Society by guesting prof. Clayman. We prefer transperitoneal to extraperitoneal approach in our department. The transperitoneal approach provides a larger working space, better anatomical and topographical orientation.We perform...
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