625
222193226014562122182
ORIGINÁLNÍ852207016996181224324367468561635735777
PRÁCE1667207016983165262348424
Ces8507936014570127174
Urol10497936014578115180208
2019;12827936014562121176229253
23(3):15607936014562122153211240262
221–22918487936014561121176230285345404
byl850898013160104125
zaznamenámu99089801314391133188234319369424470555628
11%.163389801315391186203
Pouze1851898013155108162203252
jedna212489801311767124178224
pacientka2363898013160107152171221275304347394
pod‑2772898013160116173204
stoupila850104801314173127183240261280327
otevřenou1202104801315888137184214263319375430
re‑resekci,1654104801313685117148197235286330375394410
ostatní2088104801315997129177206263282
byli23951048013161105127146
sledováni.2563104801314464114172228274322377397413
Při850119801315582102
sledování967119801314060109166221266313368387
byla13691198013160104125170
zaznamenána1554119801314492133189235320370425471525571
jedna2146119801311767124179224
lokální2392119801311771115162182236255
recidiva2662119801313280127146202221267314
v8501348013149
ledvině920134801311767124170190245294
(při1235134801312380109129
R013791348013155105
výkonu),1499134801314998142195251304327340
1×18541348013153106
rychlá1975134801313281125180199245
vzdálená2235134801314992147193212262317362
progrese2612134801316089143200228277314364
(mozkovémetastázy)8501498013129113169209253308354403511562593641678711758800850874
a17421498013150
1×18101498013154108
současně1936149801314197153199247284339390
vzdálená2344149801315094150196216267323369
(plíce)2735149801312584104124169218241
i8501648013123
lokální895164801311773117166186241260
progrese1171164801316191145203232281319370
v15571648013150
perirenálním16231648013161112142162191240296342362418437524
tuku2163164801313489132188
(při2373164801312381111131
R0).25201648013156107132145
Trifekta268116480131517394120170213248295
hodnocená8501798013158113171225280327375430475
dleMontsouris1340179801316079129229284339368407462517545565601
(R01963179801312274124
výkon+2102179801315099142196251331
IT2455179801311665
≤25351798013165
25min+26151798013153103208227281361
absence8501948013150107145196252298347
komplikace12191948013146101188246267286329377424473
CD17131948013163130
≥18651948013166
3)1953194801315376
dosažena20511948013160116153201244293348395
u24681948013158
74,12548194801315497112156
%,2726194801318198
dle2846194801316080130
Khalifeha8502098013154111157177195221270325371
a12372098013149
kol.13012098013146100121136
(R01459209801312374125
+15992098013165
IT1685209801311766
≤17662098013165
25min+18472098013153103207226281361
žádná2224209801314391148202248
komplikace)24872098013147100187243264283325373418466489
u8502248013158
59,29282248013154100112164
%,1112224801318198
dle1230224801316080130
Porpiglii13802248013155109139197217274294313333
a17332248013150
kol.18022248013147101122139
(R0,1963224801312779130145
IT2130224801312171
≤22212248013165
2023062248013153103
min,24292248013190109165180
absence26292248013150108145196252298347
komplikace8502398013147101189246267286329378424473
CD13432398013162130
≥14922398013166
3)1577239801315477
u16732398013159
6917512398013154103
%.1874239801318199
Závěr:10002546013360111158208241261
Laparoskopická1277254801314996152199227281318360413470490535577625
RL19172548013154100
je2039254801311766
standardnímřešením2120254801314172119173229275303358412431516563611648698752771856
solidních850269801314197118137194250269315370
expanzí1243269801315399157205260302322
ledvin1587269801312475133180201256
poskytující18662698013160117155198247283338358378423443
příznivé2331269801316191111152209229276325
výsled‑2679269801314999138157208266297
ky.850284801314796107
Míra9852848013186106135183
dosažení11952848013160116154202244294349369
komplexního15862848013152107194252273323369425445503559
klinického216728480131527493149168214257307363419
úspěchu2614284801315895152204251307362
(=850299801312988
trifekta)96029980131326282108158202236284307
byla12872998013161106127173
srovnatelná1480299801314170124170227273303352372428474
s19742998013141
literárními203729980131214071120149197226283302389409
údaji.24652998013159116162182202218
KLÍČOVÁ8523284014770132164236320392464
SLOVA13433284014762123207279351
Resekce8503448013156109149202248295346
ledviny,1220344801312376136186208266312325
laparoskopická,1569344801312372131181213269309354411471494542587638657
trifekta.225034480131346588116169214251301320
SUMMARY8523734014762143243345423493561
Macek10003898013186135183234280
P,1303389801315559
Novák13853898013170128177227272
K,1680389801315576
Pešl17793898013155105145168
M,19693898013186105
Stevens2097389801315182133182234291331
M,24513898013185104
Hradec25783898013169101151210263313
T,2913389801315263
Fiala850404801315172121143191
V,1065404801315668
Gouveia11564048013169128186235287309357
R,1537404801315576
Plincelnerová163640480131557798156204255278335388420476524574
L,2234404801314969
Vávřová23264048013156103151183240288338
L,2687404801315069
Bau‑27804048013155105162196
erová850419801315385142190240
L,1114419801315877
Hanuš12234198013170119177234273
T.1520419801316072
Laparoscopic16164198013158109168218250306346395451512534583
partical22234198013169119150187210258308330
nephrec‑25774198013167121181239271322372399
tomy:850434801313489177222241
a11104348013150
comprehensive11794348013149104192251282333390442499537558606657
evaluation18564348013152100149171227275306328384442
of2317434801315886
single-centre2422434801314162118177198250284334384441472503554
perioperative8504498013161115146169226287341372422454476526577
outcomes.14524498013158116150196252341395435454
Aim:1000464601336893184206
Assessment12304648013173115155209249289378432490522
of1776464801316796
perioperative18964648013169123155178236297351383433465488537589
and25104648013158116176
onco‑27104648013167126175231266
logical850479801312484146169219270294
results1169479801314295137195218253296
of1490479801316999
laparoscopic1614479801313283144196228287328379437499523573
nephron-sparing22124798013169124185246278337397432474535587619643703764
procedures850494801316193149199250310367398450490
for1364494801312986118
renal1506494801313384142191213
tumors.1743494801313492181239271312332
Material10005096013389143179234270296349375
a13995096013362
methods:14925096013393149186247308372415437
We19635098013191142
evaluate21305098013162111162185243292325377
data25315098013169119152202
from2758509801313771128219
a8505248013150
prospectively930524801316193149189248302352388410459511534582
collected15365248013155111134155208258294345405
database19715248013160109141190250300340393
in2388524801312986
one24985248013165123176
center26985248013155106164196247278
between8505398013160114147228280333390
1/20131260539801315485138189236281
and15615398013149107166
6/2018.1746539801315491144195242288307
Operations20735398013174134188219268300322379437476
were25695398013179131162213
per‑28025398013160114145174
formed850554801312988121212267329
by12035548013170119
313475548013163
surgeons.14345548013151108140200254314374414434
There18935548013161122176208261
were21875548013181135167220
17424315548013163108155
patients26115548013170121154177230290322365
available8505698013151100152175198248310334389
for1264569801313897131
final1420569801313663123173197
analysis.16425698013159119170193243285307348368
The20365698013161123177
cohort22395698013159116177237271309
included2573569801313292142166224286341403
also850584801315072111169
110425848013153
one-stage11185848013158117170205245280329389442
bilateral1582584801316183105154186237268318341
case,1945584801314999139192208
921765848013154
cases2252584801314999139192232
of2507584801315886
multiple26165848013190147169203225284307360
one-stage8505998013159117170205245280329389442
partial13205998013161111142179201249271
nephrectomy16205998013159112172230261313362399455544590
(PN)2234599801313488156184
(2–52442599801313384136188
lesions)2654599801312780120142199258297322
and8506148013151109170
in1044614801313290
811596148013163
cases12466148013158109149203244
PN15156148013164133
of1672614801316897
solitary17936148013150109133155189240271324
kidney.2142614801315580140198252301315
Altogether,2481614801317497131188249303336395449481495
1908506298013155101157
renal1032629801314194153203226
masses12926298013191142183223278319
were16456298013181134166219
resected1889629801314295136190241278331393
(left2307629801313861116145183
side2515629801315173133187
102×,27276298013163112163229249
right850644801313255114171203
side1073644801314162121173
88×),12666448013154107171199214
in1504644801311976
6416016448013153108
women17306448013179136225278336
and20866448013150107166
1102272644801315494141
men.24346448013189142200219
Cohort26736448013162118176234266303
medians8506598013190143204225274331371
(IQR1245659801313456129185
=14596598013165
interquartile1549659801312885117168200257314363394432454476528
range)2101659801313888146205258283
were:24146598013179131163214232
age26706598013155115168
6428626598013159114
(55–70)850674801312979127181228277304
years,1173674801314899147177218236
Charleson14296748013162118166197220272311369426
comorbidity18756748013149104192250281341363421442475526
index2424674801311976135187234
326776748013153
(2–4),2754674801312576127182207222
creatinine850689801314981132180213235292314372425
7812996898013162112
(68–95)1435689801313788142198251302329
µmol/L,17886898013167156215238277326346
lesion2158689801313184124146203262
diameter2444689801316890138227280314365396
2728646898013162112
(20–35)850704801312980132190239288315
mm,11897048013190179197
PADUA14117048013155111181249309
score1744704801314190146178229
819977048013154
(7–9).2075704801312982130183209224
Results:10007196013359112153210233267309328
Length1352719801314999154212243299
of1675719801315884
surgery1781719801314397126182233262312
median21167198013190141199219265321
1182460719801315493137
(IQR2619719801313150121174
88–28177198013154105159
150)850734801315498149174
min,10537348013191111168184
blood1266734801316283140198258
loss1546734801313087126164
median17397348013191143203223270327
15020887348013161105155
(IQR2266734801313555128182
80–300)24717348013160113170217269323348
ml,28487348013191112128
no8507498013159115
warm9907498013179127156243
ischemia1255749801312663109165216303322368
(WI)16457498013132122143169
used1838749801315996147205
in2065749801312681
512171749801315398
of2293749801315985
1902403749801315496148
lesions,2573749801312777115134190246283300
in2895749801312581
other850764801315989145195225
length1097764801312879134192223279
of1403764801315985
WI15157648013190111
median16537648013190141200219265321
1519967648013159101
(IQR2119764801313554125178
12–17)23197648013159101151195236263
min,26097648013190110165181
in2812764801312884
229177648013159
patients3203898013161108138158209264294333
conversion3558898013149103159204254283322341396453
to403389801313387
open4142898013158116168224
PN4388898013155120
was4530898013179127164
needed4716898013159110162220270328
and5066898013150106163
in525189801312278
232031048013154
patients32791048013160108138158208264294333
conversion36341048013149103159204254283322341396452
to4108104801313488
laparoscopic4218104801312370127175204258296343396454475521
nephrectomy47611048013159109167223252302349383437524568
(1×3203119801312974129
bleeding;3357119801316182132184242262317374389
1×37711198013153108
renal3901119801313585140187207
vein41301198013153102122177
tumor4329119801313793179236265
thrombus).4616119801313793122176264321377414437450
There50911198013151109160189238
were32031348013179129159208
4434331348013159114
complications35681348013155109197254275294340388418438493550587
according41771348013155102146200230285305360418
to4616134801314094
Clavien-Dindo4738134801316282128174195245301332402422478535591
(CD)3203149801312987154177
classificationwithin3397149801314969116153191210234260307354384404459516612632664719739794
3042081498013154104
post-operative43291498013161118155188214273331383412459489509556606
days:49521498013160106151189204
17×5173149801315495156
grade3203164801316090139197248
1,3474164801316070
13×35661648013160103165
grade3759164801316190139197248
2,4030164801316076
10×41281648013161106170
grade4326164801316191139197249
3,4597164801316075
1×46951648013160115
grade4839164801316090138197248
4,5109164801316176
3×52071648013161122
grade3203179801316089137194245
5,3471179801315467
i.e.356017980131254192107
CD36901798013163130
≥38431798013166
339321798013154
in4008179801312580
841111798013154
%41881798013182
of4293179801315885
patients.44011798013161109139158209264294334351
Symptomatic4776179801315193181239269323410457487507553
pseudoaneurysmwas3203194801316097147201258313359414464518547595633718812858895
diagnosed4113194801315978124180235290327377434
in4568194801311771
446541948013153
pts4722194801316190129
–48661948013155
all493619480131496988
treated5039194801313362111156185233290
by32032098013162108
selective33342098013148100121173222257278326377
embolization.37342098013160149208267288309351401432453510568585
Post-operative43422098013162117156190217277337390420469500521569620
hospital49912098013160118157215236269317338
stay3203224801314173121165
was33952248013180127165
median35872248013190141199219265321
639302248013159
(IQR4011224801313454125178
5–7)42112248013159112157184
days.44232248013159106150189206
Histology4656224801317089126158212233289347393
found5071224801313489145201258
4532032398013154103
benign33342398013162114171191249306
and36622398013157113172
14538562398013161106154
malignant40392398013191138159179237293341397428
lesions,4489239801313082120140197254292309
of4826239801316086
the4935239801314097149
latter5107239801312977107142192222
122×3203254801315599152217
pT1a,34492548013162106156198215
16×36872548013162108171
pT1b,38872548013162106156209224
3×41342548013162125
pT2a42882548013162106160208
and45192548013158115175
4×47172548013161123
pT3a.48692548013163106160208226
Posi‑51192548013163118158178210
tive3203269801313454101151
margin33742698013190137166222241297
rate3692269801313179109158
was38702698013180127165
11%.4055269801315492163182
Only42572698013174131151197
144742698013154
patient45482698013161109139158209264294
underwent48632698013158114171221251331381436466
new32032848013159110186
PN34082848013155121
via3547284801315071117
open36832848013158116168224
approach,39262848013150107165195249297343399415
others4359284801315989145196225264
were46422848013179129158207
monitored.48682848013190147203222253307337386444461
We32032998013192141
detected33732998013161113145195244279329388
137842998013161
local3868299801313087135184205
kidney4096299801315376134191244290
recurrence4409299801313990139195225256307364412462
(in4894299801313656113
R050292998013163116
sur‑51682998013148103133161
gery),32033148013161113143194219233
134593148013161
rapid3542314801313988147168227
distant3797314801316182120153202259289
progression4115314801316292148208238288327366386443500
(cerebral4638314801313680130160210269300349370
metas‑50373148013191144175224263292
tases)3203329801313584123175215238
and34643298013157115174
136613298013161
combined37453298013156111201260282339391451
local4219329801313088137186207
(in4449329801313656113
perirenal45913298013162116146167198249306354375
fat)4989329801313686117143
and51553298013157115174
distant3203344801316283121155205263294
(lungs)3521344801313759116174234272296
recurrence3841344801314092141199229261313371420470
(in4335344801313757115
R044743448013164118
surgery).46153448013149106137195248279331356370
Trifecta5009344801315983105133185235270320
based32033598013161108146197255
on34853598013158114
Montsouris36263598013185142198228267323379408428465
(R04113359801313486138
+42773598013166
WI43693598013190111
≤45073598013166
25min45993598013154105190209264
+48903598013166
absence49773598013155113150201257303352
of3203374801315884
CD≥33023748013163129210
335273748013154
complication)35963748013149102189245266285330377407426481537559
was41713748013179126163
74,1%,4349374801315496111154225241
based46063748013160107144195252
on48743748013158114
Khalifeh50033748013154112158177196222271327
et3203389801315383
al.330138980131507085
(R03408389801312274125
+WI35483898013165170190
≤37533898013165
25min+no38343898013153103207227281361435490
complication)43403898013148101188244265283329376405424479535557
was49123898013179126163
59,2%5090389801315399110162239
and32034048013150106164
based33954048013162110148199258
on36814048013159116
Porpiglia38194048013162116146205226283303323370
et4211404801315991
al.432440480131567693
(R04439404801313588140
+46074048013166
WI47024048013190112
≤48424048013166
2049304048013160110
min50684048013191111167
+52634048013166
absence32034198013150107145196252298347
of3570419801315884
CD36744198013163130
≥38244198013165
339094198013154
complication)39824198013149103191248269288334382412431487543566
was45684198013179127164
6947524198013154103
%.48744198013182100
Conclusion:33534346013366127190242268331376402465528551
Laparoscopic39304348013161115177229262321364415473536560611
PN45674348013167138
is4731434801313475
a48324348013162
standard4920434801315390142202264315348409
management32034498013190139196245304357446499557589
option38124498013159119152174231290
of4122449801315987
solid4229449801314199122144203
renal4456449801312980138187209
masses46854498013190139179218271312
provid‑5017449801316193149197220279312
ing3203464801312379137
favorable3363464801312473120175206255313335387
outcomes.37694648013158114146191246334386425443
Trifecta423146480131517496123174222257306
rate4560464801312876108157
was47364648013179127165
compara‑49214648013148102190248297327376408
ble3203479801316184137
to3364479801313389
published34774798013160119178201223262319372432
results.3934479801313183123180202235277296
The42544798013151111164
work44414798013180137169215
was46804798013179129169
supported4873479801314097156216276308345396456
by32034948013161108
a33354948013150
grant3409494801316091141199231
project3664494801316092149171224273310
MZ39984948013185144
ČR41664948013163117
–43074948013155
RVO43864948013155111183
VFN64165.45934948013156108175229284329376427444
KEY32045234014770134206
WORDS343752340147105189260345408
Partial32035398013155103135172194242264
nephrectomy,34915398013159112172231262313363399455544591604
laparoscopy,4119539801312372131181212269309358414474521534
trifecta.467753980131346689117169219255304324
………320356840147120240360
ÚVOD32056108018197183286388
Celosvětově33536448013163114136194234285336369425473525
je3902644801312275
stále4001644801313973123145198
zaznamenáván4223644801314393138197245334388445494542592649
mírný48956448013190111143201248
růst5167644801313088127162
solidních3203659801314199122144203261282330388
expanzí36136598013154101162211269313336
ledvin3973659801312275135184207265
související4262659801313997155205227266319341363411433
s47196598013139
rozšiřováním4782659801313187130172193224281329379437458547
indikací3203674801312380138160204255303324
k35476748013146
abdominálnímu36136748013149108168225314335392440462519540628685
zobrazovacímu43176748013144100160191241285340388437485507595651
vyšetře‑49886748013149101140193225256307341
ní.320368980131598199
Celkově33286898013163114137182238287338
tvoří3690689801313789146178200
2–339176898013154105154
%40986898013181
zhoubných42036898013147105163221281339385433491
nádorů.47206898013159108167225257315333
Česká50796898013163114154199250
republika3203704801313284144202261284306351402
má36297048013190139
v37927048013150
této3866704801313485118174
oblasti40647048013159119142190230265287
světovou4375704801314191143176232280337395
prioritu4794704801316193115173205228261319
(1).513770480131297797112
Resekce33537198013157112154210257306359
ledviny3738719801313287150201226285333
(RL)4097719801313895146176
je4298719801313388
doporučovaným44117198013170130193255288349399457507559619667761
ře‑5197719801314296132
šením3203734801314296156178269
pro34977348013171104162
ložiska3684734801313292136159199246298
kategorie40077348013156108142194256316349372426
cT144587348013159103155
(2).4638734801313891118134
Možné48067348013187147191251306
jsou5137734801313272132192
přístupy3203749801316092114152187244303349
otevřené,3572749801315991141189221272330382399
laparoskopické3994749801312068127176207263303347404463486533578629
nebo46437498013159112171229
roboticky‑asistované489674980131298514420323525730534940042949657874294965808429496581742949658234294965856429496588242949659344294965976429496602442949660804294966132
v37557498013161
závislosti38407498013156108157180221244304345381404
na42707498013171122
vybavení44177498013162116179231281335395418
pracoviště48617498013173107159210269319343384420473