[One-stage combined operations on kidney and other organs]

Patients with combined diseases of the kidney, organs of abdominal cavity and retroperitoneal space require original decisions in the choice of surgical approach and sequence of interventions on different organs. The experience of one-stage combined nephrectomies and kidney resections in 36 patients with lung, stomach, intestine, liver and other organs' diseases are presented. 11 patients had primary renal carcinoma, the kidneys were affected by other malignant tumors in 15 patients. Primary benign processes in the kidneys were found in 3 patients and also in 7 patients these processes were the consequence of earlier performed operations. Interventions on 3-6 organs were necessary in 11 cases. It makes sense to begin one-stage combined transperitoneal interventions with "clean" stages--without section of gastrointestinal tract's lumen. 1 patient died because of peritonitis due to insufficiency of sutures of colon anastomosis. The follow-up ranged from 6 months to 12 years. The recurrences and metastases were found in 9 operated patients within 7 to 20 months, and there were no symptoms of diseases in 24 patients. It is concluded that extended radical one-stage operations on the organs of abdominal cavity and retroperitoneal space combined with operations on the kidney are endurable and effective if the surgical technique is thorough.