Dobrovolskiy V. The choice of surgical modality to treat patients with small renal masses.

The dissertation is devoted to the actual problem of contemporary urology - improvement of thetreatment efficiency in patients with small renal masses (SRM) by the way of individualized choice of optimal option that based on use of developed own nephrometry scale. Basing on results of investigation the high efficiency and technical feasibility of partial nephrectomy, tumor enucleoresection and radiofrequency ablation in the treatment of patients with small renal masses has been determined and confirmed. It has been established the expediency of measuring the threshold values of the distance from the tumor to the cavity of the kidney and the level of invasion of the tumor into the cavity system for determination of the likelihood of the development of NSS complications and conversions. It has been established that renal function after surgery is significantly less suppressed after the use of noninvasive methods for treatment of SRMs compared with partial nephrectomy, which demonstrates their preferences in cases of need for maximal preservation of renal parenchyma. It has been developed a method of nephrometric diagnosis of tumor parameters, which allows the individualized selection of the SRM treatment modality with the lowest risk of conversion and the preservation of a functioning parenchyma affected kidney tumor. The effectiveness of applying the proposed LVIVscore scale for the optimal surgical management in SRM patients has been confirmed.