604
1215585226014562113168
ORIGINÁLNÍ3862207016996181224324367468561635735777
PRÁCE4677207016983165262348424
Ces37177936014570127174
Urol39167936014578115180208
2021;41497936014562121178233249
25(1):44237936014562122153207231253
120–13047027936014561113172235289341400
byla624898013161107130177
12825898013160104
minut952898013198119175232264
(7–23123989801313788136183234
minut)1497898013197118175231264290
Průměrná182489801316392150238290320378426
velikost2273898013157108130150195251290324
tu‑262089801314198130
moru6241048013190146177234
při880104801315686107
LR1010104801314497
byla11291048013156101123170
22,7mm13221048013148100116166267354
(12–35mm),1699104801312470113163210258359446470484
nejvyšší22061048013153105126173224263300320
hod‑25491048013154110169201
nota6241198013159116147196
RENAL8431198013150100168229276
nefrometrického11421198013154106133165220309361393423445492536587644701
skóre1866119801313680135166217
7a2106119801314992
Histologicky2238119801316586124157212234291350370417462512
byl6241348013162109132
v7801348013158
98621348013153
případech9391348013169101123183233293346396454
popsán14161348013170129190230280338
světlobuněčný17781348013149100151184206265325384442495544602648
renální2450134801314092150199221279300
karcinom624149801314796126172193249306395
(8×1042149801313483147
pT1a,12121498013165108157198216
1×14511498013158114
pT3a),15881498013165108161209233248
v18591498013154
jednom1936149801312374133190247336
případě2295149801316596117175224283334
se2652149801314698
jednalo624164801312475134191239260317
o9641648013162
karcinom1049164801314695126171192248305394
papilární14661648013165114172194214262292350370
(pT1a)1859164801313493135185226251
Resekční21471648013159111151203247293350370
okraj25401648013163108140189210
(pR1)624179801313091147196216
byl8641798013170117140
pozitivní10291798013169129171194227249299359380
1×14331798013163120
Jedenkrát15951798013147100161215273319353403435
byla20551798013169117140189
provedena22681798013169101159207260321374433482
konverze6241948013147102160206256287332382
v10291948013146
resekci1098194801313282121173218264284
otevřenou1405194801315586136184215265322379436
pro1864194801315788143
dosažení20301948013156113152201245295352372
onkolo‑24251948013155112157212234291325
gické624209801316081128172222
radikality869209801313887145166210260281301334384
výkonu12762098013155106151207264320
Bezprostředně16372098013161113156216247302341374405455514571623
po22832098013166124
výkonu24302098013155106151207264320
nedošlo6242248013160113174232272294352
u10002248013166
žádného1090224801314495155213266324383
nemocného14972248013167120210268318376429488546
k20672248013155
významnému21452248013150102149208257347405458548605
poklesu6242398013161119164187239278333
renálních980239801313081138185206263283330387
funkcí1390239801312684141185231252
ve1665239801314798
srovnání1786239801313969124171229277334354
s21632398013139
předoperač‑2225239801315990140199256316368399448495525
ními624254801315979167188
hodnotami8352548013160117176233290321370458478
Do13542548013172130
současné1507254801314199155203251290346398
doby19282548013161118177223
nebylo21742548013160112170216239296
nutné24932548013159115148205257
u6242698013158
žádného705269801314291149205256312369
z10972698013139
deseti11582698013158109148199231251
pacientů14322698013155104151171222278308364
použít18182698013156113169212232264
náhradu21052698013153100157186235292347
funkce2475269801312481137181226275
ledvin624284801312374133180202257
pro904284801315586140
renální1067284801312777133180201256277
selhávání1366284801313687108164211257305361381
Všechny1786284801315190142189245301346
výkony2154284801314495139195251296
včetně2472284801314490139170227278
pooperačního6242998013162121181241296327377426484505566624
období12722998013167128188247308330
se16252998013150103
obešly17522998013167127182222243292
bez20672998013170124168
komplikací22592998013155112203263285307352403452473
V6243148013156
rámci703314801313180168216236
dispenzarizace962314801316586124182235291334384414436479528576625
(průměrná1610314801313594125182269321351409457
doba20903148013164121181229
sledování2342314801314667119178235282331388408
51624329801315499
měsíců)7463298013196148187207254310334
nebyla11033298013166118176222244292
zaznamenána14183298013151100144202249337389446493550598
žádná20393298013150100158215263
lokální2325329801312986131181202258279
re‑2627329801313989123
cidiva624344801314970128148197245
v8923448013152
místě9673448013189109147181230
resekce,1220344801313485124176220266316332
u15753448013160
jedné1658344801312274133190242
nemocné19233448013160112200257306363415
byla23613448013162108130178
čtyři2562344801315085136167188
měsíce6243598013190142181201248298
po9453598013156114
výkonu1082359801314596141197254310
popsána14153598013156114174213262318366
generalizace18043598013155107164216246295316336379429476526
renálního2353359801312878135183204260281340397
karcinomu624374801314796126172193249306395451
Závěr:7743893013562119173228267293
V10963898013156
časovém1176389801314999138197245297386
úseku15863898013166105158204262
1/2007–5/20201872389801316193146197252301350401437490541591642
jsme2538389801313170159212
provedli624404801316091146193244303324345
celkem992404801314494116159210297
521312404801314998
resekcí1433404801312878117169214260281
solitárních1737404801313693115136168217247305325372429
ledvin,2189404801311970129177199256273
z24854048013140
toho2548404801313388145202
v6244198013150
106984198013153101
případech823419801315789111171221280333383440
(19,21288419801312573118132187
%)14994198013178103
laparoskopicky1626419801312069128178209266306351408468491539584636
LR22994198013146101
tumoru2424419801313189177236268326
solitární624434801314199122144177227258317338
ledviny987434801312275135184207265311
je1322434801312275
ve14214348013149101
vybraných15464348013149101161193243301347394452
indikacích2022434801312280139161206257306327375433
a24794348013149
v25524348013150
ru‑2626434801313391124
kách624449801314695143199
zkušeného846449801314085141179231288339396453
operatéra13224498013154112165196244275325355404
bezpečnou17494498013156109152211264312368425482
alternativou225444980131456698148179236284315336384440496
resekci624464801313284124177223270292
otevřené940464801315891142191223274332385
KLÍČOVÁ6254934014770132164236320392464
SLOVA11154934014763124208280352
Laparoskopie,6245098013149100160210241297337382439499522574591
nádor12395098013161110169227259
ledviny,1522509801312678139188211268314327
resekce1874509801313485125179224271322
ledviny,2220509801312578138188211268314327
soli‑25715098013143101125146179
tární624524801313484115174195
ledvina,843524801312477137186209267315334
teplá1201524801313485144168216
ischemie1441524801312362111169222311333385
SUMMARY6255534014762143243345423493561
Kolář7745698013154109131177207
J,1004569801313248
Stránský1075569801314575105154209247290340
P,1438569801314953
Pitra1514569801314969100131179
T,1716569801314556
Bartoš1795569801314998127163217255
Veselá2073569801315098136188209256
A,2352569801315877
Ferda2452569801314595125181228
J,2703569801313248
Hes6245848013169122163
O,811584801317085
Hora9215848013165124156206
M11515848013182
Laparoscopic1277584801314697156206238294334383439499522570
partial18715848013157107138175198246268
nephrectomy21635848013156109168227258310359395451541587
of624599801315987
solitary735599801314199122144177227258310
kidneys1069599801314670130187240288329
Aim:774614301357097190214
To10076148013151102
evaluate1133614801314998147169226274306357
laparoscopic1514614801312068127177208264304352408468490538
partial20766148013157107138175196244266
nephrec‑23666148013155108168226257308357384
tomies624629801313490180201254294
(LPN)942629801313179133201228
of1195629801316088
solitary13076298013143101124145179228260312
kidneys1643629801314872131188242289330
performed19976298013162116147179237269359412472
at2493629801315284
our26016298013160118149
Department6246448013170122180228258293380432488518
and11656448013145101159
to1347644801312983
compare1453644801314498185243291321371
the1847644801312985136
data20066448013154102132180
with,2209644801317495127184201
and24326448013145101159
the2614644801312985136
results624659801313284124180202235277
of,92565980131558398
their1047659801313088141162193
open12646598013155115169227
counterparts15156598013145101159216248299330390440471508550
in2089659801311976
the2189659801313189141
literature235465980131204175125157206239296327379
Material7746743013590145182237275303357384
andmethods:11806743013552113176287342380442503566611635
A18336748013164
retrospective1920674801313282115146201240298351400435457505556
analy‑24996748013146102150172219251
sis624689801314162101
of749689801315785
patients8596898013158108140163215273305347
who12306898013177136194
underwent14486898013157114174227258340392450482
LPN19546898013148102170
of2148689801315685
solitary2257689801313997120142175225256308
kid‑2589689801314569128161
ney6247048013159112160
during8087048013160117148170228287
the1119704801313493146
years12897048013148100148179220
2007–202015337048013154106161210258306357407458
Results:7747193013563118163223250287333357
In1154719801312380
the1257719801313794146
time1426719801313657145197
period16467198013164117147168225284
1/2007–5/20201953719801315788139190244292339390424476526575625
our26017198013162118149
Department6247348013171124182231261297386438494525
conducted11727348013152106164222278326361410470
a16657348013152
total1740734801313388119168189
of1952734801316088
59220637348013156103152
LPN22387348013152105171
with24327348013182104136193
1026487348013156102
cases624749801314998136188227
(17%)874749801313278140233257
of1154749801316188
solitary12657498013143101123143175224254305
kidney1593749801314871129186238284
resections1900749801313586125177225260281338395433
(for2356749801313257113144
com‑25237498013151106194227
parison6247648013161110140161199256314
–9617648013157
in1041764801312682
the1146764801313794146
same1315764801314392180232
time1570764801313758145197
frame1790764801313263112200252
4220657648013156104
open21927648013161120173230
solitary24457648013144101123143175224254305
kidney297689801314872133192247296
resections329789801314396138192243280303362422462
(5378489801314193
8%)3895898013155152178
were4098898013192146178231
conducted4353898013162119179240299349386438500
from487889801314074132224
a29761048013150
total3049104801313388119168189
of3261104801315885
72533691048013153104156
open35481048013158117170226
partial37971048013161109140176196244265
nephrectomies)40851048013158110169226256307355390445534554606645669
The47901048013151110162
av‑4975104801314996127
erage2976119801315384132191243
age32421198013153111163
of3428119801316290
patients35401198013165114145166217274305345
who39081198013183140198
were41291198013183134164214
indicated4366119801312783142162210258289339398
for4787119801313389120
LPN49301198013152106172
of2976134801315987
a30871348013157
solitary3168134801314199121142175224255307
kidney3498134801315578137195247295
was38161348013188137177
6640161348013162116
years41551348013156108156187227
(56–774406134801313687138196243295
years)47251348013156108155186227251
In5014134801313188
the2976149801313594147
past,31471498013170121161195214
eight3385149801316284144202234
of3643149801316896
them37631498013142101155246
underwent40331498013167125186239271354407466498
contralateral45551498013157114173205237288310359391443475525547
nephrectomy29761648013158109166223252301348382436523567
due35651648013154109160
to3747164801312882
tumour,3851164801312884170226282311322
in4196164801311772
one42911648013152108159
case4472164801314491129180
the4674164801312884135
kidney4831164801314163119175226271
was29761798013178125162
functionally-solitary3160179801312379134180214234289345391411431476506544600621640671718747796
and3978179801314499156
in4156179801311772
another4250179801314398154184239290319
there4591179801312883133163211
was48241798013173120157
an5003179801314499
agenesis29761948013150108159216268307327364
of3363194801315481
the3467194801312985137
kidney3627194801314264122178230276
The39391948013146104156
duration41181948013155110140189220241297354
of4495194801315481
laparoscopy4599194801311865123172202257296343398457503
was29762098013180128167
on31662098013166124
average33132098013157104155185234293345
9136812098013161108
minutes38122098013198119175231264314353
(55–1554189209801313686134188233277325
minutes),45372098013198118175231264314353377392
the4952209801314198150
hilumwas297622480131597999155242338387425
clamped3423224801314465112199257309368
in3813224801311874
739102248013148
cases,3981224801314492130182220238
in4241224801311874
which43382248013174131151198254
the4614224801312986137
average4774224801314490141170219277328
warm29762398013178125154241
ischemia3239239801311754100155205291311357
time3618239801312848133184
lasted3824239801311763101133181239
for4085239801312377107
12minutes4214239801314789195214269323355403441
(7–23min‑4677239801312373119164214319339394425
utes)2976254801315891141180203
The32162548013153112164
average3403254801315197148178227286337
size3763254801314363106156
of3942254801316087
the4052254801313692144
tumour4219254801313692180237294324
indicated4566254801312581140160207256287337396
for4985254801313086117
laparoscopy2976269801312371129178208264303350405464510
was35092698013183132170
2237022698013157109
7mm38242698013154156244
(12–35mm),4091269801313278122173220269370458482497
the4611269801313794146
highest4780269801316283141197249288322
RENAL29762848013155103169229275
nephrometry32732848013153104161217246300386437468498547
score3842284801313582135165214
was40782848013173121158
7a4258284801314890
Among43872848013158144200256313
histologi‑4722284801315372109142195216272329349380
cal2976299801314997118
findings3117299801312249105163184240298336
there3476299801312986137168218
were37172998013174125155205
939452998013149
cases4017299801314493131183222
of4262299801315381
clear4365299801314565117164194
cell4582299801314493115135
renal4740299801312878135182203
cell4966299801314494115136
carcinomas2976314801314895124168188243298384431468
(8×3466314801312371133
pT1a,3621314801315495143183199
1×38423148013147101
pT3a),3965314801315496147193217230
in4217314801311772
one43113148013152108158
case4491314801314390127178
a46913148013143
papillary47563148013158106162183202222268297346
renal2976329801313283140187208
cell3207329801314898120140
carcinoma3370329801314897127173193250307395443
(pT1a)3836329801312887130180221245
was41043298013179127166
diagnosed4293329801315979127185242299338390449
Positive47823298013154109148168200221269320
surgical2976344801314196127183204251300321
margin33203448013189137167224244301
(pR1)3644344801312887141189208
was38753448013178127165
found4063344801312884141198256
in4342344801312278
one44433448013157115167
case4633344801314896135187
Once,48593448013172130178227243
a29763598013150
conversion30493598013148103160206257287327347404461
to3533359801312984
open36403598013154113166223
surgery3886359801313691121178230260311
was42203598013174123162
required4405359801312778137193213243294353
in4781359801311875
order4879359801315384141193223
to2976374801313489
achieve3088374801315199155176227275326
oncological34373748013159117164219241298357378425474495
radicality3955374801313382140161208257278298331381
In4371374801312581
the4475374801313592144
immediate46423748013125112200252311332379410460
aftermath2976389801315078115165196286334366423
of3423389801316693
the3540389801314199151
surgery37153898013148104135192245275327
there4065389801314199152182233
was43223898013187136175
no45213898013166124
major46683898013198147168226257
de‑49483898013168120154
cline297640480131497090147199
in3198404801312784
renal3305404801313787144192213
function3541404801313391148195230251308365
To39474048013156106
date,40764048013164112143192208
there4307404801313996147178228
has45584048013164111150
been47314048013165118171228
no49824048013163120
need29764198013159111164223
to3222419801313084
apply33294198013146105164186233
renal3585419801313181138186207
replacement3815419801312879137159207254304392444501532
therapy4370419801312986138169217276322
in4715419801311975
case4813419801314594132184
of5020419801315582
renal2976434801313283140187208
failure320743480131257495116172202252
In3498434801311976
all359743480131456687
surgeries3707434801313691122178230260282333373
including4103434801311875122143199257278334393
the4519434801312986138
postsurgi‑46804348013156114153187227283313370390422
cal2976449801314998119
period31184498013168121151172229288
no34294498013166123
complications35754498013156111200258280301348397428449506563601
occurred41994498013166114160216246277328387
During46274498013178135166187244302
the4952449801314198150
follow-up2976464801312985107127184262294352410
(average3409464801313479126176207255314366
5137984648013159104
months)39254648013195152210241298336359
there4307464801314097149179229
was45594648013185134172
no47544648013164122
local4899464801312885133182203
recurrence2976479801313283131188218249299356404453
of3452479801316087
the3562479801313693145
tumour,3730479801313591179236293323336
once40894798013159117164214
metastatic43264798013191143175224262296344375396444
disease4793479801316181119171218257309
was29764948013179128167
described31664948013158110149197227249307360419
four3608494801312884141171
months38024948013189146204234291330
after4155494801314875112162192
the4370494801313390142
surgery4535494801314095125182234264315
Conclusion:31265093013564124186235263324369397458520544
In3689509801312380
the3793509801313087140
time3957509801313051139192
period41735098013156110141163220280
1/2007–5/20204477509801314981133184239288336387422474525574625
we29765248013179132
conducted31325248013152108166226283331367418479
a36355248013153
total3712524801313490122172194
of3930524801316290
5240445248013157107
solitary41755248013144103126147180230261313
kidney4512524801315074133191244291
partial48275248013164114145182205253275
nephrectomies29765398013159112172230262313363399455544566619659
with36595398013182104138196
laparoscopic3879539801312674134184215272312360416477499547
approach44515398013152112172204260310359417
in4892539801312583
1049995398013156103
cases2976554801314997136188228
(193227554801312572116
2%)33585548013154147171
In3567554801311976
the3666554801313087139
hands38295548013154102159217256
of4108554801315482
a42135548013146
skilled4282554801314085108129150202261
surgeon4567554801313792123180231289347
LPN4937554801314599165
of2976569801315785
solitary3084569801313692114135167215245295
kidney3402569801314264122178229275
represents,3700569801312878136167217256307363394434452
in4175569801311874
specific4272569801313693146194214239265312
cases,4607569801314492131182221239
a48695698013144
safe4937569801313988114165
alternative2976584801315072105156188246295327349399451
to3451584801313490
open35655848013158118173230
surgery3819584801314198129187240271323
KEY29786134014770134206
WORDS321061340147106190261346409
Laparoscopy,29766298013149100160210242298338387443504551564
partial35646298013169119151188210258281
nephrectomy,38696298013167120180239270322371408464554600613
renal4506629801314192150199222
tumour,47526298013142100189247306337350
solitary2976644801314199122144177227258310
kidney,3310644801314670129187240288301
warm36356448013179129160250
ischemia3909644801312362111169222311333381
time4314644801313456145198
………297667340147120240360
ÚVOD29787158018197183286388
Chirurgické29767498013162118139169226256313334381425475
řešení3475749801312778116168225245
tumoru3744749801312985173230261317
solitární4085749801313693115136168216247304325
ledviny4433749801311971130178200256301
je4757749801311970
oproti48517498013153112143198230251
resekci2976764801313282120172216261282
u32817648013153
zdravé3357764801314399129177223273
kontralaterální3653764801314297153184214263284331361411441489510566586
ledviny4262764801311970128176198254298
výkon4583764801314495140195251
riziko‑485776480131284991113157212245