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OBJECTIVE To discuss the feasibility, safety, and effectiveness of conventional laparoscopic partial nephrectomy combined with pyelolithotomy for patients with ipsilateral renal tumor and staghorn kidney stone. MATERIALS AND METHODS Retrospective multicentral comparative study. Group "Combo" was presented by patients with the mentioned combined pathology (n=15). Group "Standart" (n=69) formed from common patients who underwent standard lap partial nephrectomy for renal tumor in the absence of kidney stones. Perioperative factors and results were studied and compared. Video presentation of combined surgical technique is available at: https://youtu.be/fAfYJDvGzsU. RESULTS Of all patients, no positive margins, no conversions to open surgery or nephrectomy & any complications Clavien >III were detected. There were no any significant differences between the two groups except for OR time (150 [120; 210] vs 130 [100; 180] min; p=0,001). Differences between indexes of WIT (16,27+/-3,8 vs 15,9+/-4,5 min; p=0,107), EBL (200 [150; 300] vs 200 [150; 300] cc; p=0,981), length of stay (7 [6;9] vs 8[6;9] days; p=0,611), intraop complications (0,00 vs 4,3%; p=0,411) and values of postop Clavien III rate (0,00 vs 4,3%; p=0,411) for "Combo" & "Standart" respectively were comparable as well as oncological outcomes. Stone-free rate for combined procedures reached 93,3%. CONCLUSION conventional laparoscopic partial nephrectomy combined with pyelolithotomy for patients with ipsilateral renal tumor and staghorn kidney stone is safe and efficient alternative to 2-step treatment of this rare disease.

OBJECTIVE To discuss the feasibility, safety, and effectiveness of conventional laparoscopic partial nephrectomy for patients with kidney tumors R.E.N.A.L. score 10 and higher. MATERIALS AND METHODS Retrospective comparative study. Everyone who has been treated from I 2015 to I 2020 by one surgeon in our department by lap partial nephrectomy was included. Patients were randomized by criteria of R.E.N.A.L. score in two groups: 40 those who had this index 10 or more ("R10+"), and 69 - all the rest ("R less or equal 9"). Perioperative factors and results were studied and compared. Video presentation of the surgical technique is available at: https://youtu.be/1254WSFMxJ0. RESULTS No conversions to open surgery or nephrectomy & any complications Clavien >III were detected. Of all patients, benign lesions were identified in 21(19,3%). Up stage from 1-2 to 3 occurred in 6 (6,82%) cases. Intraop complications: 4,3% vs 2,5% (p=0,6) and the same values of postop Clavien III rate for "R less or equal 9" & "R10+" groups respectively. There were no any significant differences between the two groups except for three parameters: OR time, estimated blood loss & warm ischemia time. In "R10+" cohort these values were 170 [130; 210] min, 250 [162; 337] ml & 20,1+/-5,7 min. And in "R less or equal 9" - 130 [100; 180] min, 200 [150; 300] ml & 15,9+/-4,5 min respectively (p