Objective: development of an algorithm for diagnosing and choosing the tactics of surgical intervention for localized kidney cancer based on the analysis of multispiral computed tomography data (MSCT) to reduce the risk of perioperative complications and to improve the functional results of nephron-sparing surgery (NSS).
Subjects and methods. As material for prospective randomized clinical trial were results of MSCT and surgical treatment of patients (n = 130) with clinically localized kidney cancer at an early stage of a disease (40 (30.8%) patients with a stage of T1aN0M0 and 90 (69.2%) patients with T1bN0M0 stage) which were operated in our clinical center during the period from 2014 to 2019 years. Assessment of the surgical complications was carried out on classification of Clavien-Dindo. Calculation of a glomerular filtration rate (SKF, ml/min./1.73sq.m) was carried out on the equation of MDRD (Modification of Diet in Renal Disease). All diagnostic tests in the oncological clinic were performed on the X-ray computer tomography, based on the operating system «Windows» (General Electric (GE Healthcare) company, model CT660, 64-spiral system with IQ Enhance technology).
Results. According to the results of monovariant and multivariate analysis, it was found that of all the studied parameters, only nephrometric MSCT data, such as the diameter, the spatial localization of the tumor in the kidney, the presence of a pseudocapsule, the predominance of a solid component at the periphery of formation, the presence of an extrarenal component in the tumor, as well as deformation of the pyelocaliceal system (р < 0,05 for all indicators), are the main differential diagnostic criteria justify the possibility of the technical enucleoresection or classical partial nephrectomy. In the comparative analysis of results of PNS it is revealed that use of the developed way of nephrometry assessment of a tumor of a kidney according to MSCT had statistically significant impact on duration of surgical intervention (U = 53,0, р = 0,001), blood loss volume (U = 226,5, р = 0,001), time of ischemia (F = 0,1, р = 0,008), and also on functional conditions of renal function after operation (U = 354,5, р = 0,035). According to the results of a morphological study of surgical material, no relationship was found between the indentation from the tumor node for the progression of the disease (F = 1,0, p = 1,0).
Conclusion. Development and use of a new nephrometry score of assessment certain differential and diagnostic criteria of a tumor according to MSСT is a basis for the choice of surgical intervention (nephron-sparing surgery or enucleoresection) at the localized kidney cancer form.

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