Year 2014 Vol. 22 No 5

ONCOLOGY

U.U. ANDRUSHCHUK 1, Y.P. OSTROVSKY 1, V.V. ZHARKOV 2, S.A. KURGANOVICH 1, T.T. GEVORKYAN 1, V.E. PONOMAREVA 2, M.M. SHASHURO 2, N.M. NOVITSKAJA 1

THE COMPARATIVE ANALYSIS OF SURGICAL TREATMENT OF PATIENTS WITH TUMORS OF THE MAIN LOCATIONS AND COMPETITIVE CORONARY HEART DISEASE WITH DRUG THERAPY AND AFTER THE PRELIMINARY MYOCARDIAL REVASCULARIZATION

SE “Republican Scientific Practical Center “Cardiology”, 1 Minsk,
SE “N.N. Alexandrov Republican Scientific Practical Center of Oncology and Medical Radiology” 2, Minsk,
The Republic of Belarus

Objectives. To assess a comparative analysis of the immediate results of radical surgical treatment of patients with tumors of the main locations and competing coronary heart disease (CHD) with drug therapy and after the preliminary myocardial revascularization on the basis of the designed algorithm.
Methods. The patients (n=238) have been radically operated on for tumors of the main locations accompanied by cardiotropic therapy (1st group) and 13 patients – after myocardial revascularization surgery (2nd group). Patients of the first group were reliably older, but with a less pronounced cardiac pathology. The average functional class of heart failure and angina pectoris in patients of the second group was found to be significantly higher. There was no difference in the groups by gender, body mass index, type of oncological surgery.
Results. The duration of the operations amounted to 150,8±4,63 min. vs 331,3±35,6 min. for the first and second groups, respectively (p<0,005). The incidence of major cardiac complications was 10,1% and 0%, respectively (p=0,37), non-cardiac – 7,6% and 15,4% (p=0,65), all major postoperative complications – 16,8% and 15,4% (p=0,72), in-hospital mortality – 3,4% and 7,7% (p=0,50), average length of a hospital stay – 21,5±0,61 and 24,3±1,90 (p=0,19). Cardiac pathology itself was not considered to be as the main reason of the 9 (3,6%) deaths within the hospital period in both groups, but in 2 cases of the first group (0,8%) it exacerbated the complicated course of early postoperative period.
Conclusion. There were no significant differences in the proportion of major cardiac, non-cardiac, major postoperative complications, hospital mortality, duration of hospitalization of patients after radical surgery for tumor of the main locations with competitive CHD operated with drug therapy or after preliminary myocardial revascularization according to the worked out algorithm.

Keywords: cancer, coronary heart disease, aortic coronary shunting
p. 589-595 of the original issue
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e-mail: heartslight@mail.ru,
Andrushchuk Vladimir Vladimirovich
Information about the authors:
Andruschuk VV, MD, a cardiac surgeon of the 2nd cardiac surgery department of the State Institution "Republican Scientific and Practical Centre Cardiology", the Laboratory of Cardiac Surgery.
Zharkov VV, MD, professor, a csenior researcher of the Department of Thoracic Anesthesiology oncopathology with a group of anestesiology of SE "Republican Scientific and Practical Centre of Oncology and Medical Radiology named by N.N. Aleksandrov. "
Ostrovsky YP, MD, professor, a corresponding member of the National Academy of Sciences, a head of the chair of Cardiac Surgery GUO "Belarusian Medical Academy of Postgraduate Education," the chief cardiac surgeon freelance of Ministry of Health of the Republic of Belarus.
Mounds SA, a specialist-physician of ultrasonic diagnostics SI "Republican Scientific and Practical Centre Cardiology", of the laboratory of cardiac surgery.
Gevorgyan TT, a specialist department of functional diagnostics SI "Republican Scientific and Practical Centre Cardiology".
Ponomareva VE, a physician of SI "Republican Scientific and Practical Centre of Oncology and Medical Radiology named by N.N. Aleksandrov" .
Shashuro MM, an assistant of department of thoracic cancer pathology with a group of anesthesiology GU "Republican Scientific and Practical Center of Oncology and Medical Radiology named by N.N. Aleksandrov".
Nowicka NM, an assistant of heart surgery laboratory SI "Republican Scientific and Practical Centre Cardiology ".
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