RESUMEN
It was operated 17 patients with kidney and bladder cancer against the background of severe concomitant coronary artery disease (52.9%), aortic aneurysm (35.3%) or combination of coronary artery disease with Leriche syndrome (5.9%) or hemodynamically significant stenosis of internal carotid artery (5.9%). Patients were operated for the period from 1998 to 2012. All patients were male at the age from 39 to 80 years (mean 62.1 years). The first stage of kidney cancer was diagnosed in 8 (53.3%) patients, the second stage - in 1 (6.7%) patient, the third stage - in 2 (13.3%) patients and the fourth stage was observed in 4 (26.7%) patients. Bladder cancer had 1 and 2 stages. Simultaneous operations were performed in 3 (17.6%) patients. 12 (70.6%) patients were operated consequentially. Surgery for kidney cancer was not done in 2 (11.8%) of 17 patients because of patient death after coronary bypass surgery or patient refusal of surgery after carotid arteries stenting. Intraoperative and postoperative complications have been developed in 9 (52.9%) of 17 patients. 2 (11.8%) patients died. The complications frequency and mortality after simultaneous operations were 25% (1 of 4) and 0. These parameters were 57.1% (8 of 14) and 14.3% respectively in case of consequent tactics. It was not observed myocardial infarction and aortic aneurysm rupture after surgeries for kidney and bladder cancer. Overall 1, 3, 5 - year survival of patients with kidney cancer and severe concomitant cardiovascular diseases was 100%, 73.3% and 52.4% respectively. It was concluded that surgical treatment of severe concomitant coronary artery disease and aortic aneurysm in patients with kidney and bladder cancer decreases risk of myocardial infarction and aortic aneurysm rupture in intraoperative and postoperative periods.
Asunto(s)
Enfermedades Cardiovasculares , Procedimientos Quirúrgicos Cardiovasculares , Neoplasias Renales , Complicaciones Posoperatorias , Neoplasias de la Vejiga Urinaria , Procedimientos Quirúrgicos Urológicos , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/mortalidad , Enfermedades Cardiovasculares/fisiopatología , Enfermedades Cardiovasculares/cirugía , Comorbilidad , Humanos , Cuidados Intraoperatorios/métodos , Complicaciones Intraoperatorias/epidemiología , Complicaciones Intraoperatorias/etiología , Riñón/patología , Riñón/cirugía , Neoplasias Renales/mortalidad , Neoplasias Renales/patología , Neoplasias Renales/cirugía , Masculino , Persona de Mediana Edad , Moscú , Estadificación de Neoplasias , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Ajuste de Riesgo , Análisis de Supervivencia , Resultado del Tratamiento , Vejiga Urinaria/patología , Vejiga Urinaria/cirugía , Neoplasias de la Vejiga Urinaria/mortalidad , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/cirugía , Procedimientos Quirúrgicos Urológicos/efectos adversos , Procedimientos Quirúrgicos Urológicos/métodos , Procedimientos Quirúrgicos Urológicos/estadística & datos numéricosAsunto(s)
Antineoplásicos/efectos adversos , Corazón/efectos de los fármacos , Corazón/efectos de la radiación , Enfermedad de Hodgkin/terapia , Pericardio/efectos de los fármacos , Pericardio/efectos de la radiación , Radioterapia/efectos adversos , Animales , Ecocardiografía , Electrocardiografía , Cardiopatías/inducido químicamente , Cardiopatías/etiología , Enfermedad de Hodgkin/tratamiento farmacológico , Enfermedad de Hodgkin/radioterapia , Humanos , Conejos , Traumatismos por Radiación/etiología , Dosificación RadioterapéuticaRESUMEN
Postradiation pericarditis was diagnosed in 11 of 52 patients treated for lymphogranulomatosis with radiation applied to enlarged mediastinal lymph nodes. The risk of postradiation pericarditis is greater in cases of high radiation doses (more than 45 Gy) and in patients with postradiation pneumonitis. Postradiation pericarditis can develop both during the exposure and long after radiation therapy; therefore long-term follow-up is required for these patients.