MODERN METODOLODYIN EVALIATION OF OPERABILITY AT ESOPHAGEAL CANCER PATIENTS
Introduction. At the present stage of esophageal surgery development, the patient's ability to safely transfer resection intervention from the position of balancing the prevalence of the tumor process and the functional abilities of the body is a cornerstone problem of thoracic Oncology. Objective: to develop a methodology for assessing the operability of patients with esophageal cancer based on a high-valid, highly informative prognostic model using the main predictors of general somatic complications of esophageal resection. Materials and methods. We analyzed the results of surgical treatment of 210 patients, all of whom underwent esophageal resection in the treatment center for high-level esophageal cancer surgery. 14 cases of moderate and severe "surgical" complications were excluded from the analysis, and further single-factor and multi-factor analysis was performed based on 196 cases. Results. After assessing the risk of developing complications using a model or nomogram, a specific patient with a predicted risk of developing "General somatic" complications of up to 33.3% was considered operable and without further examination, underwent preoperative training according to the recommendations of an oncologist, anesthesiologist and cardiologist. With an estimated probability of developing general somatic complications in the range of 33.3 % - 66.6 %, the patient was subject to a comprehensive examination according to the recommendations of a cardiologist and an anesthesiologist-resuscitator. A patient with an estimated probability of developing general somatic complications above 66.6% was considered inoperable Conclusion. Operability of patients with esophageal cancer is mainly determined by the severity of comorbid and functional status factors. Objective quantitative assessment of risk factors, the possibility of targeted preoperative correction, allows to screen patients for their operability, objectify and purposefully reduce the risks of developing cardiovascular and respiratory complications of the postoperative period.