hepatoАнналы хирургической гепатологииAnnaly khirurgicheskoy gepatologii = Annals of HPB Surgery1995-54642408-9524НЭИКОН ИСП10.16931/1995-5464.2019399-109hepato-488Research ArticleОНКОЛОГИЧЕСКИЙ КОНСИЛИУМ ПРИ РАКЕ ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫCANCER COUNCIL FOR PANCREATIC CANCERГраницы операбельности при раке поджелудочной железы: что лимитирует?Operability boundaries in pancreatic cancer: what is the limit?https://orcid.org/0000-0002-0921-7199СубботинВ. В.SubbotinV. V

Субботин Валерий Вячеславович – доктор мед. наук, заведующий центром анестезиологии-реаниматологии 

Субботин Валерий Вячеславович – 111123, Москва, шоссе Энтузиастов, д. 86. Тел.: +7-916-612-25-04. 

Valeriy V. Subbotin – Doct. of Sci. (Med.), Head of the ICU Department

v.subbotin@mknc.ruhttps://orcid.org/0000-0002-5857-2998ДушинИ. Н.DushinI. N.

Душин Иван Николаевич – врач анестезиолог-реаниматолог отделения анестезиологии-реанимации №1

Ivan N. Dushin – ICU-physician of the ICU Department №1

ivan-dushin@mail.ruhttps://orcid.org/0000-0003-4887-1166ЗабалуевД. А.ZabaluevD. A.

Забалуев Денис Алексеевич – врач анестезиолог-реаниматолог отделения анестезиологии-реанимации №1

Denis A. Zabaluev – ICU-physician of the ICU Department №1

d.zabaluev@mknc.ruhttps://orcid.org/0000-0002-4230-4796КамневС. А.KamnevS. A.

Камнев Сергей Анатольевич – врач анестезиолог-реаниматолог отделения анестезиологии-реанимации №1

Sergey A. Kamnev – ICU-physician of the ICU Department №1

korium1605@gmail.comhttps://orcid.org/0000-0001-7633-6852КлимовА. А.KlimovA. A.

Климов Андрей Андреевич – врач анестезиолог-реаниматолог отделения анестезиологии-реанимации №1

Andrey A. Klimov – ICU-physician of the ICU Department №1

an.an.klimov@gmail.comhttps://orcid.org/0000-0002-2918-5091МалаховаА. А.MalakhovaA. A.

Малахова Анна Анатольевна – врач анестезиолог-реаниматолог отделения анестезиологии-реанимации №1

Anna A. Malakhova – ICU-physician of the ICU Department №1

an.an.malahova@yandex.ruhttps://orcid.org/0000-0003-4013-4970ОсокинЯ. А.OsokinYa. A.

Осокин Яков Александрович – клинический ординатор отделения анестезиологии-реанимации №1

Yakov A. Osokin – Resident of the ICU Department №1

jamnstuff@gmail.comГБУЗ “Московский клинический научный центр им. А.С. Логинова” ДЗМРоссияLoginov Moscow Clinical Scientific Center, Department of Health of MoscowRussian FederationГБУЗ “Московский клинический научный центр им. А.С. Логинова” ДЗМRussian FederationLoginov Moscow Clinical Scientific Center of Moscow Department of HealthcareRussian Federation20192108201924399109Copyright © Субботин В.В., Душин И.Н., Забалуев Д.А., Камнев С.А., Климов А.А., Малахова А.А., Осокин Я.А., 20192019Субботин В.В., Душин И.Н., Забалуев Д.А., Камнев С.А., Климов А.А., Малахова А.А., Осокин Я.А.Subbotin V.V., Dushin I.N., Zabaluev D.A., Kamnev S.A., Klimov A.A., Malakhova A.A., Osokin Y.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hepato.elpub.ru/jour/article/view/488

Предоперационная диагностика сопутствующих заболеваний необходима для выявления лимитирующих факторов в периоперационном периоде и правильной оценки возможностей пациента перенести предстоящее вмешательство. При наличии выраженных сопутствующих и фоновых заболеваний и, как следствие, высокой вероятности развития неблагоприятных событий необходимо разработать стратегию подготовки пациента к оперативному вмешательству и реализовать ее. Такая подготовка должна включать как медикаментозную, так и хирургическую коррекцию сопутствующих заболеваний для уменьшения возможных рисков. Таким образом, взвешенный, командный, мультидисциплинарный подход в периоперационном периоде позволяет значимо уменьшить риски и летальность у пациентов, оперируемых по поводу рака поджелудочной железы. Если мультидисциплинарной команде удается распознать и нейтрализовать лимитирующие факторы, то операбельность приближается к абсолютной, но если улучшения состояния пациента достичь не получается, то от операции следует воздержаться и применить другие методы лечения.

Preoperative diagnosis of comorbidities is essential for identifying the limiting factors inperioperative period and correct assessment of patient’s ability to undergo surgery. Severe concomitant diseases followed by advanced risk of adverse events require development and implementation of the strategy of preoperative preparation of patient. These measuress hould include both medicamentous and surgical correction of concomitant diseases in order to reduce perioperative risks. Thus, multidisciplinary perioperative approach makes it possible to reduce significantly the risks and mortality in patients undergoing surgery for pancreatic cancer. Diagnosis and correction of limiting factors approach operability to absolute one. However, operation should be avoided or alternative approaches should be preferred if co-morbidities are significant and failed to be corrected.

поджелудочная железаракхирургическое вмешательствопредоперационная подготовкафакторы рискасопутствующие заболеванияосложнениялетальностьpancreascancersurgical interventionpreoperative preparationrisk factorsconcomitant diseasescomplicationsmortalityReferencesRose J., Weiser T.G., Hider P., Wilson L., Gruen R.L., Bickler S.W. Estimated need for surgery worldwide based on prevalence of diseases: a modelling strategy for the WHO Global Health Estimate. Lancet Glob. Health. 2015; 3, Suppl 2: S13– S20. http://doi.org/10.1016/S2214-109X(15)70087-2.Rose J., Weiser T.G., Hider P., Wilson L., Gruen R.L., Bickler S.W. Estimated need for surgery worldwide based on prevalence of diseases: a modelling strategy for the WHO Global Health Estimate. Lancet Glob. Health. 2015; 3, Suppl 2: S13– S20. http://doi.org/10.1016/S2214-109X(15)70087-2.Bainbridge D., Martin J., Arango M., Cheng D. Evidence-based Peri-operative Clinical Outcomes Research (EPiCOR) Group. Perioperative and anaesthetic-related mortality in developed and developing countries: a systematic review and meta-analysis. Lancet. 2012; 380 (9847): 1075–1081. http://doi.org/10.1016/j.juro.2013.02.084.Bainbridge D., Martin J., Arango M., Cheng D. Evidence-based Peri-operative Clinical Outcomes Research (EPiCOR) Group. Perioperative and anaesthetic-related mortality in developed and developing countries: a systematic review and meta-analysis. Lancet. 2012; 380 (9847): 1075–1081. http://doi.org/10.1016/j.juro.2013.02.084.Pearse R.M., Harrison D.A., James P., Watson D., Hinds C., Rhodes A., Grounds R.M., Bennett E.D. Identification and characterisation of the high-risk surgical population in the United Kingdom. Crit. Care. 2006; 10 (3): R81. http://doi.org/10.1186/cc4928.Pearse R.M., Harrison D.A., James P., Watson D., Hinds C., Rhodes A., Grounds R.M., Bennett E.D. Identification and characterisation of the high-risk surgical population in the United Kingdom. Crit. Care. 2006; 10 (3): R81. http://doi.org/10.1186/cc4928.Clifon B.S., Hotten W.I. Deaths associated with anaesthesia. Br. J. Anaesth. 1963; 35: 250–259.Clifon B.S., Hotten W.I. Deaths associated with anaesthesia. Br. J. Anaesth. 1963; 35: 250–259.Marx G.F., Mateo C.V., Orkin L.R. Computer analysis of postanesthetic deaths. Anesthesiology. 1973; 39 (1): 54–58.Marx G.F., Mateo C.V., Orkin L.R. Computer analysis of postanesthetic deaths. Anesthesiology. 1973; 39 (1): 54–58.Cohen M.M., Duncan P.G., Pope W.D.B., Wolkenstein C. A survey of 112,000 anesthetics at one teaching hospital (1975–1983). Can. Anaesth. Soc. J. 1986; 33 (1): 22–31.Cohen M.M., Duncan P.G., Pope W.D.B., Wolkenstein C. A survey of 112,000 anesthetics at one teaching hospital (1975–1983). Can. Anaesth. Soc. J. 1986; 33 (1): 22–31.Monk T.G., Saini V., Weldon B.C., Sigl J.C. Anesthetic manage ment and one-year mortality after noncardiac surgery. Anesth. Analg. 2005; 100 (1): 4–10. http://doi.org/10.1213/01.ANE.0000147519.82841.5E.Monk T.G., Saini V., Weldon B.C., Sigl J.C. Anesthetic manage ment and one-year mortality after noncardiac surgery. Anesth. Analg. 2005; 100 (1): 4–10. http://doi.org/10.1213/01.ANE.0000147519.82841.5E.Moonesinghe S.R., Mythen M.G., Das P., Rowan K.M., Grocott M.P. Risk stratification tools for predicting morbidity and mortality in adult patients undergoing major surgery: qualitative systematic review. Anesthesiology. 2013; 119 (4): 959–981. http://doi.org/10.1097/ALN.0b013e3182a4e94d.Moonesinghe S.R., Mythen M.G., Das P., Rowan K.M., Grocott M.P. Risk stratification tools for predicting morbidity and mortality in adult patients undergoing major surgery: qualitative systematic review. Anesthesiology. 2013; 119 (4): 959–981. http://doi.org/10.1097/ALN.0b013e3182a4e94d.Bilimoria K.Y., Liu Y., Paruch J.L., Zhou L., Kmiecik T.E., Ko C.Y., Cohen M.E. Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons. J. Am. Coll. Surg. 2013; 217 (5): 833–842.e1-3. http://doi.org/10.1016/j. jamcollsurg.2013.07.385.Bilimoria K.Y., Liu Y., Paruch J.L., Zhou L., Kmiecik T.E., Ko C.Y., Cohen M.E. Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons. J. Am. Coll. Surg. 2013; 217 (5): 833–842.e1-3. http://doi.org/10.1016/j. jamcollsurg.2013.07.385.Kristensen S.D., Knuuti J., Saraste A., Anker S., Bøtker H.E., De Hert S., Ford I., Gonzalez Juanatey J.R., Gorenek B., Heyndrickx G.R., Hoeft A., Huber K., Iung B., Kjeldsen K.P., Longrois D., Luescher T.F., Pierard L., Pocock S., Price S., Roffi M., Sirnes P.A., Uva M.S., Voudris V., Funck-Brentano C. Authors/Task Force Members. 2014 ESC/ESA guidelines on noncardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur. J. Anaesthesiol. 2014; 31 (10): 517–573. http://doi.org/10.1097/EJA.0000000000000150.Kristensen S.D., Knuuti J., Saraste A., Anker S., Bøtker H.E., De Hert S., Ford I., Gonzalez Juanatey J.R., Gorenek B., Heyndrickx G.R., Hoeft A., Huber K., Iung B., Kjeldsen K.P., Longrois D., Luescher T.F., Pierard L., Pocock S., Price S., Roffi M., Sirnes P.A., Uva M.S., Voudris V., Funck-Brentano C. Authors/Task Force Members. 2014 ESC/ESA guidelines on noncardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur. J. Anaesthesiol. 2014; 31 (10): 517–573. http://doi.org/10.1097/EJA.0000000000000150.Hammill B.G., Curtis L.H., Bennett-Guerrero E., O'Connor C.M., Jollis J.G., Schulman K.A., Hernandez A.F. Impact of heart failure on patients undergoing major noncardiac surgery. Anesthesiology. 2008; 108 (4): 559–567. http://doi.org/10.1097/ALN.0b013e31816725ef.Hammill B.G., Curtis L.H., Bennett-Guerrero E., O'Connor C.M., Jollis J.G., Schulman K.A., Hernandez A.F. Impact of heart failure on patients undergoing major noncardiac surgery. Anesthesiology. 2008; 108 (4): 559–567. http://doi.org/10.1097/ALN.0b013e31816725ef.Goldman L., Caldera D.L., Nussbaum S.R., Southwick F.S., Krogstad D., Murray B., Burke D.S., O'Malley T.A., Goroll A.H., Caplan C.H., Nolan J., Carabello B., Slater E.E. Multifactorial index of cardiac risk in noncardiac surgical procedures. N. Engl. J. Med. 1977; 20; 297 (16): 845–850.Goldman L., Caldera D.L., Nussbaum S.R., Southwick F.S., Krogstad D., Murray B., Burke D.S., O'Malley T.A., Goroll A.H., Caplan C.H., Nolan J., Carabello B., Slater E.E. Multifactorial index of cardiac risk in noncardiac surgical procedures. N. Engl. J. Med. 1977; 20; 297 (16): 845–850.Detsky A.S., Abrams H.B., Forbath N., Scott J.G., Hilliard J.R. Cardiac assessment for patients undergoing noncardiac surgery. A multifactorial clinical risk index. Arch. Intern. Med. 1986; 146 (11): 2131–2134.Detsky A.S., Abrams H.B., Forbath N., Scott J.G., Hilliard J.R. Cardiac assessment for patients undergoing noncardiac surgery. A multifactorial clinical risk index. Arch. Intern. Med. 1986; 146 (11): 2131–2134.Lee T.H., Marcantonio E.R., Mangione C.M., Thomas E.J., Polanczyk C.A., Cook E.F., Sugarbaker D.J., Donaldson M.C., Poss R., Ho K.K., Ludwig L.E., Pedan A., Goldman L. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999; 100 (10): 1043–1049.Lee T.H., Marcantonio E.R., Mangione C.M., Thomas E.J., Polanczyk C.A., Cook E.F., Sugarbaker D.J., Donaldson M.C., Poss R., Ho K.K., Ludwig L.E., Pedan A., Goldman L. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999; 100 (10): 1043–1049.van Diepen S., Bakal J.A., McAlister F.A., Ezekowitz J.A. Mortality and readmission of patients with heart failure, atrial fibrillation, or coronary artery disease undergoing noncardiac surgery: an analysis of 38 047 patients. Circulation. 2011; 124 (3): 289–296. http://doi.org/10.1161/CIRCULATIONAHA.110.011130.van Diepen S., Bakal J.A., McAlister F.A., Ezekowitz J.A. Mortality and readmission of patients with heart failure, atrial fibrillation, or coronary artery disease undergoing noncardiac surgery: an analysis of 38 047 patients. Circulation. 2011; 124 (3): 289–296. http://doi.org/10.1161/CIRCULATIONAHA.110.011130.Kazmers A., Cerqueira M.D., Zierler R.E. Peri-operative and late outcome in patients with left ventricular ejection fraction of 35% or less who require major vascular surgery. J. Vasc. Surg. 1988; 8 (3): 307–315.Kazmers A., Cerqueira M.D., Zierler R.E. Peri-operative and late outcome in patients with left ventricular ejection fraction of 35% or less who require major vascular surgery. J. Vasc. Surg. 1988; 8 (3): 307–315.Fleisher L.A., Fleischmann K.E., Auerbach A.D., Barnason S.A., Beckman J.A., Bozkurt B., Davila-Roman V.G., GerhardHerman M.D., Holly T.A., Kane G.C., Marine J.E., Nelson M.T., Spencer C.C., Thompson A., Ting H.H., Uretsky B.F., Wijeysundera D.N. 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J. Am. Coll. Cardiol. 2014; 64 (22): e77–e137. http://doi.org/10.1016/j.jacc.2014.07.944.Fleisher L.A., Fleischmann K.E., Auerbach A.D., Barnason S.A., Beckman J.A., Bozkurt B., Davila-Roman V.G., GerhardHerman M.D., Holly T.A., Kane G.C., Marine J.E., Nelson M.T., Spencer C.C., Thompson A., Ting H.H., Uretsky B.F., Wijeysundera D.N. 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J. Am. Coll. Cardiol. 2014; 64 (22): e77–e137. http://doi.org/10.1016/j.jacc.2014.07.944.Kennedy H.L., Whitlock J.A., Sprague M.K., Kennedy L.J., Buckingham T.A., Goldberg R.J. Long-term follow-up of asymptomatic healthy subjects with frequent and complex ventricular ectopy. N. Engl. J. Med. 1985; 312 (4): 193–197.Kennedy H.L., Whitlock J.A., Sprague M.K., Kennedy L.J., Buckingham T.A., Goldberg R.J. Long-term follow-up of asymptomatic healthy subjects with frequent and complex ventricular ectopy. N. Engl. J. Med. 1985; 312 (4): 193–197.Perez-Silva A., Luis Merino J. Frequent ventricular extrasystoles: significance, prognosis and treatment. J. ESC Coun. Cardiol. Pract. 2011; 9 (17).Perez-Silva A., Luis Merino J. Frequent ventricular extrasystoles: significance, prognosis and treatment. J. ESC Coun. Cardiol. Pract. 2011; 9 (17).Tendera M., Aboyans V., Bartelink M.L., Baumgartner I., Clément D., Collet J.P., Cremonesi A., De Carlo M., Erbel R., Fowkes F.G., Heras M., Kownator S., Minar E., Ostergren J., Poldermans D., Riambau V., Roffi M., Röther J., Sievert H., van Sambeek M., Zeller T. ESC Committee for Practice Guidelines. ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries: the Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). Eur. Heart. J. 2011; 32 (22): 2851–2906. http://doi.org/10.1093/eurheartj/ehr211. Epub 2011 Aug 26.Tendera M., Aboyans V., Bartelink M.L., Baumgartner I., Clément D., Collet J.P., Cremonesi A., De Carlo M., Erbel R., Fowkes F.G., Heras M., Kownator S., Minar E., Ostergren J., Poldermans D., Riambau V., Roffi M., Röther J., Sievert H., van Sambeek M., Zeller T. ESC Committee for Practice Guidelines. ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries: the Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). Eur. Heart. J. 2011; 32 (22): 2851–2906. http://doi.org/10.1093/eurheartj/ehr211. Epub 2011 Aug 26.Giovanardi F., Lai Q., Garofalo M., Arroyo Murillo G.A., Choppin de Janvry E., Hassan R., Larghi Laureiro Z., Consolo A., Melandro F., Berloco P.B. Collaterals management during pancreatoduodenectomy in patients with celiac axis stenosis: A systematic review of the literature. Pancreatology. 2018; pii: S1424-3903(18)30087-5. http://doi.org/10.1016/j.pan.2018.05.003.Giovanardi F., Lai Q., Garofalo M., Arroyo Murillo G.A., Choppin de Janvry E., Hassan R., Larghi Laureiro Z., Consolo A., Melandro F., Berloco P.B. Collaterals management during pancreatoduodenectomy in patients with celiac axis stenosis: A systematic review of the literature. Pancreatology. 2018; pii: S1424-3903(18)30087-5. http://doi.org/10.1016/j.pan.2018.05.003.Nara S., Sakamoto Y., Shimada K., Sano T., Kosuge T., Takahashi Y., Onaya H., Yamamoto J. Arterial reconstruction during pancreatoduodenectomy in patients with celiac axis stenosis –utility of doppler ultrasonography. World J. Surg. 2005; 29 (7): 885–889. http://doi.org/10.1007/s00268-005-7878-x.Nara S., Sakamoto Y., Shimada K., Sano T., Kosuge T., Takahashi Y., Onaya H., Yamamoto J. Arterial reconstruction during pancreatoduodenectomy in patients with celiac axis stenosis –utility of doppler ultrasonography. World J. Surg. 2005; 29 (7): 885–889. http://doi.org/10.1007/s00268-005-7878-x.Yang C.K., Teng A., Lee D.Y., Rose K. Pulmonary complications after major abdominal surgery: National Surgical Quality Improvement Program analysis. J. Surg. Res. 2015; 198 (2): 441–449. http://doi.org/10.1016/j.jss.2015.03.028.Yang C.K., Teng A., Lee D.Y., Rose K. Pulmonary complications after major abdominal surgery: National Surgical Quality Improvement Program analysis. J. Surg. Res. 2015; 198 (2): 441–449. http://doi.org/10.1016/j.jss.2015.03.028.Fernandez-Bustamante A., Frendl G., Sprung J., Kor D.J., Subramaniam B., Martinez Ruiz R., Lee J.W., Henderson W.G., Moss A., Mehdiratta N., Colwell M.M., Bartels K., Kolodzie K., Giquel J., Vidal Melo M.F. Postoperative pulmonary complications, early mortality, and hospital stay following noncardiothoracic surgery: a multicenter study by the perioperative research network investigators. JAMA Surg. 2017; 152 (2): 157–166. http://doi.org/10.1001/jamasurg.2016.4065.Fernandez-Bustamante A., Frendl G., Sprung J., Kor D.J., Subramaniam B., Martinez Ruiz R., Lee J.W., Henderson W.G., Moss A., Mehdiratta N., Colwell M.M., Bartels K., Kolodzie K., Giquel J., Vidal Melo M.F. Postoperative pulmonary complications, early mortality, and hospital stay following noncardiothoracic surgery: a multicenter study by the perioperative research network investigators. JAMA Surg. 2017; 152 (2): 157–166. http://doi.org/10.1001/jamasurg.2016.4065.Benjamin E.J., Blaha M.J., Chiuve S.E., Cushman M., Das S.R., Deo R., de Ferranti S.D., Floyd J., Fornage M., Gillespie C., Isasi C.R., Jiménez M.C., Jordan L.C., Judd S.E., Lackland D., Lichtman J.H., Lisabeth L., Liu S., Longenecker C.T., Mackey R.H., Matsushita K., Mozaffarian D., Mussolino M.E., Nasir K., Neumar R.W., Palaniappan L., Pandey D.K., Thiagarajan R.R., Reeves M.J., Ritchey M., Rodriguez C.J., Roth G.A., Rosamond W.D., Sasson C., Towfighi A., Tsao C.W., Turner M.B., Virani S.S., Voeks J.H., Willey J.Z., Wilkins J.T., Wu J.H., Alger H.M., Wong S.S., Muntner P. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 2017; 135 (10): e146–e603. http://doi.org/10.1161/CIR.0000000000000485.Benjamin E.J., Blaha M.J., Chiuve S.E., Cushman M., Das S.R., Deo R., de Ferranti S.D., Floyd J., Fornage M., Gillespie C., Isasi C.R., Jiménez M.C., Jordan L.C., Judd S.E., Lackland D., Lichtman J.H., Lisabeth L., Liu S., Longenecker C.T., Mackey R.H., Matsushita K., Mozaffarian D., Mussolino M.E., Nasir K., Neumar R.W., Palaniappan L., Pandey D.K., Thiagarajan R.R., Reeves M.J., Ritchey M., Rodriguez C.J., Roth G.A., Rosamond W.D., Sasson C., Towfighi A., Tsao C.W., Turner M.B., Virani S.S., Voeks J.H., Willey J.Z., Wilkins J.T., Wu J.H., Alger H.M., Wong S.S., Muntner P. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 2017; 135 (10): e146–e603. http://doi.org/10.1161/CIR.0000000000000485.Golestaneh L., Alvarez P.J., Reaven N.L., Funk S.E., McGaughey K.J., Romero A., Brenner M.S., Onuigbo M. Allcause costs increase exponentially with increased chronic kidney disease stage. Am. J. Manag. Care. 2017; 23 (10 Suppl): S163–S172.Golestaneh L., Alvarez P.J., Reaven N.L., Funk S.E., McGaughey K.J., Romero A., Brenner M.S., Onuigbo M. Allcause costs increase exponentially with increased chronic kidney disease stage. Am. J. Manag. Care. 2017; 23 (10 Suppl): S163–S172.Squires M.H. 3rd, Mehta V.V., Fisher S.B., Lad N.L., Kooby D.A., Sarmiento J.M., Cardona K., Russell M.C., Staley C.A. 3rd, Maithel S.K. Effect of preoperative renal insufficiency on postoperative outcomes after pancreatic resection: a single institution experience of 1,061 consecutive patients. J. Am. Coll. Surg. 2014; 218 (1): 92–101. http://doi.org/0.1016/j.jamcollsurg.2013.09.012.Squires M.H. 3rd, Mehta V.V., Fisher S.B., Lad N.L., Kooby D.A., Sarmiento J.M., Cardona K., Russell M.C., Staley C.A. 3rd, Maithel S.K. Effect of preoperative renal insufficiency on postoperative outcomes after pancreatic resection: a single institution experience of 1,061 consecutive patients. J. Am. Coll. Surg. 2014; 218 (1): 92–101. http://doi.org/0.1016/j.jamcollsurg.2013.09.012.Barbas A.S., Speicher P.J., Clary B.M. Hepatic and pancreatic resection in patients with end-stage renal disease: a propensity analysis. HPB (Oxford). 2014; 16 (11): 1016–1022. http://doi.org/10.1111/hpb.12281.Barbas A.S., Speicher P.J., Clary B.M. Hepatic and pancreatic resection in patients with end-stage renal disease: a propensity analysis. HPB (Oxford). 2014; 16 (11): 1016–1022. http://doi.org/10.1111/hpb.12281.Norman K.S., Domingo S.R., Wong L.L. Pancreatic resections in renal failure patients: is it worth the risk? HPB Surg. 2014; 2014: 938251. http://doi.org/10.1155/2014/938251.Norman K.S., Domingo S.R., Wong L.L. Pancreatic resections in renal failure patients: is it worth the risk? HPB Surg. 2014; 2014: 938251. http://doi.org/10.1155/2014/938251.Дедов И.И., Шестакова М.В., Галстян Г.Р. Распространенность сахарного диабета 2-го типа у взрослого населения России (исследование NATION). Сахарный диабет. 2016; 2: 104–112.Dedov I.I., Shestakova M.V., Galstyan G.R. Prevalence of diabetes mellitus type 2 in adult population of Russia (NATION study). Saharnyiy diabet. 2016; 2: 104–112. (In Russian)Cruse P.J., Foord R. A 5-year prospective study of 23649 surgical wounds. Arch. Surg. 1973; 107 (2): 206–210.Cruse P.J., Foord R. A 5-year prospective study of 23649 surgical wounds. Arch. Surg. 1973; 107 (2): 206–210.Collard R.M., Boter H., Schoevers R.A., Oude Voshaar R.C. Prevalence of frailty in community-dwelling older persons: a systematic review. J. Am. Geriatr. Soc. 2012; 60 (8): 1487–1492. http://doi.org/10.1111/j.1532-5415.2012.04054.x.Collard R.M., Boter H., Schoevers R.A., Oude Voshaar R.C. Prevalence of frailty in community-dwelling older persons: a systematic review. J. Am. Geriatr. Soc. 2012; 60 (8): 1487–1492. http://doi.org/10.1111/j.1532-5415.2012.04054.x.Robinson T.N., Wu D.S., Sauaia A., Dunn C.L., StevensLapsley J.E., Moss M., Stiegmann G.V., Gajdos C., Cleveland J.C. Jr., Inouye S.K. Slower walking speed forecasts increased postoperative morbidity and one year mortality across surgical specialties. Ann. Surg. 2013; 258 (4): 582–588; discussion 588–590. http://doi.org/10.1097/SLA.0b013e3182a4e96c.Robinson T.N., Wu D.S., Sauaia A., Dunn C.L., StevensLapsley J.E., Moss M., Stiegmann G.V., Gajdos C., Cleveland J.C. Jr., Inouye S.K. Slower walking speed forecasts increased postoperative morbidity and one year mortality across surgical specialties. Ann. Surg. 2013; 258 (4): 582–588; discussion 588–590. http://doi.org/10.1097/SLA.0b013e3182a4e96c.Rockwood K., Song X., MacKnight C., Bergman H., Hogan D.B., McDowell I., Mitnitski A. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005; 173 (5): 489–495.Rockwood K., Song X., MacKnight C., Bergman H., Hogan D.B., McDowell I., Mitnitski A. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005; 173 (5): 489–495.Hewitt J., Carter B., McCarthy K., Pearce L., Law J., Wilson F.V., Tay H.S., McCormack C., Stechman M.J., Moug S.J., Myint P.K. Frailty predicts mortality in all emergency surgical admissions regardless of age. An observational study. Age Ageing. 2019. pii: afy217. http://doi.org/10.1093/ageing/afy217.Hewitt J., Carter B., McCarthy K., Pearce L., Law J., Wilson F.V., Tay H.S., McCormack C., Stechman M.J., Moug S.J., Myint P.K. Frailty predicts mortality in all emergency surgical admissions regardless of age. An observational study. Age Ageing. 2019. pii: afy217. http://doi.org/10.1093/ageing/afy217.Weimann A., Braga M., Carli F., Higashiguchi T., Hübner M., Klek S., Laviano A., Ljungqvist O., Lobo D.N., Martindale R., Waitzberg D.L., Bischoff S.C., Singer P. ESPEN guideline: clinical nutrition in surgery. Clin. Nutr. 2017; 36 (3): 623–650. http://doi.org/10.1016/j.clnu.2017.02.013.Weimann A., Braga M., Carli F., Higashiguchi T., Hübner M., Klek S., Laviano A., Ljungqvist O., Lobo D.N., Martindale R., Waitzberg D.L., Bischoff S.C., Singer P. ESPEN guideline: clinical nutrition in surgery. Clin. Nutr. 2017; 36 (3): 623–650. http://doi.org/10.1016/j.clnu.2017.02.013.Sergi G., Perissinotto E., Pisent C., Buja A., Maggi S., Coin A., Grigoletto F., Enzi G., ILSA Working Group. An adequate threshold for body mass index to detect underweight condition in elderly persons: the Italian Longitudinal Study on Aging (ILSA). J. Gerontol. A. Biol. Sci. Med. Sci. 2005; 60 (7): 866–871.Sergi G., Perissinotto E., Pisent C., Buja A., Maggi S., Coin A., Grigoletto F., Enzi G., ILSA Working Group. An adequate threshold for body mass index to detect underweight condition in elderly persons: the Italian Longitudinal Study on Aging (ILSA). J. Gerontol. A. Biol. Sci. Med. Sci. 2005; 60 (7): 866–871.Nelson C.L., Elkassabany N.M., Kamath A.F., Liu J. Low albumin levels, more than morbid obesity, are associated with complications after TKA. Clin. Orthop. Relat. Res. 2015; 473 (10): 3163–3172. http://doi.org/10.1007/s11999-015-4333-7.Nelson C.L., Elkassabany N.M., Kamath A.F., Liu J. Low albumin levels, more than morbid obesity, are associated with complications after TKA. Clin. Orthop. Relat. Res. 2015; 473 (10): 3163–3172. http://doi.org/10.1007/s11999-015-4333-7.De Hert S., Staender S., Fritsch G., Hinkelbein J., Afshari A., Bettelli G., Bock M., Chew M.S., Coburn M., De Robertis E., Drinhaus H., Feldheiser A., Geldner G., Lahner D., Macas A., Neuhaus C., Rauch S., Santos-Ampuero M.A., Solca M., Tanha N., Traskaite V., Wagner G., Wappler F. Pre-operative evaluation of adults undergoing elective noncardiac surgery. Eur. J. Anaesthesiol. 2018; 35 (6): 407–465. http://doi.org/10.1097/EJA.0000000000000817.De Hert S., Staender S., Fritsch G., Hinkelbein J., Afshari A., Bettelli G., Bock M., Chew M.S., Coburn M., De Robertis E., Drinhaus H., Feldheiser A., Geldner G., Lahner D., Macas A., Neuhaus C., Rauch S., Santos-Ampuero M.A., Solca M., Tanha N., Traskaite V., Wagner G., Wappler F. Pre-operative evaluation of adults undergoing elective noncardiac surgery. Eur. J. Anaesthesiol. 2018; 35 (6): 407–465. http://doi.org/10.1097/EJA.0000000000000817.Bose S., Talmor D. Who is a high-risk surgical patient? Curr. Opin. Crit. Care. 2018; 24 (6): 547–553. http://doi.org/10.1097/MCC.0000000000000556.Bose S., Talmor D. Who is a high-risk surgical patient? Curr. Opin. Crit. Care. 2018; 24 (6): 547–553. http://doi.org/10.1097/MCC.0000000000000556.Национальные рекомендации по ведению пациентов с заболеваниями брахиоцефальных артерий. Ангиология и сосудистая хирургия. 2013; 19: 73.Nacional'nye rekomendacii po vedeniyu pacientov s zabolevaniyami brahiocefal'nyh arterij [National guidelines for the management of patients with brachiocephalic artery disease]. Angiologiya i sosudistaya khirurgiya. 2013; 19: 73. (In Russian)Shoji F., Takeo S., Yamazaki K., Miura N., Katsura M., Oku Y., Shimokawa M. Impact of preoperative ultrasonography screening for carotid artery stenosis in lung cancer patients. Ann. Thorac. Surg. 2018; 106 (4): 1047–1054. http://doi.org/10.1016/j.athoracsur.2018.04.072.Shoji F., Takeo S., Yamazaki K., Miura N., Katsura M., Oku Y., Shimokawa M. Impact of preoperative ultrasonography screening for carotid artery stenosis in lung cancer patients. Ann. Thorac. Surg. 2018; 106 (4): 1047–1054. http://doi.org/10.1016/j.athoracsur.2018.04.072.Клинические рекомендации “Периоперационное ведение пациентов с сопутствующим сахарным диабетом”. Общероссийская общественная организация “Федерация анестезиологов и реаниматологов”, 2017. 55 с.Klinicheskie rekomendacii “Perioperacionnoe vedenie pacientov s soputstvuyushchim saharnym diabetom”. Obshcherossijskaya obshchestvennaya organizaciya “Federaciya anesteziologov i reanimatologov” [Clinical guidelines. Perioperative management of patients with diabetes mellitus. Federation of anesthesiologists and reanimatologists]. 2017. 55 р. (In Russian)Miller R.D., Cohen N.H., Eriksson L.I., Fleisher L.A., WienerKronish J.P., Young W.L. Eighth edition. 2015. 1071 p.Miller R.D., Cohen N.H., Eriksson L.I., Fleisher L.A., WienerKronish J.P., Young W.L. Eighth edition. 2015. 1071 p.Клинические рекомендации “Желудочковые аритмии”. Общероссийская общественная организация “Федерация анестезиологов и реаниматологов”, 2018. 47 с.Klinicheskie rekomendacii “Zheludochkovye aritmii”. Obshcherossijskaya obshchestvennaya organizaciya “Federaciya anesteziologov i reanimatologov” [Clinical guidelines “Ventricular arrhythmias”. Federation of anesthesiologists and reanimatologists]. 2018. 47 р. (In Russian)Jeon C.Y., Pandol S.J., Wu B., Cook-Wiens G., Gottlieb R.A., Merz C.N., Goodman M.T. The association of statin use after cancer diagnosis with survival in pancreatic cancer patients: A SEER-Medicare analysis. PLoS One. 2015; 10 (4): e0121783. http://doi.org/10.1371/journal.pone.0121783.Jeon C.Y., Pandol S.J., Wu B., Cook-Wiens G., Gottlieb R.A., Merz C.N., Goodman M.T. The association of statin use after cancer diagnosis with survival in pancreatic cancer patients: A SEER-Medicare analysis. PLoS One. 2015; 10 (4): e0121783. http://doi.org/10.1371/journal.pone.0121783.Edrich T., Sadovnikoff N. Anesthesia for patients with severe chronic obstructive pulmonary disease. Curr. Opin. Anaesthesiol. 2010; 23: 18–24. http://doi.org/10.1097/ACO.0b013e328331ea5b.Edrich T., Sadovnikoff N. Anesthesia for patients with severe chronic obstructive pulmonary disease. Curr. Opin. Anaesthesiol. 2010; 23: 18–24. http://doi.org/10.1097/ACO.0b013e328331ea5b.Томилина Н.А., Андрусев А.М., Перегудова Н.Г., Шинкарев М.Б. Заместительная терапия терминальной хронической почечной недостаточности в Российской Федерации в 2010–2015 гг. Нефрология и диализ. 2017; 19 (4): 93 c. Приложение.Tomilina N.A., Andrusev A.M., Peregudova N.G., Shinkarev M.B. Renal replacement the rapy for terminal chronic renal failure in the Russian Federation in 2010–2015. Nefrologiya i dializ. 2017; 19 (4): 93 p. Supplement. (In Russian)Thompson S., James M., Wiebe N., Hemmelgarn B., Manns B., Klarenbach S., Tonelli M.; Alberta Kidney Disease Network. Cause of death in patients with reduced kidney function. J. Am. Soc. Nephrol. 2015; 26 (10): 2504–2511. http://doi.org/10.1681/ASN.2014070714.Thompson S., James M., Wiebe N., Hemmelgarn B., Manns B., Klarenbach S., Tonelli M.; Alberta Kidney Disease Network. Cause of death in patients with reduced kidney function. J. Am. Soc. Nephrol. 2015; 26 (10): 2504–2511. http://doi.org/10.1681/ASN.2014070714.Funakoshi T., Horimatsu T., Nakamura M., Shiroshita K., Suyama K., Mukoyama M., Mizukami T., Sakurada T., Baba E., Tsuruya K., Nozaki A., Yahata K., Ozaki Y., Ubara Y., Yasui H., Yoshimoto A., Fukuma S., Kondo N., Matsubara T., Matsubara K., Fukuhara S., Yanagita M., Muto M. Chemotherapy in cancer patients undergoing haemodialysis: a nationwide study in Japan. ESMO Open. 2018; 3 (2): e000301. http://doi.org/10.1136/esmoopen-2017-000301.Funakoshi T., Horimatsu T., Nakamura M., Shiroshita K., Suyama K., Mukoyama M., Mizukami T., Sakurada T., Baba E., Tsuruya K., Nozaki A., Yahata K., Ozaki Y., Ubara Y., Yasui H., Yoshimoto A., Fukuma S., Kondo N., Matsubara T., Matsubara K., Fukuhara S., Yanagita M., Muto M. Chemotherapy in cancer patients undergoing haemodialysis: a nationwide study in Japan. ESMO Open. 2018; 3 (2): e000301. http://doi.org/10.1136/esmoopen-2017-000301.Standard of Medical Care in Diabetes. American Diabetes Association. Clin. Diabetes. 2017; 35 (1): 5–26. http://doi.org/10.2337/cd16-0067.Standard of Medical Care in Diabetes. American Diabetes Association. Clin. Diabetes. 2017; 35 (1): 5–26. http://doi.org/10.2337/cd16-0067.Abadal A.C., Flores J.S. The significance of hyperglycemia in acute coronary syndrome. Rev. Esp. Cardiol. 2008; 61 (5): 447–450. http://doi.org/10.1016/S1885-5857(08)60156-5.Abadal A.C., Flores J.S. The significance of hyperglycemia in acute coronary syndrome. Rev. Esp. Cardiol. 2008; 61 (5): 447–450. http://doi.org/10.1016/S1885-5857(08)60156-5.Arrieta H., Astrugue C., Regueme S., Durrieu J., Maillard A., Rieger A., Terrebonne E., Laurent C., Maget B., Servent V., Lavau-Denès S., Dauba J., Fonck M., Thiébaut R., BourdelMarchasson I. Effects of a physical activity programme to prevent physical performance decline in onco-geriatric patients: a randomized multicentre trial. J. Cachexia Sarcopenia Muscle. 2019; 10 (2): 287–297. http://doi.org/10.1002/jcsm.12382.Arrieta H., Astrugue C., Regueme S., Durrieu J., Maillard A., Rieger A., Terrebonne E., Laurent C., Maget B., Servent V., Lavau-Denès S., Dauba J., Fonck M., Thiébaut R., BourdelMarchasson I. Effects of a physical activity programme to prevent physical performance decline in onco-geriatric patients: a randomized multicentre trial. J. Cachexia Sarcopenia Muscle. 2019; 10 (2): 287–297. http://doi.org/10.1002/jcsm.12382.

The authors declare that there are no conflicts of interest present.