Socio-economic assessment of patient blood management practical implementation in surgical treatment of coronary heart disease (I20-I25).

Aim    To evaluate possible social and economic benefits of correcting preoperative iron deficiency /iron deficiency anemia as a comorbidity in a model population in the process of transition from the routine practice to the optimized preparation of patients to elective surgery (as exemplified by several circulatory diseases: I20 - I25, class IX ICD 10).Material and methods    By building imitation models depending on the patient blood management (PBM) practice, changes in years of life lost/saved adjusted for disability were evaluated, including in monetary terms, in relation to the annual number of operations performed for ischemic heart disease (IHD) (I20 - I25) in the age group of 17 years and older, as well as a potential effect of PBM on the applied health economics.Results    With implementation of the PBM systemic measures in cardiac surgery, the potentially prevented annual social and economic damage will amount to more than 38 thousand years of life saved and more than 20.2 billion rubles in monetary terms. Furthermore, it will be possible to exclude 9435 hemotransfusion from the cardiosurgical practice, which will annually save more than 2.3 thousand liters of blood with a total cost of 77.7 million rubles in favor of clinical situations that have no alternative.Conclusion    The implementation of PBM in cardiac surgery, the discipline with the highest levels of preoperative iron deficiency/anemia and the use of blood components, will not only improve the clinical outcomes and cost-effectiveness of surgical interventions, but will also prevent social and economic damage to the country.

[Cancer of the body of the stomach: comparison of results with surgical and combined therapy]. / Rak tela zheludka: sravnitel'naia analiz rezul'tatov khirurgicheskogo i kombinirovannogo lecheniia.

The immediate and end results of surgical and combined treatment of cancer of the body of the stomach have been evaluated. The combined therapy used intensive preoperative procedures. No significant differences in mortality and postoperative complication rates between combined treatment and surgery were reported. The joint use of preoperative irradiation and radical surgery was followed by better end results in therapy of such locally advanced malignancies as invasion through the stomach wall, metastases to the regional lymph nodes, stage III and infiltrative growth.