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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">mossj</journal-id><journal-title-group><journal-title xml:lang="ru">Московский хирургический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Moscow Surgical Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2072-3180</issn><publisher><publisher-name>ООО «ПРОФИЛЬ – 2С»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17238/2072-3180-2024-3-119-128</article-id><article-id custom-type="elpub" pub-id-type="custom">mossj-823</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОНКОЛОГИЯ</subject></subj-group></article-categories><title-group><article-title>Эффективность мультимодальной пререабилитации у пациентов высокого риска кардиологических осложнений</article-title><trans-title-group xml:lang="en"><trans-title>The effectiveness of multimodal prehabilitation in high-risk patients for cardiac complications</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8590-2350</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тонеев</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Toneev</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Тонеев Евгений Александрович – кандидат медицинских наук, врач-торакальный хирург хирургического отделения торакальной онкологии; доцент кафедры факультетской хирургии, медицинский факультет им Т.З. Биктимирова, Институт медицины, экологии и физической культуры,</p><p>432017, Ульяновск, ул. 12-сентября, д. 90;</p><p>432011, Ульяновск, Россия, ул. Л. Толстого, д. 42.</p></bio><bio xml:lang="en"><p>Toneev Evgeny Aleksandrovich – Candidate of Medical Sciences, Thoracic Surgeon of the Surgical Department of Thoracic Oncology; Associate Professor of the Faculty Surgery Department, T.Z. Biktimirov Medical Faculty, Institute of Medicine, Ecology, and Physical Education,</p><p>90, 12th of September St., Ulyanovsk, 432017;</p><p>42, L. Tolstoy St., Ulyanovsk, 432011.</p></bio><email xlink:type="simple">e.toneev@inbox.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0006-5125-2840</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Комаров</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Komarov</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Комаров Андрей Сергеевич – врач анестезиолог-реаниматолог; ассистент кафедры госпитальной хирургии, медицинский факультет им Т.З. Биктимирова, Институт медицины, экологии и физической культуры,</p><p>432017, Ульяновск, ул.12-сентября, д.90; </p><p>432011, Ульяновск, ул. Л. Толстого, д. 42.</p></bio><bio xml:lang="en"><p>Komarov Andrey Sergeevich – Anesthesiologist-Resuscitator; Assistant of the Hospital Surgery Department, T.Z. Biktimirov Medical Faculty, Institute of Medicine, Ecology, and Physical Education,</p><p>90, 12th of September St., Ulyanovsk, 432017;</p><p>42, L. Tolstoy St., Ulyanovsk, 432011.</p></bio><email xlink:type="simple">andrey-komarov-88@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8076-7145</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мидленко</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Midlenko</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мидленко Олег Владимирович – доктор медицинских наук, профессор кафедры госпитальной хирургии, Институт медицины, экологии и физической культуры,</p><p>432011, Ульяновск, ул. Л. Толстого, д. 42.</p></bio><bio xml:lang="en"><p>Midlenko Oleg Vladimirovich – Doctor of Medical Sciences, Professor of the Hospital Surgery Department, Institute of Medicine, Ecology, and Physical Education,</p><p>42, L. Tolstoy St., Ulyanovsk, 432011.</p></bio><email xlink:type="simple">953151@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-4685-7926</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Маракаев</surname><given-names>Д. Х.</given-names></name><name name-style="western" xml:lang="en"><surname>Marakaev</surname><given-names>D. Kh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Маракаев Дамир Хамзиевич – кандидат медицинских наук, врач-хирург 5 хирургического отделения; Доцент кафедры госпитальной хирургии, медицинский факультет им Т.З. Биктимирова, Институт медицины, экологии и физической культуры,</p><p>432011, Россия, Ульяновск, ул. Л. Толстого, д. 42.</p></bio><bio xml:lang="en"><p>Marakaev Damir Khamzievich – Candidate of Medical Sciences, Surgeon of the 5th Surgical Department; Associate Professor of the Hospital Surgery Department, T.Z. Biktimirov Medical Faculty, Institute of Medicine, Ecology, and Physical Education,</p><p>42, L. Tolstoy St., Ulyanovsk, 432011.</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-1455-8287</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мухутдинова</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Mukhutdinova</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мухутдинова Алия Наисовна – студентка 4 курса медицинского факультета им Т.З. Биктимирова, Институт медицины, экологии и физической культуры,</p><p>432011, Ульяновск, ул. Л. Толстого, д. 42.</p></bio><bio xml:lang="en"><p>Mukhutdinova Aliya Naisovna – 4th-year student of the T.Z. Biktimirov Medical Faculty, Institute of Medicine, Ecology, and Physical Education,</p><p>42, L. Tolstoy St., Ulyanovsk, 432011.</p></bio><email xlink:type="simple">thedogshav.2000@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0004-0218-666X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шагдалеев</surname><given-names>Р. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Shagdaleev</surname><given-names>R. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шагдалеев Роман Фатыхович – ординатор кафедры госпитальной хирургии, анестезиологии, реаниматологии, урологии, травматологии и ортопедии, факультет стоматологии, фармации и последипломного медицинского образования, Институт медицины, экологии и физической культуры,</p><p>432011, Ульяновск, ул. Л. Толстого, д. 42.</p></bio><bio xml:lang="en"><p>Shagdaleev Roman Fatykhovich – Resident of the Department of Hospital Surgery, Anesthesiology, Resuscitation, Urology, Traumatology, and Orthopedics, Faculty of Dentistry, Pharmacy, and Postgraduate Medical Education, Institute of Medicine, Ecology, and Physical Education,</p><p>42, L. Tolstoy St., Ulyanovsk, 432011.</p></bio><email xlink:type="simple">roman2000shagdaleev@gmail.com</email><xref ref-type="aff" rid="aff-5"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГУЗ ОКОД; ФГБОУ ВО Ульяновский государственный университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>State Clinical Oncology Dispensary of Ulyanovsk; Ulyanovsk State University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ГУЗ ОКОД; ФГБОУ ВО Ульяновский государственный университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Ulyanovsk State Clinical Oncology Dispensary; Ulyanovsk State University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГБОУ ВО Ульяновский государственный университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Ulyanovsk State University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ГУЗ УОКЦСВМП г. Ульяновск; ФГБОУ ВО Ульяновский государственный университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Ulyanovsk Regional Clinical Center for Specialized Medical Care; Ulyanovsk State University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ФГБОУ ВО Ульяновский государственный университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Ulyanovsk State University,</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>09</day><month>09</month><year>2024</year></pub-date><volume>0</volume><issue>3</issue><fpage>119</fpage><lpage>128</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Тонеев Е.А., Комаров А.С., Мидленко О.В., Маракаев Д.Х., Мухутдинова А.Н., Шагдалеев Р.Ф., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Тонеев Е.А., Комаров А.С., Мидленко О.В., Маракаев Д.Х., Мухутдинова А.Н., Шагдалеев Р.Ф.</copyright-holder><copyright-holder xml:lang="en">Toneev E.A., Komarov A.S., Midlenko O.V., Marakaev D.K., Mukhutdinova A.N., Shagdaleev R.F.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.mossj.ru/jour/article/view/823">https://www.mossj.ru/jour/article/view/823</self-uri><abstract><sec><title>Введение</title><p>Введение. В настоящее время хирургический метод применяется для лечения злокачественных новообразований легкого. Наиболее часто данная патология встречается у пациентов пожилого возраста, имеющих выраженный коморбидный фон. Эти условия создают риск возникновения кардиологических осложнений после перенесенной операции, что ухудшает течение послеоперационного периода.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. В статье представлен анализ послеоперационных показателей у пациентов из группы риска кардиологических осложнений после перенесенной лобэктомии по поводу злокачественных новообразований легких. Исследуемые разделены на 2 группы: пациенты, которым проводилась мультимодальная пререабилитация (n=39) и группа контроля (n=36). Перед рандомизацией проведена оценка показателей функции внешнего дыхания, фракции выброса левого желудочка, среднего давления в легочной артерии, а также результатов функциональных тестов. Оценка риска развития кардиологических осложнений проводилась согласно предложенной модели риска.</p></sec><sec><title>Результаты</title><p>Результаты. При анализе послеоперационных осложнений (Grade II–Grade V) было отмечено меньшее их количество в группе пациентов, прошедших пререабилитацию (р=0,020). Частота кардиологических осложнения в группе пререабилитации была существенно ниже, чем в группе контроля (p=0,040). Срок госпитализации пациентов значительно различался в зависимости от наличия пререабилитации: в контрольной группе он составил 12,08±2,26 дней, а в группе пререабилитации – 11,05±1,81 дней (p=0,031).</p></sec><sec><title>Выводы</title><p>Выводы. Использование программы пререабилитации у пациентов высокого риска может позволить снизить риск развития кардиологических осложнений после хирургического лечения рака легкого.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. Currently, surgical treatment is the main type of therapy for malignant lung neoplasms. This pathology is most commonly found in elderly patients with significant comorbid conditions. These conditions create a risk of cardiovascular complications after surgery, which worsens the postoperative period.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. The article presents an analysis of postoperative indicators in patients from the high-risk group for cardiovascular complications after undergoing lobectomy for malignant lung neoplasms. The subjects were divided into two groups: patients who underwent multimodal prehabilitation (n=39) and the control group (n=36). Before randomization, an assessment of external respiratory function, left ventricular ejection fraction, mean pulmonary artery pressure, and functional test results was performed. The risk assessment for developing cardiovascular complications was conducted according to the proposed risk model.</p></sec><sec><title>Results</title><p>Results. An analysis of postoperative complications (Grade II–Grade V) showed a lower number of complications in the group of patients who underwent prehabilitation (p=0,020). The frequency of cardiovascular complications in the prehabilitation group was significantly lower than in the control group (p=0,040). The length of hospitalization differed significantly depending on the presence of prehabilitation: in the control group, it was 12,08±2,26 days, while in the prehabilitation group it was 11,05±1,81 days (p=0,031).</p></sec><sec><title>Conclusions</title><p>Conclusions. The use of a prehabilitation program in high-risk patients may help reduce the risk of developing cardiac complications after surgical treatment of lung cancer.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>рак легкого</kwd><kwd>пререабилитация</kwd><kwd>лобэктомия</kwd><kwd>кардиологические осложнения</kwd></kwd-group><kwd-group xml:lang="en"><kwd>lung cancer</kwd><kwd>prehabilitation</kwd><kwd>lobectomy</kwd><kwd>cardiac complications</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Nepogodiev D., Martin J., Biccard B., Makupe A., Bhangu A., Nepogodiev D. et al. Global burden of postoperative death. Lancet, 2019, рр. 393–401. https://doi.org/10.1016/S0140-6736(18)33139-8</mixed-citation><mixed-citation xml:lang="en">Nepogodiev D., Martin J., Biccard B., Makupe A., Bhangu A., Nepogodiev D. et al. Global burden of postoperative death. 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