And because I once asked the famous surgeon, academician Yury Belova, if he has worthy disciples. Yuri immediately called Roman Komarov. Belov and Mosquitoes – not just teacher and student. They are also co-authors of unique books about modern one-stage surgery. Such operations are now beginning to enter the medical practice of saving the most difficult, but if to be absolutely exact – hopeless patients.
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the novel argues: “it is Inappropriate to call the hopeless patients. There has to be hope. Even the most difficult patients can be, and most importantly – you need to help.” It is no accident ten years ago, when one-stage operations began to assert itself, when the possibility of their implementation is not believed even by many colleagues, the administration, when one of the medical leaders called them “surgical banditry”, the teacher and student wrote the now well-known in the medical world a book: “one-stage cardiovascular and cancer surgery: when, to whom and how?” And this today talking with Roman. He came right after carrying out another such operation. So the question of “when?” can be omitted. Ask about is “who and how”.
Roman Komarov: No, and the question of “when” important. I will try to explain why. Talking about the 62-year-old patient from the Rostov region. He was diagnosed with cancer of the stomach with the transition to the esophagus. In addition, he has an aortic aneurysm. The patient is spared a lot of clinics and specialists. Said late to do something. During surgery, the stomach may rupture the aneurysm, and the patient dies on the operating table. The aneurysm had refused to operate due to running cancer. After much walking pthe clinics worked word of mouth: the patient appeared in our clinic.
novel! The patient was immediately hospitalized? Not was doubt of the need for complex operations?
Roman Komarov I Confess: love is a complex operation. And a team of colleagues, my associates.
was confident of success?
Roman Komarov Otherwise would not have undertaken. And the risk of any surgery is always present. There is nothing more difficult human body. And you can never predict the outcome. Maybe not everyone knows that sometimes tragically end the operation to remove the Appendix. Mortality in operations banal appendicitis in our country is 0.1-0.2 percent. A little? Wrong! In absolute terms, this is not a harmless figure.
I Think that there is no prosthetic aortic heart valves. This is a misconception. They are now not in deficit, in contrast to the frame
But back to the operating room. Where to start? With the removal of the tumor? Or get rid of the aneurysm?
Roman Komarov In each case its approach. The operation itself is preceded by a pedantic, we can say meticulous research. On their basis developed the tactics of operations. The word template is not acceptable. In this particular case, first remove the stomach, part of the esophagus. Reconstructed gastrointestinal tract. And then spent the aortic prosthesis. The operation lasted nearly six hours. It is important that now there is anesthetic help. Anesthesiologists allow us to operate for hours. And duration of the operation does not affect the outcome.
Operated transferred to the intensive care unit?
Roman Komarov three hours later, the patient came to. Breathing on his own. He is now in the intensive care unit. And tomorrow will be transferred to. Fears his condition causes.
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You, however, overconfident.
Roman Komarov It seems. Without a doubt in any profession does not happen. But the experience, the result suggests that this patient saved.
And how many on your account? First, remember?
Roman Komarov On account of hundreds. The first and ten years ago had a patient from Karelia. Of course, remember him. And now, after all these years, unable to voice the last name is Semin. He is now 80 years old. Every year he wishes me a happy New year. He had a tumor of the colon and coronary heart disease.
When you decided to do the first operation, was aware of the risk?
Roman Komarov Any business goes through three stages. First. “What is this nonsense conceived by thee,” say colleagues. The second stage: “this is something there. But…” Finally, the third: “Who knows?” That is first of all hostility. And then almost dismissively: nothing special! Of course, the risk was. But he was acquitted: other the chances of the patient was not.
Time showed that simultaneous operations are included in medical practice. The demand for them is growing and will grow. For the simple reason that a growing number of centenarians. And long life rarely goes by without the emergence of various diseases. And above all people suffering of cardiovascular and oncological diseases. In our country single-step operations available to all who need them? Or…
Roman Komarov While hospitals in which such operations are conducted, one. Primarily because of the apparent shortage of staff. Sometimes, for some reason I think that there is no prosthetic aortic heart valves. This is a misconception. They are now not in deficit. What can be said specifically about the frames.
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Now, when the NHS changes come, we must rethink the training of surgeons. It is appropriate to say that in Sechenovskiy medical University rector, academician Pyotr Glybochko, you might say, willed by seeking to modernize the process of preparation. In Sechenovskiy the educational, scientific process combined with practical medicine.
So, faith in the future is the place to be?
Roman Komarov the Doctor without it.
And patients in need of simultaneous operations, also without such faith does not. Them, the needy, many in the country?
Roman Komarov a Lot. Satisfaction in our operations is only a few percent. And every percentage – life. And not only people of advanced old age. A lot of them and among those in the Prime of life.