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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">medalphabet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский алфавит</journal-title><trans-title-group xml:lang="en"><trans-title>Medical alphabet</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2078-5631</issn><issn pub-type="epub">2949-2807</issn><publisher><publisher-name>ООО «Альфмед»</publisher-name></publisher></journal-meta><article-meta><article-id custom-type="elpub" pub-id-type="custom">medalphabet-147</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>Статьи</subject></subj-group></article-categories><title-group><article-title>Концепция ускоренной реабилитации в хирургическом лечении рака пищевода и желудка: постановка проблемы</article-title><trans-title-group xml:lang="en"><trans-title>Concept of ERAS in surgery of esophagus and gastric cancer: problem aspects</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тер-Ованесов</surname><given-names>М. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Ter-Ovanesov</surname><given-names>M. D.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кукош</surname><given-names>М. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Kukosh</surname><given-names>M. Yu.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Габоян</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Gaboyan</surname><given-names>A. S.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Левицкий</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Levitsky</surname><given-names>A. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зраибиа</surname><given-names>А.</given-names></name><name name-style="western" xml:lang="en"><surname>Zraibia</surname><given-names>A.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ ВО «Российский университет дружбы народов»; ГБУЗ «Городская клиническая больница № 40» Департамента здравоохранения г. Москвы</institution><country>Россия</country></aff><aff xml:lang="en"><institution>People’s Friendship University of Russia; Municipal Clinical Hospital No 40</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГАОУ ВО «Российский университет дружбы народов»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>People’s Friendship University of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2017</year></pub-date><pub-date pub-type="epub"><day>25</day><month>05</month><year>2017</year></pub-date><volume>1</volume><issue>16</issue><issue-title>Диагностика и онкотерапия</issue-title><fpage>17</fpage><lpage>22</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Тер-Ованесов М.Д., Кукош М.Ю., Габоян А.С., Левицкий А.В., Зраибиа А., 2017</copyright-statement><copyright-year>2017</copyright-year><copyright-holder xml:lang="ru">Тер-Ованесов М.Д., Кукош М.Ю., Габоян А.С., Левицкий А.В., Зраибиа А.</copyright-holder><copyright-holder xml:lang="en">Ter-Ovanesov M.D., Kukosh M.Y., Gaboyan A.S., Levitsky A.V., Zraibia A.</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.med-alphabet.com/jour/article/view/147">https://www.med-alphabet.com/jour/article/view/147</self-uri><abstract><p>Общепризнанными преимуществами ERAS являются снижение хирургического стресса, поддержание физиологичного гомеостаза, ускоренное восстановление пациентов после операции, уменьшение количества послеоперационных осложнений, снижение длительности пребывания в стационаре и стоимости лечения. Одной из важнейших инноваций в хирургии желудочнокишечного тракта является внедрение ERAS-технологий. Обзор литературы свидетельствует о том, что на сегодняшний день из-за малого числа проспективных рандомизированных испытаний и мета-анализов убедительной доказательной базы для широкого внедрения ERAS-методик в хирургическое лечение рака желудка и пищевода нет. В то же время, важнейшим фактором продвижения концепции ускоренной реабилитации является возможность оказания высококачественной специализированной хирургической помощи большему количеству пациентов с меньшими финансовыми затратами. Таким образом, необходимо проведение масштабных клинических исследований с целью оптимизации и стандартизации ведения периоперационного периода при таких технических сложных и травматичных хирургических вмешательствах, как гастрэктомия и эзофагэктомия.</p></abstract><trans-abstract xml:lang="en"><p>The well recognized benefits of the concept of enhanced recovery after surgery (ERAS) are reducing of surgical stress, supporting physiologic homeostasis, fast rehabilitation after an operation, decrease of postoperative morbidity rates, length of hospital stay and cost of treatment. One of the most important innovation in the surgery of the gastrointestinal tract is implementation of ERAS techniques. The survey indicates lacks of prospective randomized trials and met-analysis. Now there is no evidence base for wide incorporation of ERAS in surgical treatment of gastric and esophageal cancer. At the same time a notable factor of its implementation is the possibility of high quality surgical treatment to a more number of patients for less money. Therefore it is necessary to prove extended clinical trials for optimization and standardization of perioperative period such technical complicated surgery as gastrectomy, esophagectomy.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>онкохирургия</kwd><kwd>фаст-трек</kwd><kwd>хирургия</kwd><kwd>ускоренная реабилитация после операции</kwd><kwd>рак желудка</kwd><kwd>рак пищевода</kwd><kwd>нутритивная поддержка</kwd></kwd-group><kwd-group xml:lang="en"><kwd>cancer surgery</kwd><kwd>gastric cancer</kwd><kwd>esophagectomy</kwd><kwd>gastric surgery</kwd><kwd>enhanced recovery after surgery</kwd><kwd>ERAS</kwd><kwd>fast -track surgery</kwd><kwd>perioperative care</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">Beamish A. 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