Cystectomy, as a type of surgical treatment, is performed for various diseases of the bladder. Most often — with malignant tumors, as well as with benign pathological conditions. Complications in the postoperative period in patients undergoing cystectomy are mainly caused by the need to ensure adequate urine derivation. One of the options for solving this problem is the implementation of ileocystoplasty, which, in turn, is associated with the performance of technically difficult and large-scale manipulations during the operation. Successful prevention of severe complications of cystectomy (or their elimination) is probably possible only in those multidisciplinary medical organizations in which the provision of medical care to patients with urological oncology is a daily programmed activity. Outpatient health care specialists play a special role in routing patients with bladder diseases, and not only their formal referral and delivery to multidisciplinary medical and prophylactic institutions in an emergency mode with “on-duty” syndromic diagnoses such as “renal colic or hematuria”. At present, in St. Petersburg, all conditions have been created for the concentration of patients with severe diseases of the bladder in a number of specialized medical organizations, in which a large number of cystectomies with intestinal plastic are routinely performed annually, which makes it possible with a high probability to guarantee a favorable clinical outcome without discrediting method of the rarity of its implementation.
Despite the successes in the examination and treatment of patients with prostate cancer, the problems associated with the organization of medical care for patients suffering from this disease remain. Defects in the verification of oncological diseases of the prostate often cause a decrease in parameters reflecting the quality and life expectancy of men. The data on the clinical case presented in the work demonstrate the difficulties of verifying a disease of a patient with prostate cancer, despite the involvement of many specialists of several medical institutions in the diagnostic process. With significant amounts of medical measures, the quality of the medical care provided at all stages can be considered inappropriate, primarily due to a violation of continuity in the management of the patient. Health care resources were used irrationally despite the fact that attempts were made to save the patient’s life at all levels and stages of medical care. Probably, defects in the provision of medical care could have been prevented by applying unified approaches in the diagnostic and treatment process using the advantages of information technology in modern computer databases of medical institutions, which make it possible to monitor the stages and volume of medical care provided to patients individually. In addition, the proper organization of medical care, as well as the targeted routing of patient flows should be provided not so much by clinicians as health managers. In the absence of opportunities in the treatment and prevention facilities, where patients are sometimes unplanned in urgent cases, the possibilities for carrying out diagnostic and treatment procedures, the healthcare organizers, together with the clinicians, must find reserves for referring patients to specialized medical organizations, in which examination and treatment of patients can be guaranteed. At the same time, the role, importance and effectiveness of the activities of health managers in the examination of the quality of medical care in each case should be evaluated separately.
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