About Difficulties in the Quality Examination of Medical Care at the Problem of the Early Post-Operative Period in Cases of Performance of the Cistectomy in the Conditions of a Multi-Profile Hospital

Abstract

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. Adversity in the postoperative period in patients undergoing cystectomy is mainly due to the need to ensure adequate derivation of urine. One of the solutions to this problem is the implementation of ileocystoplastic, which, in turn, is associated with the implementation of technically difficult and large-scale manipulations during surgery. Organizationally performing a surgical aid such as cystectomy on a stream in a round-the-clock emergency hospital does not make much sense. 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 an oncourological profile is an everyday programmed activity. Specialists of the prehospital medical care section have a special role in routing patients with bladder diseases, and not only their formal referral and delivery to non-specialized medical and preventive care institutions in emergency mode with syndromic diagnoses such as “renal colic or macrohematuria”. Currently, 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 the required number of cystectomy operations with intestinal plastic is performed annually, which makes it possible to guarantee the maximum effect of the use of such surgical interventions without discrediting the method by the rarity of its implementation, and with favorable long-term results of treatment of patients.