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Esophageal surgery is a rare and narrow specialty, and there are very few oncologists in this area. Yuri Kondratsky is one of the most successful surgeons in this field, he gives interviews during treatment tours. In it, he talks about the unique work-class clinical developments that have been achieved in the department of esophageal and stomach tumors and what this means for patients.
Please tell us about your work experience.
«For the past 20 years, I have been working at the National Cancer Institute. I`m engaged in surgery of the stomach, esophagus and thoracic oncology. I`m the head of the department of esophageal tumors. I see a very great development and real evolution during all the time of my work and, in particular, in recent years.»
How many patients come to you a year?
«The National Cancer Institute is the largest cancer institution in the country. About 1000 patients a year come to our department and undergo 300-400 large, that is, not diagnostic, but full-fledged medical operations for neoplasms of the esophagus and stomach.»
What modern equipment is there in the department of esophageal tumors?
«The department is equipped with one of the most modern HN laparoscopic stands.
All doctors of the department have completed an internship either in Charite (Germany), or in Israel or in the Netherlands. We also cooperate with our European colleagues in clinical trials.
I consider it a great achievement of our institution that all surgeons have a narrow specialization. Usually, clinics of even a very high world level can not afford this. But, thanks to the large flow of patients and the correct organization of work, we were able to divide our activities by organs and types of operations. Thus, we are reaching a higher level than general surgeons.»
Please tell us about the methods adopted at the National Cancer Institute.
«We are very proud of the laparoscopic stand with ICG technology, which allows us to show lesions of the lymph nodes.
We also have our own school of thoracic surgery. This situation is due to specific experience. Unfortunately, in the post-Soviet space, patients are most often treated at advanced stages. This is bad for patients, and we are sorry that this is the case at the moment, but it has allowed surgeons to have a unique experience. I am not afraid of this word — we have our own experience of conducting laparoscopic interventions in advanced stages of esophageal cancer on a global scale. Unfortunately, in many developed countries, the patients we specialize in are effectively left untreated. This is a very expensive treatment and many people cannot get it. Laparoscopic esophageal surgery is more affordable in Ukraine and we can help more patients.
Another important point related to clinical management is that in large open combined interventions, patient management is decisive. With the correct active tactics, within 7 days after the combined intervention, a patient can be discharged who eats and takes care himself. I probably don’t want to be satisfied with what has already been achieved with the wrong anesthetic support.»
Is it possible to make a prediction for a patient online?
«Online consultation is not a problem today. We have access to all the images, histology, videocolonoscopy. However, the patient’s objective condition is also of great importance. Therefore, it is important for me that the patient is also present at this consultation, and the quality of the video is acceptable.»
What can Ukraine offer in comparison with other European countries in terms of cancer treatment?
«In Ukraine, the quality of surgical medical care is quite high, while the bureaucratic and legal burden on the medical system remains relatively low. This saves the patient from unnecessary examinations and restrictions, reduces the time for providing medical care, and also relieves an unjustified financial burden.»
Note from the author.
Cancers of the esophagus and stomach still have a high relapse and mortality. In this regard, doctors should be approached especially carefully for the treatment of such a pathology.
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