The objective was to improve the surgical treatment tactics in patients with non-small cell lung cancer (NSCLC) and coronary heart disease (CHD), requiring myocardial revascularization.Methods and materials. Two groups consisting of 24 patients operated on for NSCLC were examined. In one group, operations for NSCLC were performed in the second stage after coronary artery bypass grafting (CABG). Survival rates in both groups and factors influencing them were evaluated.Results. The number of postoperative complications in both groups was comparable: 20.8 % in patients with CABG and 16.6 % in the group operated only for NSCLC. Indicators of relapse-free and overall survival did not differ significantly from each other (p=0.90 and p=0.95). Only the stage of the disease (p=0.009) and the implementation of complex cancer treatment in case of its necessity (p=0.035) had a reliably impact on the long-term results of the operation. The first stage of myocardial revascularization surgery did not affect the results of treatment (p=0.94), as well as the age of patients, the volume of performed surgery, the morphological picture of the tumor.Conclusion. The staging approach to the treatment of patients with NSCLC and critical forms of CHD requiring myocardial revascularization is reliable, convenient and does not affect the long-term results of treatment.

В в е д е н и е. Хирургическое удаление опухоли с лимфодиссекцией до настоящего времени оста-ется одним из основных методов радикального лечения немелкоклеточного рака легкого (НМРЛ). В качестве операций используют анатомические ре-зекции легких, позволяющие убрать вместе с опу-холевым очагом регионарные сосудистые и лимфа-тические коллекторы. Если при периферическом расположении опухоли операцией выбора, как пра-вило, является лобэктомия, то при централизации опухолевого процесса пневмонэктомия занимает одну из ведущих позиций. По данным J. Deslauriers [1], пневмонэктомия при центральном раке легко-го остается одной из основных операций выбора.Как альтернатива пневмонэктомии еще в конце XX в. в практику внедряются бронхопластические и ангиопластические операции, позволяющие уда-лить не все легкое, а его часть. Изначально эти опе-рации использовали у больных старшего возраста с сопутствующими заболеваниями, не позволяющи-ми выполнить пневмонэктомию [2,3]. Впоследствии они стали выполняться более широко [4,5]. Их сто-ронники утверждали, что отдаленные результаты не уступают таковым, полученным при выполнении пневмонэктомии [6][7][8], а качество жизни значительно лучше [9]. Однако существуют и возражения против альтернативного использования бронхо-и ангиопла-стических операций, связанные с возрастанием числа The OBJECTIVE of the study is to substantiate the applying of broncho-and angioplasty lobectomy as an alternative to pneumonectomy in NSCLC. MATERIAL AND METHODS. The results of treatment of two comparable groups of patients with NSCLC were presented. In one group, patients underwent broncho-or angioplasty lobectomies (group A), in another -pneumonectomy (group B). The number of complications, overall and disease-free survival in both groups, as well as the factors affected the results were analyzed. RESULTS. The number of postoperative complications in group A and group B was 12.5 % and 15.6 %, respectively. The median of disease-free survival and overall survival in both groups did not differ meaningfully, consisting of 20 months and 48 months in group A, and 19 months and 25 months in group B (p=0.91) and (p=0.97). The results of treatment were meaningfully affected only by the stage of the disease (p=0.017) and multidisciplinary treatment (p=0.007), including chemotherapy and radiation therapy. CONCLUSIONS. Performing of broncho-and angioplasty lobectomies can be justified as an alternative to lung removal in NSCLC within the multidisciplinary treatment.

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Uterine leiomyoma is rarely accompanied by the detection of distant metastases, including lungs. The basis of modern strategies of diagnosis of metastatic leiomyoma is the carrying out incisional or excisional biopsy of identified lesions with the subsequent performance of the immunohistochemical studies. Taking into account the indolent course of the disease, in modern practice, the main tactics of management of such patients is a long-term follow-up with the appointment of antiestrogen therapy.