The article deals with the epidemiology and main causes of sudden cardiac death in professional athletes and people participating in sports as amateurs. Pathogenesis of the main nosologies, as well as preventive measures and emergency care in case of life-threatening conditions are described.

Aim. To analyze the results of treatment of patients with kidney tumors in urology departments of the Siberian State Medical University clinics.Materials and methods. The number of patients with kidney tumors hospitalized in the urology department of the general surgery clinic was 7–10 % of the total annual number of surgical interventions in the urology department. We analyzed 132 cases of malignant kidney tumors. All patients went through imaging and laboratory studies.Results. Treatment results are known in 125 (94.0 %) patients. Mean age of patients was 57.9 years (27 to 86), there were 77 men and 55 women (1.4:1 ratio). Mean tumor size was 6.5 ± 3.6 cm, no significant differences were observed between men and women. Radical nephrectomy was performed in 75 (56.8 %) patients, kidney resection in 57 (43.2 %) patients. Tumor size in nephrectomy cases was 8.2 ± 3.7 cm and 4.3 ± 2.1 cm in kidney resection (p <0.05). In patients with larger tumors five-year survival was lower: tumor size £4 cm was associated with five-year survival of 79.6 %, while tumor size >7 cm with only 36.9 % (p = 0.001).In our study, 23 (17.4 %) patients with inferior vena cava thrombosis were operated on: 11 (8.3 %) men, 12 (9.1 %) women. Mean age of patients with inferior vena cava thrombosis was 57.2 years (between 35 and 74 years). In this group of patients, mean tumor size was 10.8 ± 4.1 cm (between 4.2 and 19). Based on TNM classification, tumors were classified as follows: T3b stage – 17 (12.9 %), T4 stage – 6 (4.5 %), N0 – 15 (11.4 %), N+ – 8 (6.1 %). Left kidney was affected in 6 (4.5 %) cases, right kidney was affected in 17 (12.9 %) cases. Type of surgery performed in this group of patients was classified as: radical nephrectomy with thrombectomy and lymphadenectomy, one case included resection of the inferior vena cava with a section reconstructed using a xenopericardial transplant. Mean surgery duration was 212.4 ± 52.3 (130–320) minutes. Mean blood loss volume was 1177.0 ± 933.4 (100–4600) ml. Postoperative complications were observed in 35 (21.2 %) patients. Overall five-year survival for patients with malignant kidney tumors was 61.8 %, for patients with tumor thrombosis it was 31.3 %.Conclusion. Surgical treatment of patients with malignant kidney tumors allows to significantly improve patients’ survival preserving quality of life.

Renal tumors account for 2 to 3 % of all malignant tumors in adults. Of all patients with renal cell carcinoma, 30 to 40 % have advanced forms of the disease. In the literature, the term "giant renal tumor" is used for tumors larger than 20 cm. In this article, we report a case of surgical treatment for a giant malignant kidney tumor.Patient N., female, 54 years old, referred to an outpatient clinic with complaints of a change in the shape of the abdomen on the left with a palpable large tumor, abdominal pain, shortness of breath, weakness, constipation, episodes of blood in the urine and increased blood pressure. Body mass index 30.2 kg/m2. Ultrasound examination revealed a large tumor in the left retroperitoneal space. Laboratory testing of blood, urine was performed, findings were unremarkable. According to the data of magnetic resonance imaging, the left kidney was transformed into a large cystic solid formation, measuring 30.5 х 17.5 х 17.0 cm, heterogeneously accumulating a contrast agent with a solid component. Patient was admitted to the urology department for surgical treatment. We performed radical nephrectomy on the left with thoracolumbar laparotomy access on the left with resection of the 10th rib, resecting the renal tumor with the adrenal gland, total weight of the complex was 10.7 kg. The histological structure was determined as poorly differentiated renal carcinoma with invasion of the perinephric tissue. In the adrenal gland, fields of fresh erythrocytes with an admixture of tumor tissue were noted. Examined lymph node tissue was completely replaced by tumor cells. Postoperative period was characterized by episodes of dynamic intestinal obstruction. The patient was discharged from the department in a satisfactory condition on the 13th day after the operation, but died 1.5 months after discharge, the cause of death has not been established, as no autopsy was performed. Thus, the size of the tumor is not a contraindication to surgical treatment, which improves the survival rate of patients with malignant renal tumors.