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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rsj</journal-id><journal-title-group><journal-title xml:lang="ru">Российский хирургический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Russian surgical journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">3034-7270</issn><issn pub-type="epub">3033-5604</issn><publisher><publisher-name>Фонд Алмазова</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.18705/3034-7270-2025-1-2-94-102</article-id><article-id custom-type="elpub" pub-id-type="custom">rsj-28</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>МИНИМАЛЬНО ИНВАЗИВНАЯ ХИРУРГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>МИНИМАЛЬНО ИНВАЗИВНАЯ ХИРУРГИЯ</subject></subj-group></article-categories><title-group><article-title>Возможности роботической хирургии в лечении рака предстательной железы и опухолей почки у пациентов с выраженной сопутствующей патологией</article-title><trans-title-group xml:lang="en"><trans-title>Opportunities of robotic surgery in treatment of prostate cancer and renal masses in patients with severe comorbidities</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0000-4434-6677</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шелипанов</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Shelipanov</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шелипанов Денис Александрович – канд. мед. наук, ассистент кафедры урологии с курсом роботической хирургии с клиникой лечебного факультета Института медицинского образования</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Shelipanov Denis A. – Candidate of Medical Sciences, Assistant Lecturer of the Department of Urology with a Course of Robotic Surgery with Clinic</p><p>St. Petersburg</p></bio><email xlink:type="simple">shelipanov@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6371-4620</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Федоров</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Fedorov</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Федоров Дмитрий Александрович – ассистент кафедры урологии с курсом роботической хирургии с клиникой лечебного факультета Института медицинского образования</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Fedorov Dmitry A. – Assistant Lecturer of the Department of Urology with a Course of Robotic Surgery with Clinic</p><p>St. Petersburg</p></bio><email xlink:type="simple">tvoiurolog@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Антипова</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Antipova</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Антипова Надежда Анатольевна – ассистент кафедры урологии с курсом роботической хирургии с клиникой лечебного факультета Института медицинского образования</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Antipova Nadezhda A. – Assistant Lecturer of the Department of Urology with a Course of Robotic Surgery with Clinic</p><p>St. Petersburg</p></bio><email xlink:type="simple">aysina1984@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Васильев</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Vasilev</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Васильев Артем Александрович – ассистент кафедры урологии с курсом роботической хирургии с клиникой лечебного факультета Института медицинского образования</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Vasilev Artyom A. – Assistant Lecturer of the Department of Urology with a Course of Robotic Surgery with Clinic</p><p>St. Petersburg</p></bio><email xlink:type="simple">scapaflow12@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гилев</surname><given-names>Е. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Gilev</surname><given-names>E. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гилев Евгений Сергеевич – ассистент кафедры урологии с курсом роботической хирургии с клиникой лечебного факультета Института медицинского образования</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Gilev Evgeny S. – Assistant Lecturer of the Department of Urology with a Course of Robotic Surgery with Clinic</p><p>St. Petersburg</p></bio><email xlink:type="simple">jackpafosky@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Симонян</surname><given-names>А. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Simonyan</surname><given-names>A. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Симонян Артур Меликович – аспирант кафедры урологии с курсом роботической хирургии с клиникой лечебного факультета Института медицинского образования</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Simonyan Artur M. – Postgraduate Student of the Department of Urology with a Course of Robotic Surgery with Clinic</p><p>St. Petersburg</p></bio><email xlink:type="simple">artsaimon143@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0081-6985</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мосоян</surname><given-names>М. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Mosoyan</surname><given-names>M. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мосоян Мкртич Семенович – д-р мед. наук, профессор кафедры урологии с курсом роботической хирургии с клиникой лечебного факультета Института медицинского образования, заведующий кафедрой урологии с курсом роботической хирургии с клиникой</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Mosoyan Mkrtich S. – Doctor of Medical Sciences, Professor, Head of the Department of Urology with a Course of Robotic Surgery with Clinic</p><p>St. Petersburg</p></bio><email xlink:type="simple">moso03@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр им. В.А. Алмазова Министерства здравоохранения России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Almazov National Research Medical Center of the Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>09</day><month>09</month><year>2025</year></pub-date><volume>1</volume><issue>2</issue><fpage>94</fpage><lpage>102</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Шелипанов Д.А., Федоров Д.А., Антипова Н.А., Васильев А.А., Гилев Е.С., Симонян А.М., Мосоян М.С., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Шелипанов Д.А., Федоров Д.А., Антипова Н.А., Васильев А.А., Гилев Е.С., Симонян А.М., Мосоян М.С.</copyright-holder><copyright-holder xml:lang="en">Shelipanov D.A., Fedorov D.A., Antipova N.A., Vasilev A.A., Gilev E.S., Simonyan A.M., Mosoyan M.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://rsj.elpub.ru/jour/article/view/28">https://rsj.elpub.ru/jour/article/view/28</self-uri><abstract><p>Более ранняя диагностика онкологических заболеваний, повышение эффективности проведения терапевтических мероприятий в сочетании с улучшением хирургических методов лечения привели к улучшению прогноза и функциональных результатов для пациентов, увеличению продолжительности жизни, постоянному расширению границ выживаемости и доли пациентов с наличием сопутствующей патологии. С ростом ожидаемой продолжительности жизни и в целом старения населения проблеме коморбидности и «хрупкости», и лечению в том числе онкоурологических заболеваний у данной группы пациентов в настоящее время уделяется все большее внимание. За последние десятилетия подходы к ведению таких пациентов значимо изменились в пользу расширения показаний к радикальному лечению. При этом робот-ассистированная хирургия, как один из наиболее современных, эффективных и безопасных методов, представляется крайне перспективным способом лечения рака предстательной железы и опухолей почки у пациентов с тяжелой сопутствующей патологией. Приводятся мировые данные по лечению рака предстательной железы и рака почки у коморбидных пациентов с помощью роботической хирургии, а также собственные результаты данных методик.</p></abstract><trans-abstract xml:lang="en"><p>Earlier diagnosis of cancer, increased effectiveness of therapeutic measures in combination with improved surgical treatment methods have led to improved prognosis and functional outcomes for patients, increased life expectancy and constant expansion of survival boundaries, as well as an increase in the proportion of patients with comorbidities. With the increase in life expectancy and population aging in general, the problem of comorbidity and "frailty" and the treatment of oncourological diseases in this group of patients are currently receiving increasing attention. Over the past decades, approaches to the management of such patients have changed significantly in favor of expanding the indications for radical treatment. At the same time, robot-assisted surgery, as one of the most modern, effective and safe methods, seems to be an extremely promising way to treat prostate cancer and kidney tumors in patients with severe comorbidities. This article presents world data on the treatment of prostate cancer and kidney cancer in comorbid patients using robotic surgery, as well as our own results of these methods.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>рак предстательной железы</kwd><kwd>опухоли почки</kwd><kwd>робот-ассистированная хирургия</kwd><kwd>простатэктомия</kwd><kwd>резекция почки</kwd><kwd>радикальная нефрэктомия</kwd><kwd>коморбидные пациенты</kwd><kwd>«хрупкие» пациенты</kwd></kwd-group><kwd-group xml:lang="en"><kwd>prostate cancer</kwd><kwd>renal masses</kwd><kwd>robot-assisted surgery</kwd><kwd>prostatectomy</kwd><kwd>partial nephrectomy</kwd><kwd>radical nephrectomy</kwd><kwd>comorbid patients</kwd><kwd>"frail" patients</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Aburto J.M., Villavicencio F., Basellini U., et al. Dynamics of life expectancy and life span equality. 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