Thesis work of S. N. Kononchuk “Anesthetic support of open radical cystectomy in the presence of urinary bladder cancer” describes an original technique of balanced endotracheal anesthesia combined with extended bilateral paravertebral block, and offers scientific substantiation of application of the technique with the aim of improving the effectiveness and safety of anesthetic support of open radical cystectomies of urinary bladder cancer.

The subject of the thesis work of S. N. Kononchuk has high current relevance and importance. Malignant neoplasm of the urinary bladder is one of severe and prevalent oncology diseases of the genito-urinary system. In certain cases, urinary bladder cancer is diagnosed to have muscle layer invasion, and the definitive treatment technique of such lesions is radical cystectomy. The procedure is essentially a combination reconstructive surgical intervention performed at two levels of the abdomen, which involves a single-stage extripation of urinary bladder affected by the tumor, extended pelvic lymph node dissection, and the implementation of a urine derivation system option using the resected portion of the patient’s own intestinal tracts. Considering the vastness of the intervention and high extent of medical injuries caused by radical cystectomy, the globally accepted approach involves the application of combination anesthesia (general anesthesia involving artificial lung ventilation combined with regional anesthesia procedures). The author or the thesis research offers an up to date answer to the following questions: “to what extent are the neuraxial blocking techniques offer therapeutic quality and safety to patients affected by urinary bladder cancer, considering that these are are usually persons of advanced age that are additionally affected by concomitant pathologies?” and: “Are there any alternatives?”.

The candidate obtained theoretic and practical results of clinical and laboratory studies that possessed high degree of academic novelty based on the following:

• a technique of regional (extended bilateral paravertebral) block was developed;
• the technique was put to comparison with the techniques of central neuraxial block employed currently (epidural and combination spinal and epidural anesthesia);
• main peroperative hemodynamic indicators associated with regional block were studied in patients;
• the effect of extended bilateral paravertebral block, extended epidural and combination spinal/epidural block on surgical stress response was evaluated;
• based on the principles of scientific medicine and statistical data processing practices, the effectiveness and safety of the developed technique of open radical cystectomy support was substantiated;
• algorithms for the forecasting of intraoperational hemodynamic instability and of the necessity of timely additional administration of pain management narcotics during the early postoperative period were proposed.

The obtained research results bear practical and fundamental significance for the professional specialty of the author -- anesthesiology and intensive therapy.