TRANSANAL ENDOSCOPIC MICROSURGERY IN TREATMENT OF RECTAL NEOPLASM AT THE CLINIC OF DIGESTIVE SURGERY IN UNIVERSITY HOSPITAL RIJEKA
| Autor: | Jakšić, Luciana |
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| Přispěvatelé: | Zelić, Marko, Bačić, Đordano, Grbas, Harry, Hauser, Goran |
| Jazyk: | chorvatština |
| Rok vydání: | 2020 |
| Předmět: | |
| Popis: | Cilj rada: Transanalna endoskopska mikrokirurgija u posljednje vrijeme dobiva sve više na važnosti te se uzdiže kao minimalno invazivna metoda koja odabranim pacijentima s rektalnim neoplazmama može ponuditi izlječenje uz maksimalno očuvanje kvalitete života. Da bi se iskoristio maksimalan potencijal ove metode, nužno je pravilno postavljanje indikacije što se postiže preciznom preoperativnom procjenom staginga. Cilj ovog rada je procjena uspješnosti staginga na Zavodu za digestivnu kirurgiju Klinike za kirurgiju, KBC-a Rijeka. Materijali i metode: Retrospektivno je analizirana dokumentacija za petogodišnje razdoblje od 2014. do kraja 2018. godine. Odabrani pacijenti su oni koji su, u navedenom razdoblju, bili na TEM zahvatu uz rektalnu neoplazmu kao indikaciju za zahvat. Podaci su organizirani i obrađeni u Microsoft Excel Office 2017 programu te MedCalc programu verzija 19.3.1. Rezultati: Najčešća indikacija za TEM zahvat jesu benigne promjene. Preoperativna obrada je provedena kod malog broja pacijenata (28,3%) te je utvrđena značajna razlika cTNM-a i pTNM-a. Najčešće korištena metoda za procjenu staginga je TRUS koji pokazuje značajna odstupanja, poglavito u smislu overstaginga. Preoperativna biopsija se pokazala relativno preciznom metodom za određivanje potrebe za preoperativnim stagingom. Zaključak: Zbog značajnih odstupanja u preciznosti transrektalnog ultrazvuka te relativno malog uzorka za analizu, potrebna su daljnja istraživanja i preispitivanje TRUS-a kao glavne metode za procjenu lokalnog T staginga. Aim: Transanal endoscopic microsurgery is lately getting more importance and is rising as a minimally invasive surgical method that can offer healing with maximal preservation of quality of life to chosen patients with rectal neoplasm. To use the maximal potential of this procedure, setting a precise indication with preoperative staging is of great importance. The aim of this study is the evaluation of preoperative staging at the Clinic for digestive surgery of Clinical Hospital Center Rijeka. Materials and Methods: Medical documentation for a five year period, between 2014. and 2018., was retrospectively analysed. Patients chosen for this study all had TEM surgery for rectal neoplasm during this period. The data were organised and processed in Microsoft Office Excel 2017 program and MedCalc version 19.3.1. The results: The most common indication for TEM procedure were benign lesions. A small number of patients had preoperative staging (28,3%) and there is a significant difference between cTNM and pTNM. Transanal ultrasound was the most commonly used method for the assessment of preoperative staging, but it showed significant deviations, especially in the means of overstaging. Preoperative biopsy was shown as a relatively precise method for determining the necessity for preoperative staging. Conclusion: Because of significant deviations in the precision of transrectal ultrasound and a relatively small sample for the analysis, further studies are needed, as well as reconsideration of transrectal ultrasound as a main local T staging method. |
| Databáze: | OpenAIRE |
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