Show simple item record

Analysis of surgical procedures in the treatment of obstructive rectosigmoid cancer

dc.contributor.advisorKrstić, Slobodan
dc.contributor.otherKaramarković, Aleksandar
dc.contributor.otherŠijački, Ana
dc.contributor.otherMitrović, Mihajlo M.
dc.creatorResanović, Vladimir R.
dc.date.accessioned2016-01-05T12:07:28Z
dc.date.available2016-01-05T12:07:28Z
dc.date.issued2015-05-27
dc.identifier.urihttp://eteze.bg.ac.rs/application/showtheses?thesesId=2029
dc.identifier.urihttps://fedorabg.bg.ac.rs/fedora/get/o:9801/bdef:Content/download
dc.identifier.urihttp://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=46945807
dc.identifier.urihttp://nardus.mpn.gov.rs/123456789/2501
dc.descriptionCilj rada: Odrediti adekvatnu metodu (Hartmann-ova procedura vs. bipolarna kolostomija) za rešavanje crevne opstrukcije koja je prouzrokovana zloćudnim tumorima rektosigmoidnog segmenta debelog creva. Pratiti pojavu hirurških i nehirurških komplikacija, kao i potrebu za transfuzijom krvi i ishod lečenja. Metoda rada: Studijom je obuhvaćeno ukupno 120 ispitanika, koji su operisani dvema različitim tehnikama, metodom bipolarne kolostomije i Hartmann-ovom procedurom. Svi ispitanici su randomizovani u četiri odgovarajuće grupe, shodno godinama života i ASA skoru. Određivana je incidenca hirurških i nehirurških komplikacija, kao i potreba za transfuzijom krvi i njena količina. Takođe, opserviran je i ishod lečenja, odnosno praćen je intrahospitalni mortalitet (preživljavanje). Rezultati: Ispitivanjem nije dobijena statistički značajna razlika u pojavi hirurških i nehirurških komplikacija kod pacijenata operisanih dvema tehnikama. Takođe, nije registrovana statistički značajna razlika u preživljavanju u funkciji primenjene hirurške strategije. U pogledu ishoda lečenja, konstatovano je da uticaj na mortalitet ima pojava nehirurških komplikacija, kao i visoke vrednosti ASA skora. Hirurške komplikacije takođe imaju uticaj na preživljavanje (intrahospitalni mortalitet). zaključak koji se nameće je da su obe ove procedure dovoljno sigurne, sa gotovo jednakim rezultatima lečenja i stopom komplikacija. Nijedna od ove dve metode se u tom smislu ne nameće kao superiorna u odnosu na onu drugu. Međutim, u slučaju značajne distenzije creva tehnički je primerenija metoda bipolarne kolostome. Bipolarna kolostomija u odnosu na Hartmann-ovu proceduru ima prednost u činjenici da je nakon kreiranja bipolarne kolostome rešen problem crevne distenzije i da se na drugoj definitivnoj hirurškoj proceduri može imati bolji onkološki pristup. Mana je svakako što je neophodna druga hirurška intervencija, za koju ne mogu biti pripremljeni svi pacijenti u tako kratkom vremenskom roku, pa se kod takvih primena Hartmann-ove procedure sa uklanjanjem tumora čini kao onkološki prihvatljivije rešenje.sr
dc.descriptionObjective: To determine the appropriate method (Hartmann's procedure vs. bipolar colostomy) for the solution of bowel obstruction caused by malignant tumors of rectosigmoid colon. Monitor the occurrence of surgical and nonsurgical complications, and the need for blood transfusion and outcome. Method of work: The study included 120 patients, who were operated on two different techniques, using bipolar colostomy and Hartmann's procedure. All subjects were randomized into four corresponding groups, according to age and ASA score. We examined the incidence of surgical and nonsurgical complications, and the need for blood transfusion and its quantity. Also, the outcome of treatment was monitored, as well as intrahospital mortality ( the rate of cummulative survival). Results: The study showed that there was no statistically significant difference in the occurrence of surgical and nonsurgical complications in patients operated by two techniques. Also, it didn’t find statistically significant differences in survival as a function of applied surgical strategy. In terms of outcome, it was concluded that there is impact on mortality from emerging nonsurgical complications, as well as the high value of the ASA score. Surgical complications also have an impact on survival (hospital mortality). The conclusion that emerges is that both of these procedures are safe enough, with almost equal treatment outcomes and complication rate. Neither of these two methods is superior to the other. However, in the case of significant bowel distension bipolar colostomy is technically more appropriate method. Bipolar colostomy compared to Hartmann's procedure has the advantage in the fact that creation of bipolar colostomy solved the problem of intestinal distension and on the second definitive surgical procedure surgeon can have better access to oncology. The downside is that second surgical procedure is necessary, and some patients can not be ready for next procedure in such a short period of time. In cases like this, the application of Hartmann's procedure with removal of the tumor seems like better solution.en
dc.formatapplication/pdf
dc.languagesr
dc.publisherУниверзитет у Београду, Медицински факултетsr
dc.rightsAutorstvo-Nekomercijalno-Bez prerade 3.0 Srbija (CC BY-NC-ND 3.0)
dc.sourceУниверзитет у Београдуsr
dc.subjectHartmann-ova procedura, bipolarna kolostomija, crevna opstrukcija, tumori rektosigmoidnog kolonasr
dc.subjectHartmann's procedure, bipolar colostomy, intestinal obstruction, tumors of rectosigmoid canceren
dc.titleAnaliza hirurških metoda rešavanja crevne opstrukcije uzrokovane zloćudnim tumorima rektosigmoidnog dela debelog crevasr
dc.titleAnalysis of surgical procedures in the treatment of obstructive rectosigmoid canceren
dc.typePhD thesis
dcterms.abstractКрстић, Слободан; Митровић, Михајло М.; Шијачки, Aна; Карамарковић, Aлександар; Ресановић, Владимир Р.; Aнализа хируршких метода решавања цревне опструкције узроковане злоћудним туморима ректосигмоидног дела дебелог црева; Aнализа хируршких метода решавања цревне опструкције узроковане злоћудним туморима ректосигмоидног дела дебелог црева;


Files in this item

Thumbnail
Thumbnail

This item appears in the following Collection(s)

Show simple item record