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Impact of surgical approach on treatment outcome in patients with esophageal and esophagogastric junction cancer

dc.contributor.advisorPeško, Predrag
dc.contributor.otherSimić, Aleksandar P.
dc.contributor.otherSabljak, Predrag
dc.contributor.otherMicev, Marjan
dc.creatorVeličković, Dejan
dc.date.accessioned2020-02-27T11:23:40Z
dc.date.available2020-02-27T11:23:40Z
dc.date.available2020-07-03T08:55:10Z
dc.date.issued2019-09-19
dc.identifier.urihttp://eteze.bg.ac.rs/application/showtheses?thesesId=7278
dc.identifier.urihttps://nardus.mpn.gov.rs/handle/123456789/12139
dc.identifier.urihttps://fedorabg.bg.ac.rs/fedora/get/o:21023/bdef:Content/download
dc.identifier.urihttp://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=51890447
dc.description.abstractHirurgija karcinoma jednjaka i ezofagogastričnog prelaza, kao jedna od najkompleksnijih oblasti digestivne hirurgije, je i dalje povezana sa visokim stopama morbiditeta i mortaliteta, uz relativno nisko ukupno preživljavanje. Uprkos velikom napretku poslednjih decenija, stope mortaliteta se u mnogim centrima širom sveta održavaju na vrednostima od 5-10%, a petogodišnje preživljavanje radikalno operisanih pacijenata retko kada prelazi stopu od 25-30%. Iako je velikim delom ova hirurgija standardizovana, neka pitanja i dalje ostaju otvorena. Definisanjem ciljeva naše studije smo se fokusirali na postojeće kontroverze, i time pokušali da damo skromni doprinos u iznalaženju optimalnih modaliteta lečenja ovih pacijenata. Naša studija je po dizajnu retrospektivna kohortna studija, koja je obuhvatila dvanaestogodišnji period od 01.01.2004.-01.01.2016 godine. U navedenom periodu je u Centru za hirurgiju jednjaka operisano 1129 pacijenata zbog karcinoma jednjaka i želuca. U studiju smo uključili radikalno operisane pacijente sa karcinomom jednjaka i ezofagogastričnog prelaza, kojih je nakon definisanja kriterijuma bilo ukupno 529. Osnovni ciljevi naše studije bili su: 1. utvđivanje kliničko-patološki karakteristika i perioperativnih rezultata lečenja (morbiditet i mortalitet), kao i analiza preživljavanja ove homogene populacije pacijenata; 2. Ispitivanje značaja Lymph Node Ratio (LNR) i njegovo poređenje sa N stadijumom prema 7. izdanju TNM klasifikacije; 3. Ispitivanje značaja hirurškog pristupa za ishod lečenja pacijenata sa karcinomomima ezofagogastričnog prelaza tipa II po Siewert-ovoj klasifikaciji; 4. Uticaj statusa cirkumferentne resekcione margine, definisane prema dva postojeća kriterijuma klasifikacije (Kraljevsko udruženje patologa i Američko udruženje patologa) na ukupno preživljavanje, pojavu recidiva i pojavu lokalnih recidiva bolesti; 5. Uticaj transfuzije alogene krvi na ishod lečenja operisanih pacijenata. Karcinom jednjaka i ezofagogastričnog prelaza se najčešće javljao u sedmoj deceniji života (60±10.3), a dominirao je muški pol (4:1). Mediana dužine hospitalizacije je iznosila 15 dana (raspon:14.0-19.0 dana), a intrahospitalni mortalitet 2.8%...sr
dc.description.abstractcomplex field in digestive surgery, is still burdened with high morbidity and mortality rates and relatively poor overall survival. Despite the great progress in the recent decades, a mortality rate remains high worldwide (5-10%), with 5-year survival rates that rarely exceeds 25-30% in the population of patients operated with radical intent. Althought mostly standardized, there are some dilemmas that remain unanswered. Aims of our study were focused on the existing controversies, trying to give a modest contribution in defining optimal treatment modalities for this patient population. Our study was designed as restrospective cohort study, with all limitations by the study design, which enrolled consecutive patients operated on esophageal and esophagogastric junction cancer in the period between January 2004 and January 2016. There were 1129 surgically treated patients due to esophageal and gastric cancer in the observed period. Finally, 529 patiens have met our criteria and were included in the analysis. Aims of our study were: 1. To determine basic clinical and pathological characteristics, perioperative (morbidity and mortality) and long term outcome of the study population; 2. To investigate significance of LNR; 3. To compare two surgical approaches (esophagectomy versus extended total gastrectomy), and their impact on outcome of patients with Siewert type II esophagogastric junction cancer; 4. To compare two different classifications of CRM and their impact on surgical outcome; 5. To investigate impact of allogeneic blood transfusion following surgical treatment of esophageal and esophagogastric junction cancer. Most of the patients in our study were in seventh decade of life (60±10.3), with male predominance (4:1). Median in-hospital stay was 15 days (range: 14.0-19.0), in-hospital mortality of 2.8%...en
dc.formatapplication/pdf
dc.languagesr
dc.publisherУниверзитет у Београду, Медицински факултетsr
dc.rightsopenAccessen
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.sourceУниверзитет у Београдуsr
dc.subjectkarcinom jednjakasr
dc.subjectesophageal canceren
dc.subjectkarcinom ezofagogastričnog prelazasr
dc.subjectezofagektomijasr
dc.subjecthirurški pristupsr
dc.subjectcirkumferentna resekciona marginasr
dc.subjecttransfuzija alogene krvisr
dc.subjectishod lečenjasr
dc.subjectesophagogastric junction canceren
dc.subjectesophagectomyen
dc.subjectsurgical approachen
dc.subjectcircumferential resection marginen
dc.subjectallogeneic blood transfusionen
dc.subjecttreatment outcomeen
dc.titleZnačaj hirurškog pristupa za ishod lečenja bolesnika sa karcinomom jednjaka i ezofagogastričnog prelazasr
dc.title.alternativeImpact of surgical approach on treatment outcome in patients with esophageal and esophagogastric junction canceren
dc.typedoctoralThesisen
dc.rights.licenseBY-NC
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/11413/Disertacija.pdf
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/11414/IzvestajKomisije22194.pdf
dc.identifier.fulltexthttps://nardus.mpn.gov.rs/bitstream/id/11413/Disertacija.pdf
dc.identifier.fulltexthttps://nardus.mpn.gov.rs/bitstream/id/11414/IzvestajKomisije22194.pdf
dc.identifier.rcubhttps://hdl.handle.net/21.15107/rcub_nardus_12139


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