Show simple item record

Evaluation of surgical methods in the treatment of gastroschisis

dc.contributor.advisorMiković, Željko
dc.contributor.otherLukač, Marija
dc.contributor.otherKrstić, Zoran
dc.contributor.otherSinđić-Antunović, Sanja
dc.contributor.otherJokić, Radoica
dc.creatorMilojković-Marinović, Vesna A.
dc.date.accessioned2017-06-13T14:05:00Z
dc.date.available2017-06-13T14:05:00Z
dc.date.available2020-07-03T08:52:40Z
dc.date.issued2017-04-11
dc.identifier.urihttp://eteze.bg.ac.rs/application/showtheses?thesesId=5036
dc.identifier.urihttp://nardus.mpn.gov.rs/handle/123456789/8293
dc.identifier.urihttps://fedorabg.bg.ac.rs/fedora/get/o:15738/bdef:Content/download
dc.identifier.urihttp://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=48977679
dc.description.abstractZnačajan rizik morbiditeta i mortaliteta udružen sa gastroshizom, zahteva kritičnu procenu aktuelnih metoda lečenja. Cilj rada je ocena efikasnosti hirurškog lečenja u populaciji dece sa gastroshizom. Materijal i metod: Retrospektivna kohortna studija komparacije ishoda primene dve tehnike: primarno fascijalno zatvaranje defekta ili primena silastične vreće sa silastičnim prstenom u lečenju gastroshize, u Institutu za zdravstvenu zaštitu majke i deteta Srbije „Dr Vukan Čupić“, od 2001.-2015.g. Rezultat: Nakon selekcije ispitanika u studijskom uzorku je 54 ispitanika: u silastičnoj kohorti (SKG) 21, u hirurškoj kohorti (HKG) 33 ispitanika. Nema statističke značajnosti razlike prema demografskim karakteristikama ispitanika, primeni TPN, učestalosti sepse, broju reintervencija, trajanju hospitalizacije. Statistička značajnost razlike ostvarena je u silastičnoj kohorti sa kraćom primenom mehaničke ventilacije (p = 0.004). Ne postoji statistička značajnost razlike prema učestalosti komplikacija: ileus, kompartment sy, smrtni ishod. NEC je statistički značajno češća komplikacija u silastičnoj kohorti gastroshize (RR 1.31, 95% CI: 1.03-1.52; p = 0.006). Apsolutni rizik (AR) komplikacija i smrtnog ishoda ne prelazi 20% uz 95% interval poverenja (CI) u populaciji dece operisane od gastroshize. Diskusija: Vaskularna insuficijencija creva na nivou trbušnog zida, uz prisutnu perinatalnu sepsu i asfiksiju i uz specifične tehničke komplikacije pri primeni silastične vreće, uslovljavaju nastanak crevne ishemije i nastanak NEC-a. To ukazuje na značaj optimalnog izbora bolesnika za određenu vrstu operativne tehnike, a u zavisnosti od patološkog supstrata. Zaključak: Efikasnost primene dve tehnike u lečenju gastroshize je jednaka, ali se razlikuju po učestalosti komplikacija. NEC je vodeći faktor morbiditeta i mortaliteta u silastičnoj kohorti.sr
dc.description.abstractIntroduction: A significant risk of morbidity and mortality, associated with gastroschisis, demands a critical assessment of actual treatment methods. The aim of this study is evaluation of efficiency of surgical treatment of gastroschisis. Materials and methods: A retrospective cohort study conducted at the Institute for mother and child healthcare „Dr Vukan Čupić“, Serbia, from 2001-2015, comparing the outcome of two techniques for gastroschisis management: primary fascial closure and the use of silastic silo. Results: This study includes 54 patients: 21 in the silastic cohort (SKG) and 33 in the surgical cohort (HKG). There is no statistically significant difference regarding the demographic characteristics, use of TPN, sepsis, number of reinterventions and duration of hospitalization and also regarding complications: ileus, compartment sy, lethal outcome. A statistically significant difference is present in the silastic cohort regarding a shorter use of mechanical ventilation (p = 0.004). NEC is statistically more frequent complication in the silastic cohort (RR 1.31, 95% CI:1.03-1.52; p = 0.006). The absolute risk (AR) of incidence of complications and lethal outcome does not exceed 20% with 95% confidence interval (CI) in surgically treated children. Discussion: Bowel vascular insufficiency at the abdominal wall, in addition of perinatal sepsis, asphyxiation and specific technical complications using a silastic silo, result in bowel ischemia and the development of NEC. This indicates the significance of optimal patient selection for certain types of operational techniques, depending on the pathological substrate. Conclusion: The efficiency of two techniques in gastroschisis management is equal. They differ in the incidence of complications. NEC is the leading morbidity and mortality factor in the silastic cohort.en
dc.formatapplication/pdf
dc.languagesr
dc.publisherУниверзитет у Београду, Медицински факултетsr
dc.rightsopenAccessen
dc.sourceУниверзитет у Београдуsr
dc.subjectgastroschisisen
dc.subjectprimary fascial repair versus staged closureen
dc.subjectmanagementen
dc.subjectoutcomesen
dc.titleProcena uspešnosti hirurških metoda u lečenju gastroshizesr
dc.title.alternativeEvaluation of surgical methods in the treatment of gastroschisisen
dc.typedoctoralThesis
dc.rights.licenseBY-NC-ND
dcterms.abstractМиковић, Жељко; Лукач, Марија; Крстић, Зоран; Синђић-Aнтуновић, Сања; Јокић, Радоица; Милојковић-Мариновић, Весна A.; Процена успешности хируршких метода у лечењу гастросхизе; Процена успешности хируршких метода у лечењу гастросхизе;
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/10680/Disertacija10954.pdf
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/10681/IzvestajKomisije10954.pdf


Files in this item

Thumbnail
Thumbnail

This item appears in the following Collection(s)

Show simple item record