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Srpski arhiv za celokupno lekarstvo
2015, vol. 143, br. 3-4, str. 158-161
jezik rada: engleski
vrsta rada: originalan članak
doi:10.2298/SARH1504158M


Poređenje funkcionalnih rezultata koloničnog 'J' rezervoara i latero-terminalne anastomoze posle prednje niske resekcije kod karcinoma rektuma
aClinic for Digestive Surgery, First Surgical Clinic, Clinical Center of Serbia, Belgrade + University of Belgrade, School of Medicine, Belgrade
bClinic for Digestive Surgery, First Surgical Clinic, Clinical Center of Serbia, Belgrade

e-adresa: mbecambeca@yahoo.com

Sažetak

Uvod Funkcionalni rezultati posle prednje niske resekcije rektuma zbog karcinoma su oblast koja dobija na značaju i na koju sve više pažnje obraćaju kolorektalni hirurzi i svi ostali zainteresovani za ovu problematiku. Ne postoji saglasnost o idealnom načinu rekonstrukcije posle ovih operacija, iako je u poslednjih nekoliko godina objavljen veliki broj radova koji obrađuju ovu temu. Cilj rada Urađena je prospektivna studija s paralelnim grupama gde su poređeni kolonični rezervoar i latero-terminalna anastomoza u kontekstu defekatorne funkcije kod bolesnika s niskom kolorektalnom staplerskom anastomozom. Metode rada U istraživanje je uključeno 80 bolesnika kod kojih je izvedena latero-terminalna ili anastomoza s koloničnim rezervoarom. Funkcija defekacije je procenjena pomoću modifikovane verzije upitnika MSKCC šest meseci, godinu dana i dve godine posle operacije. Fekalna kontinencija je procenjena primenom upitnika Wexner Continence Score. Rezultati U obe grupe ispitanika zabeležen je trend poboljšanja kod svih merenih varijabli u tri pomenuta perioda kliničkog praćenja. Ovo se odnosilo na frekvenciju pražnjenja, urgenciju, noćno vlaženje, fragmentaciju i osećaj nepotpunog pražnjenja. Pomenute razlike, međutim, nisu dostigle statističku značajnost, a sagledavanjem trenda kretanja rezultata zaključili smo da stacionarno stanje nije dostignuto ni posle 24 meseca u grupi bolesnika s koloničnim rezervoarom. Zaključak Ova studija nije dokazala statistički značajnu razliku u funkciji defekacije šest meseci, godinu dana i dve godine posle prednje niske resekcije rektuma zbog karcinoma između dve posmatrane grupe bolesnika. Takođe, naši rezultati nisu dokazali prednost koloničnog rezervoara kao načina rekonstrukcije posle resekcije rektuma u odnosu na latero-terminalnu anastomozu.

Ključne reči

prednja niska resekcija; staplerska anastomoza; kolonični 'J' rezervoar; defekatorna funkcija; karcinom rektuma

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