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Vojnosanitetski pregled
2017, vol. 74, br. 4, str. 349-353
jezik rada: engleski
vrsta rada: kratki članak
doi:10.2298/VSP150224187P
Creative Commons License 4.0
Značaj obuke i obrazovanja u izvođenju totalne mezorektalne ekscizije u hirurgiji karcinoma rektuma
aUniverzitet u Novom Sadu, Medicinski fakultet, Institut za onkologiju
bDepartment of Surgical Oncology, Institute of Oncology of Vojvodina, Sremska Kamenica

e-adresa: petrovic.tomislav@onk.ns.ac.rs

Sažetak

Uvod/Cilj. U poslednje dve decenije postignut je značajan napredak u hirurgiji karcinoma rektuma. Preoperativna radioterapija, uvođenje staplera kopči i ponajviše unapređena hirurška tehnika umnogome su doprineli boljim rezultatima lečenja, pre svega smanjivanjem učestalosti ranih hirurških komplikacija i stope lokalnih recidiva. Cilj ovog istraživanja bio je da se uporede operativni i postoperativni rezultati u lečenju karcinoma rektuma između dve grupe hirurga - onih koji se usko bave kolorektalnom hirurgijom i onih koji se ovom problematikom bave sporadično. Metode. Ova retrospektivna studija obuhvatila je 146 bolesnika koji su operisani na Institutu za onkologiju Vojvodine u periodu od 1. 1. 2008. do 31. 12. 2010. godine. Bolesnici su bili podeljeni u dve grupe. U prvoj grupi N1 bio je 101 bolesnik koje su operisali visoko edukovani hirurzi za totalnu mezorektalnu eksciziju (TME), a u drugoj N2 bilo je 45 bolesnika koje su operisali hirurzi bez edukacije iz TME. Rezultati. Preoperativnu hemioiradijaciju primilo je 49 (33,56%) bolesnika. Utvrđena je statistički značajna razlika između dve grupe u trajanju operacije i potrebi za krvnim derivatima tokom operacije. Dehiscenciju anastomoze indentifikovali smo kod 3 bolesnika iz N1 grupe i kod 10 bolesnika iz N2 grupe. Sedam (4,79%) bolesnika razvilo je lokalni recidiv nakon operativnog lečenja. Statistički značajna razlika ustanovljena je u broju lokalnih recidiva i dehiscencije anastomoze između dve upoređivane grupe. Zaključak. Neophodno je kontinuirano obrazovanje i obuka u hirurgiji karcinoma rektuma kako bi se savladale nove tehnologije i hirurške tehnike, te unapredili rezultati hirurškog lečenja.

Ključne reči

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