Utjecaj liječenja preinvazivnih i ranih invazivnih malignih promjena vrata maternice mikroinvazivnim kirurškim metodama na ishode trudnoće

master's thesis

• Title (english): The impact of microinvasive surgical treatment of preinvasive and early invasive malignant lesion of the cervix on pregnancy outcomes
• Author: Elena Cahun
• Mentor: Dražan Butorac (mentor)
• Committee member: Joško Lešin (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Dražan Butorac (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Ekscizija transformacijske zone cerviksa velikom petljom (LLETZ) i konizacija hladnim nožem (CKC) metode su ekscizijskog kirurškog liječenja preinvazivnih i invazivnih promjena vrata maternice. Obje metode su sigurne i učinkovite te objedinjuju dijagnostiku i terapiju u jednom aktu. Cilj ovog istraživačkog rada bio je istražiti utjecaj navedenih tehnika na ishode trudnoće. Istraživanje je analiziralo ishode trudnoće kod 84 ispitanice koje su povrgnute navedenim zahvatima prije trudnoće. Od toga, 73 (86.9%) su imale LLETZ, a 11 (13.1%) CKC. Paritet nije pokazao statistički značajnu razliku, ali klinički je važno da je veći postotak višerotki u CKC grupi. Najčešće dijagnosticirane lezije su bile CIN 3 (51.14%) i CIN 2 (28.41%). Postoji statistički značajna povezanost između vrste zahvata, pravovremenosti poroda i načinu dovršenja poroda. CKC skupina ima veći rizik za prijevremeni porod (OR=10.76) i carski rez (OR=10.96) u usporedbi s LLETZ (OR=1.03). Iako su rezultati statistički značajni, mali uzorak CKC skupine može utjecati na preciznost procjena. Potrebna su dodatna istraživanja s većim brojem ispitanica kako bi se potvrdila značajnost ovih rezultata. CKC nosi veći rizik od komplikacija u trudnoći i porodu u usporedbi s LLETZ zahvatom, stoga je ključno pažljivo praćenje i savjetovanje pacijentica kako bi se smanjili rizici i osigurali optimalni ishodi trudnoće.

Abstract (english)

Large loop excision of the cervical transformation zone (LLETZ) and cold knife conization (CKC) are excisional surgical methods for treating preinvasive and invasive changes in the cervix. Both methods are safe and effective, combining diagnostics and therapy in a single procedure. This research aimed to investigate the impact of these techniques on pregnancy outcomes. The study analyzed pregnancy outcomes in 84 patients who underwent these procedures before pregnancy. Of these, 73 (86.9%) had LLETZ, and 11 (13.1%) had CKC. Parity did not show a statistically significant difference, but it is clinically important that there is a higher percentage of multiparas in the CKC group. The most commonly diagnosed lesions were CIN 3 (51.14%) and CIN 2 (28.41%). There is a statistically significant association between the type of procedure, the timing of delivery, and the mode of delivery. The CKC group has a higher risk for preterm delivery (OR=10.76) and cesarean section (OR=10.96) compared to LLETZ (OR=1.03). Although the results are statistically significant, the small sample size of the CKC group may affect the precision of the estimates. Further research with a larger number of patients is needed to confirm the significance of these results. CKC carries a higher risk of pregnancy and delivery complications compared to LLETZ, so careful monitoring and counseling of patients is crucial to reduce risks and ensure optimal pregnancy outcomes.

• Keywords: carski rez; konizacija; prijevremeni porod
• Keywords (english): cesarean section; conisation; premature birth
• Language: croatian
• URN:NBN: urn:nbn:hr:105:097009
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-07-23 14:16:19