Kratkoročni ishod bolesnika s gastroshizom liječenih u Kliničkom bolničkom centru Zagreb

master's thesis

• Title (english): Short term outcome in patients with gastroschisis treated in University Hospital Center Zagreb
• Author: Filip Brkić
• Mentor: Ruža Grizelj (mentor)
• Committee member: Jurica Vuković (predsjednik povjerenstva)
• Committee member: Marija Jelušić (član povjerenstva)
• Committee member: Ruža Grizelj (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pediatrics); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Intensive Care

Abstract

Gastroshiza je kongenitalna, najčešće izolirana malformacija prednje trbušne stijenke karakterizirana prolapsom abdominalnih organa, hipoplazijom trbušne šupljine i malrotacijom tankog i debelog crijeva. Takvo stanje nosi određene kratkoročne i dugoročne komplikacije. Cilj ovog retrospektivnog istraživanja, koje je obuhvatilo sve bolesnike liječene zbog gastroshize u Zavodu za neonatologiju i neonatalnu intenzivnu medicinu i Zavodu za gastroenterologiju, hepatologiju i prehranu Klinike za pedijatriju KBC-a Zagreb u periodu od svibnja 2007. godine do svibnja 2017. godine, bio je ispitati kratkoročne ishode u tih bolesnika. Iz medicinske dokumentacije izdvojili smo osnovne perinatalne i demografske podatke te kliničke karakteristike bolesnika. Potom, gastroshize smo podijelili, na temelju stanja gastrointestinalnog trakta kod poroda, na jednostavne i kompleksne te smo usporedili njihove karakteristike. Također, bilježili smo broj operacija i komplikacije tijekom hospitalizacije. Analizom podataka potvrdili smo dosadašnja stajališta: bolesnici s kompleksnim gastroshizama rađaju nezreliji (manje gestacijske dobi), rodna masa im je češće ispod 10.p. za gestaciju, imaju veći broj reoperacija i zahtijevaju značajno duže vrijeme za postizanje potpunog enteralnog unosa u odnosu na bolesnike s jednostavnim gastroshizama. Preživljenje naših bolesnika je u skladu s rezultatima drugih centara (>90%). Međutim, vrijeme do uspostave potpunog enteralnog unosa i vrijeme trajanja hospitalizacije je u našoj kohorti bolesnika značajno duže. Broj reoperacija i postojanje sepse su se izdvojili kao značajni čimbenici koji utječu na duljinu hospitalizacije. Naposljetku, većina bolesnika i nakon hospitalizacije zahtijeva dugoročan multidisciplinaran nadzor.

Abstract (english)

Gastroschisis is a congenital, usually isolated malformation of the anterior abdominal wall characterized by the prolapse of the abdominal organs, abdominal cavity hypoplasia and a malrotation of the small intestine and colon. Such condition bears certain short and long term complications. We conducted a retrospective cohort study of all gastroschisis cases treated between May 2007 and May 2017 in University Hospital Centre Zagreb, Department of pediatrics, Neonatal intensive care unit and Division of gastroenterology and hepatology. The aim of this study was to determine the short term outcomes of these patients. The medical records of 27 gastroschisis cases were reviewed for perinatal and demographic informations and clinical characteristics. Furthermore, we divided gastroschisis, based on the condition of gastrointestinal tract after birth, on simple and complex types and compared their characteristics. Also, we noted the number of surgical procedures and complications during the hospitalization. The analysis confirmed the current standpoint: patients with complex gastroschisis are born more immature (lower gestational age), their birthweight is more frequently under 10th percentile, they have higher number of resurgeries, and require significantly longer time to reach full enteral feeding compared to the patients with simple type. The survival rate is in accordance to the results of other centers (>90%). However, time to full enteral feeding and length of stay is significantly longer in our cohort. Also, number of resurgeries and presence of sepsis played significant roles in duration of hospitalization. Ultimately, most patients after hospitalization require a long term multidisciplinary supervision.

• Keywords: kratkoročni ishod; potpuni enteralni unos; duljina hospitalizacije
• Keywords (english): short term outcome; full enteral feeding; duration of hospitalization
• Language: croatian
• URN:NBN: urn:nbn:hr:105:162437
• 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: 2018-03-19 07:51:03