Sinkrone resekcije jetre kod metastaza kolorektalnog karcinoma

master's thesis

• Title (english): Synchronous liver resection in colorectal carcinoma metastases
• Author: Ivan Šerić
• Mentor: MATE ŠKEGRO (mentor)
• Committee member: Tomislav Luetić (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: MATE ŠKEGRO (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Oncology

Abstract

Kolorektalni karcinom jedan je od najčešćih tumora u općoj populaciji. Gotovo petina pacijenata u trenutku postavljanja dijagnoze ima metastaze u jetri (sinkrone jetrene metastaze). Optimalan izbor liječenja za takve bolesnike je kontroverzan. Ovaj rad analizira kirurške ishode i stopu komplikacija za pacijente podvrgnute sinkronoj resekciji jetre kod metastaza kolorektalnog karcinoma. Uključeni su svi pacijenti koji su bili podvrgnuti takvom zahvatu u zadnjih 5 godina (od 1.1.2011. do 31.12.2016.) na Klinici za kirurgiju Kliničkog bolničkog centra Zagreb. Usporedivši dobivene rezultate s podatcima iz literature ustanovljeno je da nema značajnije razlike u ishodima ili stopi komplikacija pri sinkronoj resekciji jetrenih metastaza i primarnog kolorektalnog karcinoma u odnosu na druge kirurške pristupe liječenju takve bolesti. Nadalje, pacijenti koji su bili podvrgnuti takvoj resekciji imali su značajno kraći postoperativni boravak u bolnici. Naposljetku, zaključeno je da je sinkrona resekcija jetre kod metastaza kolorektalnog karcinoma jednako siguran postupak kao i ostali pristupi liječenja takve bolesti, čak i kad se promatraju pacijenti podvrgnuti tako složenom postupku, i vodi do kraćeg postoperativnog boravka pacijenta u bolnici, a samim time i bržeg uključivanja u adjuvantne modalitete liječenja (kemoterapija i radioterapija). Sinkrona resekcija jetre kod metastaza kolorektalnog karcinoma ima povoljan učinak i na pacijente, ali i na troškove pojedine ustanove pa bi, gdje je god to moguće, to trebao biti pristup izbora.

Abstract (english)

Colorectal carcinoma is one of the most common malignant tumours. Almost a fifth of all diagnosed patients will be diagnosed with liver metastases at the same time (synchronous liver metastases). Optimal treatment for those patients is controversial. This paper will analyse the surgical outcome and complication rate for patients presenting with synchronous colorectal cancer liver metastasis in the simultaneous approach. The patients involved were all patients that underwent simultaneous surgery in the UHC Zagreb in the period of the last five years (2011 – 2016), presenting with synchronous metastases diagnosed before surgery or intraoperatively. Results have shown that there was no significant difference in the rate of surgical complications or outcome compared to staged surgery data found in the literature. Furthermore, patients undergoing simultaneous resection had significantly fewer days of hospital stay. In conclusion, simultaneous resection was found to be equally safe as staged resection, even when evaluating patients undergoing more complex operations and led to shorter hospital stay. Under appropriate clinical circumstances, simultaneous resection offers benefits to patients and the health care system and should be the recommended surgical approach.

• Keywords: kolorektalni; karcinom; jetra; metastazektomija; sinkrono
• Keywords (english): colorectal; carcinoma; liver; metastasectomy; synchronous
• Language: croatian
• URN:NBN: urn:nbn:hr:105:828094
• 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: 2018-03-26 09:11:10