Usporedba totalne laparoskopske histerektomije kod bolesnica s velikim miomatoznim maternicama

master's thesis

• Title (english): Total laparoscopic hysterectomy in patients with large myomatous uterus
• Author: Sara Seitz
• Mentor: Mario Ćorić (mentor)
• Committee member: Vladimir Banović (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Mario Ćorić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Miomi su najčešći benigni tumori maternice. Većinom su miomi asimptomatski te se
takvi uglavnom ne trebaju liječiti. Ipak, miomi mogu izazvati obilna krvarenja i
uzrokovati sideropeničnu anemiju. Također mogu uzrokovati zdjeličnu bol,
dispareuneju te inkontinenciju zbog pritiska na okolne strukture. U takvim se
slučajevima miome treba liječiti. Iako se ponekad primjenjuje medikamentno
liječenje, jedini trajni način liječenja je kirurški, miomektomijom ili histerektomijom.
U ovom smo retrospektivnom istraživanju uspoređivali dvije glavne kirurške metode
histerektomije velikih miomatoznih maternica: laparotomiju i laparoskopiju.
Laparotomijski pristup je još uvijek najčešći, posebno kod velikih maternica, ali se
udio histerektomija izveden laparoskopski kontinuirano povećava zahvaljujući
tehnološkom napretku u endoskopskoj kirurgiji općenito, kao i zbog većeg iskustva
kirurga.
Laparoskopski pristup omogućuje brži postoperacijski oporavak, manji gubitak krvi i
manju incidenciju komplikacija.
U ovo su istraživanje uključene 33 pacijentice, od kojih je 15 operirano
laparoskopskim pristupom, a 18 laparotomijskim tijekom 2016. i 2017 u Klinici za
ženske bolesti i porode „Petrova”. Usporedbom dviju skupina, koje se nisu značajno
razlikovale s obzirom na dob, paritet, BMI, veličinu maternice te prijeoperacijsku
razinu hemoglobina, ustanovljeno je da je u skupini operiranoj laparoskopski vrijeme
hospitalizacije bilo znatno kraće te intraoperacijski gubitak krvi manji. Ni u jednoj
skupini nisu zabilježene komplikacije.

Abstract (english)

Myomas are the most common benign uterine tumors. Mostly they are asymptomatic
and do not need to be treated. However, myomas can cause profuse bleeding thus
causing iron deficiency anemia. They can also cause pelvic pain, dispareunea and
incontinence due to increasing pressure on surrounding tissues. In these cases
myomas must be treated. Even though pharmacological treatment is sometimes
chosen, the only permanent solution is surgical treatment, either a myomectomy or a
hysterectomy.
In this retrospective research we compared two main surgical methods of
hysterectomy of large myomatous uteruses: laparotomy and laparoscopy.
Laparotomy is still the most commonly used approach, especially in large uteruses,
but the laparoscopic approach is becoming increasingly more common thanks to
technological advances in endoscopic surgery, as well as increased surgical
experience.
Laparoscopic approach enables faster postoperative recovery, reduced blood loss
and a smaller incidence of complications.
This research included 33 patients, 15 of whom underwent a laparoscopy and 18
underwent a laparotomy during 2016 and 2017.
The two groups of patients didn't differ significantly in regards to age, parity, BMI,
uterine size nor preoperative hemoglobine levels. We have found that hospital stay
was significantly shorter in the laparoscopic group. Blood loss levels were also
significantly lower in the laparoscopic group. There were no complications in either
group.

• Keywords: miomi; laparoskopija; histerektomija; retrospektivno istraživanje
• Keywords (english): myoma; laparoscopy; hysterectomy; retrospective research
• Language: croatian
• URN:NBN: urn:nbn:hr:105:394253
• 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: 2020-01-08 14:34:23