Embolizacija mioma maternice

master's thesis

• Title (english): Uterine fibroid embolization
• Author: Robert Martinez
• Mentor: Ivana Maurac (mentor)
• Committee member: Slavko Orešković (predsjednik povjerenstva)
• Committee member: Željko Duić (član povjerenstva)
• Committee member: Ivana Maurac (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Miomi su dobroćudni tumori glatkomišićnih stanica maternice koji čine jedan od glavnih zdravstvenih problema žena reproduktivne dobi. Uzrok njihova nastanka još uvijek je nepoznat, a barem približno shvaćanje njihove etiologije danas je omogućeno razvojem metoda molekularne biologije čime su prepoznati utjecaji hormona i potencijalni faktori rizika. Radi svog smještaja, veličine i brojnosti očituju se simptomima boli, krvarenja i urinarnih tegoba, a uz to mogu utjecati na plodnost čime se značajno smanjuje kvaliteta života pacijentica. Zbog toga čine jednu od najčešćih indikacija za histerektomiju koja je takvim pacijenticama jedini način olakšavanja simptoma, ali iako danas već rutinski postupak, on sa sobom nosi svoje komplikacije te je posljedično ženama onemogućeno daljnje rađanje djece. Razvojem interventne radiologije otvorila se nova mogućnost liječenja određenih pacijentica neoperativnim putem odnosno metodom embolizacije koja se do tada koristila u liječenju drugih tumora. Metoda embolizacije zasniva se na minimalnoinvazivnom principu kojim se kroz maleni rez pristupa arteriji u preponi u koju se potom uvodi kateter kojim se prvo prikaže, a potom i embolizira određena arterija s pripadajućim ograncima. Na taj način izbjegnute su komplikacije operativnog postupka, a uvelike je skraćen period oporavka čime je omogućen raniji povratak svakodnevnim aktivnostima no još uvijek ostaje kontroverzno pitanje planiranja obitelji kod žena koje su bile podvrgnute embolizaciji. Prva embolizacija mioma u svijetu izvedena je 1995 godine u Francuskoj, a 1997.godine u SAD-u što je označilo početak velikih kliničkih ispitivanja embolizacije mioma. Zbog toga je 2008. Američko društvo porodničara i ginekologa (ACOG) objavilo da je metoda sigurna i učinkovita temeljeno na kratkoročnim i dugoročnim ishodima praćenja pacijentica. Prvu embolizaciju mioma u Hrvatskoj izveo je interventni radiolog Rubin u Osijeku 2000. godine, a u KBC-u Zagreb embolizacije se provode od 2017.godine radi sindroma venske kongestije te od 2018.godine radi mioma.

Abstract (english)

Uterine fibroids are bening smooth-muscle cell tumors that tends to be one of main healthcare problems of reprodutive age women. Etiology is still unknown, but better understanding is now possible using the methods of molecular biology which that recognized the effect of hormones and potential risk factors. Their positioning, size and numerosity results with most common symptoms such as pain, bleeding and dysuria. There is also an effect on decreased fertility rates that combined with previous symptoms tend to significantly decrease quality of life. Because of that they are the most frequent indication for the performance of hysterectomy which was considered the only succesful method for symptoms relieve. That is why they are one of the most common indications for hysterectomy as it is the only way of relieving the symptoms for these patients. Although it is a routine procedure, it brings many complications and consequently women can no longer bear children. With the development of interventional radiology, a nonsurgical procedure known as uterine fibroid embolisation has been introduced as a method of treatment for certain female patients. Method of embolisation is based on minimally invasive approach in which the femoral artery is exposed through a small incision. Catheter is then placed inside the artery, firstly to visualise and then to embolise specific artery and its branches. Using this technique, the complications of operative procedure are avoided and recovery period is greatly reduced which allows an early return to everyday activities. But the controversial question of family planning for women who have undergone embolisation, still remains. First uterine artery embolisation (UFE) was performed in France in 1995 and 1997 in USA which marked the begining of major clinical trials of that newly established method. The American College of Obstetricians and Gynecologists(ACOG) 2008. proclaimed embolisation as safe and effective procedure based on short term and long term patient follow up. In Croatia, the first embolisation was performed by intervention radiologist Otmar Rubin in Osijek in 2000. and the method is used at the Department of Gynecology and Obstetrics University Hospital Centre Zagreb from 2017. for patients diagnosed with venous congestive syndrome nad form 2018. for patients with fibroids.

• Keywords: miom; embolizacija; histerektomija
• Keywords (english): fibroid; embolization; hysterectomy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:007928
• 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: 2023-01-19 08:52:23