Parcijalna laringektomija u kirurškom liječenju malignih bolesti grkljana

master's thesis

• Title (english): Partial laryngectomy in the surgical treatment of malignant diseases of the larynx
• Author: Katarina Bilić
• Mentor: Drago Prgomet (mentor)
• Committee member: Mario Bilić (predsjednik povjerenstva)
• Committee member: Mihael Ries (član povjerenstva)
• Committee member: Drago Prgomet (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Unatoč napretku medicine, planocelularni karcinom grkljana predstavlja ozbiljan medicinski problem. Najčešće se javlja između 50. i 70. godine života, te većinom zahvaća mušku populaciju pacijenata. Disbalans u distribuciji pojavnosti bolesti među spolovima, danas se pripisuje različitim životnim navikama muškaraca i žena, poglavito kada je riječ o konzumaciji alkohola i duhanskih proizvoda. Kirurški pristup čini osnovu liječenja ove maligne bolesti. Pacijentima, među ostalim, na raspolaganju stoje metode radioterapije i sve popularnije transoralne laserske resekcije. Često su skloni odabiru laserskog uklanjanja tumorskog tkiva zbog mogućnosti zaobilaženja otvorenog zahvata. Unatoč tome, zahvat parcijalne laringektomije neupitno i dalje predstavlja najbolje terapijsko rješenje za određene indikacije. U slučaju nemogućnosti postizanja dovoljne vidljivosti operacijskog polja za izvođenje endoskopskog zahvata ili proširenosti tumorskog procesa na određene složene anatomske strukture, direktni pristup transcervikalnog zahvata osigurava dovoljno manevarskog prostora za temeljito uklanjanje malignog tkiva. Važna komponenta zahvata, također, leži u maksimalnoj poštedi zdravih struktura i rekonstrukciji koja pacijentu treba osigurati osim zdravstvenog oporavka i povrat funkcionalnosti. Anatomske strukture grkljana sudjeluju u gutanju, disanju i fonaciji. Jasno je kako mogućnost govora, samostalnog disanja i oralnog unosa hrane čine izrazito veliku ulogu u fiziološkom, psihološkom i socijalnom zdravlju oboljelog. Pravovremeno izvedena parcijalna laringektomija u kombinaciji sa potporom složene skrbi multidisciplinarnog tima pruža optimalne rezultate. Stoga, unatoč porastu popularnosti alternativnih metoda liječenja karcinoma glotisa, parcijalna laringektomija i dalje zauzima važno mjesto među suvremenim kirurškim tehnikama.

Abstract (english)

Despite medical advances, laryngeal squamous cell carcinoma remains a serious medical problem. Men make up most of the patients and it most frequently affects them between the ages of 50 and 70. Today, the difference in lifestyle choices between men and women, particularly regarding the consumption of alcohol and tobacco products is blamed for the unequal occurrence between the sexes. A surgical approach represents the basis of treatment for this malignant disease. Patients can choose between a variety of methods, including radiotherapy and, increasingly popular, transoral laser surgery. They are often inclined to opt for laser removal of the tumour tissue in order to avoid open surgery. Despite that, partial laryngectomy still represents the best therapeutic solution for certain indications. In cases where we cannot secure an appropriate overview of the operating field for the endoscopic intervention or if the tumour has infiltrated complex anatomical structures, a direct transcervical approach provides enough space for thorough removal of malignant tissue. An important aspect of partial laryngectomy also includes maximal preservation of unaffected structures and reconstruction. This ensures the recovery of both health and function. Laryngeal anatomical structures play an important role in the act of swallowing, breathing, and phonation. It is understandable how the ability to speak, breathe freely, and eat have a great impact on patient’s physiological, psychological, and social wellbeing. Timely executed partial laryngectomy combined with multidisciplinary team care leads to successful results. Therefore, in spite of the growing interest in other methods of treatment, when it comes to laryngeal carcinoma, partial laryngectomy has an undisputable role as a contemporary surgical technique.

• Keywords: parcijalna laringektomija; organ preservation kirurgija; karcinom grkljana
• Keywords (english): partial laryngectomy; organ preservation surgery; laryngeal cancer
• Language: croatian
• URN:NBN: urn:nbn:hr:105:300443
• 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: 2023-10-23 09:45:29