Histeroskopske operacije polipa endometrija

master's thesis

• Title (english): Hysteroscopic polypectomy
• Author: Marija Zlopaša
• Mentor: Mario Ćorić (mentor)
• Committee member: Tomislav Župić (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

Abstract

Polipi endometrija značajni su zbog njihove povezanosti s nenormalnim krvarenjem iz maternice, rezultatima koji govore za njihovu povezanost s neplodnošću, ali i zbog mogućnosti njihove maligne alteracije. Za histološku dijagnozu postoje opcije frakcionirane kiretaže (slijepa biopsija) ili histeroskopske biopsije endometrija. Histeroskopska polipektomija u odnosu na slijepu biopsiju pruža veću pouzdanost nalaza, a istodobno ima nisku stopu komplikacija te se nameće kao zlatni standard. Takozvana office histeroskopija uz navedno ne zahtjeva hospitalizaciju što je prednost za pacijente, ali i za zdravstveni sustav. Cilj ovog istraživanja bio je proučiti moguće kliničke i ultrazvučne pokazatelje maligne alteracije polipa endometrija, te histeroskopiju kao tehniku uzimajući u obzir trajanje hospitalizacije i stopu komplikacija. U istraživanje je bilo uključeno 246 pacijentica koje su u razdoblju od 1. siječnja 2016. godine do 31. prosinca 2017. godine podvrgnute zahvatu histeroskopske polipektomije. Kod njih 245 je zahvat učinjen u Klinici za ženske bolesti i porode Kliničkog centra Zagreb, dok je kod jedne pacijentice zahvat učinjen u vanjskoj ustanovi, a revizija nalaza i daljnja obrada u Klinici. Rezultati su pokazali da zasada nemamo mogućnost definitivne evaluacije polipa bez patohistološkog nalaza te su potrebna daljnja istraživanja. Uočili smo povezanost indeksa tjelesne mase te nenormalnog krvarenja iz maternice kod pacijentica u postmenopauzi s patohistološkom dijagnozom karcinoma endometrija, ali zbog malog uzorka ne možemo donositi sigurne zaključke. Prosječno vrijeme postoperativnog boravka je iznosilo jedan dan, a komplikacija se dogodila u slučaju jedne pacijentice, što pokazuje da je histeroskopija sigurna metoda.

Abstract (english)

Endometrial polyps are significant due to their association with abnormal uterine bleeding, various research results that indicate their association with infertility and possibility of their malignant alteration. Fractionated curettage (blind biopsy) or hysteroscopic polypectomy are indicated for histological evaluation. Hysteroscopic polypectomy is a more reliable method, moreover, shows low complication rates which are ideal conditions for it to be qualified as the gold standard technique. The so-called office hysteroscopy with the aforementioned does not require admission which is advantageous to the patient but also to the health system. The aim of this study was to determine possible clinical and ultrasononographic indicators of endometrial polyp malignant alteration and hysteroscopy as a technique considering admission duration and its complication rate. This study included 246 female patients who have undergone hysteroscopic polypectomy, in the period of time between January 1, 2016 and December 31, 2017. 245 patients have undergone the procedure in the Department of Gynecology and Obstetrics, the University Hospital Center Zagreb and one in another hospital. The results showed that we are not yet able to evaluate endometrial polyps without histopathological examination and further research is indicated. We have noticed the correlation between body mass index and abnormal uterine bleeding in postmenopausal patients with pathohistological diagnosis of endometrial cancer, but we cannot make certain conclusions due to small sample size. Average postoperative hospital stay time was one day and one patient suffered surgical complication, indicating that hysteroscopy is a safe method.

• Keywords: polipi endometrija; maligna alteracija; histeroskopija
• Keywords (english): endometrial polyps; malignant alteration; hysteroscopy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:604226
• 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: 2019-11-21 09:59:23