Kirurško liječenje endoskopskih perforacija kolona

master's thesis

• Title (english): Surgical management of endoscopic colon perforation
• Author: Petra Čerina
• Mentor: Hrvoje Silovski (mentor)
• Committee member: Goran Augustin (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Hrvoje Silovski (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2019-07-12, 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; Internal Medicine

Abstract

Kolonoskopija služi kao zlatni standard za probir, dijagnostiku i kontroliranje bolesti debelog crijeva, npr. za karcinom debelog crijeva.
Kolonoskopija, kao i svaki drugi pregled ili liječnička intervencija, ima svoje komplikacije, od kojih je najozbiljnija i najopasnija perforacija debelog crijeva koja može rezultirati značajnim morbiditetom i mortalitetom.
Perforaciju debelog crijeva kolonoskopom treba što ranije otkriti i odmah početi liječiti. Postoje tri načina liječenja perforacije – endoskopsko, konzervativno i kirurško liječenje. Ako je perforacija kolona dijagnosticirana za vrijeme kolonoskopije može se liječiti endoskopski. U slučaju da je perforacija dijagnosticirana nakon kolonoskopije može se liječiti konzervativno ili kirurški.
Kirurško liječenje podrazumijeva laparotomiju i laparoskopiju, koje mogu biti eksplorativne i terapijske. Neki smatraju da je eksplorativno kirurško liječenje bolje od konzervativnog jer odgađanje reparacije perforacije dovodi do većeg rizika za nastanak komplikacija perforacije.
Postoje mnoge rasprave o tome koji način liječenja je najbolji jer je perforacija kolona kolonoskopom rijetka komplikacija (<1%), te zasebne institucije/bolnice nisu mogle prikupiti dovoljno podataka o liječenju perforacije debelog crijeva kolonoskopom da bi mogli donijeti strateški terapijski plan.
World Society of Emergancy Surgery (WSES) je 2017. godine objavila rad u kojem su prikupljeni i obrađeni svi podaci iz radova koji su obrađivali perforacije debelog crijeva i njihovo liječenje, te su objavili smjernice o tome kako pristupiti pacijentima s perforacijom kolona uzrokovanom kolonoskopom.

Abstract (english)

Colonoscopy is considered the gold standard in screening, diagnostics and follow-up of colon pathology, for example of colorectal cancer.
Colonoscopy, as any other examination or medical procedure, has a risk of complications, of which colonic perforation is the most serious and the most dangerous and it can result in significant mobidity and mortality.
Colonic perforation needs to be diagnosed early and treatment should be started immediately. There are three ways to manage colonic perforation – endoscopic, conservative and surgical treatment. If perforation is diagnosed during colonoscopy it can be managed endoscopically. In case perforation is diagnosed after colonoscopy conservative or surgical treatment is used.
Surgical treatment includes laparotomy and laparoscopy, and it can be used for diagnostics or treatment. Some people believe that exploratory surgical treatment is better than conservative treatment because delaying the repair of perforation can lead to increased risk of developing complications of perforation.
There are many discussions about which treatment is the best one because colonic perforation is a rare complication of colonoscopy (<1%) and because of that single institutions/hospitals were not able to collect enough information/data about the treatment of colonic perforation to develop a strategic therapeutic plan.
The World Society of Emergancy Surgery (WSES) published a paper in 2017 in which they collected and processed all information and data about colonic perforation from other papers and thereafter published guidelines for the management of colonoscopy perforation.

• Keywords: kolon; debelo crijevo; endoskopija; kolonoskopija; perforacija debelog crijeva; laparoskopija; laparotomija
• Keywords (english): colon; endoscopy; colonoscopy; colonic perforation; laparotomy; laparoscopy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:514349
• 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: 2020-03-06 12:15:12