Kirurško liječenje kriptorhizma u Kliničkom bolničkom centru Zagreb

master's thesis

• Title (english): Surgical treatment of cryptorchidism at University Hospital Center Zagreb
• Author: Mario Koporčić
• Mentor: Anko Antabak (mentor)
• Committee member: Krešimir Bulić (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Anko Antabak (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2022-09-20, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Kriptorhizam (nespušteni testis) je odsutnost jednog ili obaju testisa u normalnom skrotalnom položaju, a nastaje kao posljedica zaostajanja testisa na njegovom normalnom putu spuštanja. Ovisno o lokaciji zaostalog testisa, on može biti smješten intraabdominalno, ingvinalno ili u visokom skrotalnom položaju. Kriptorhizam može biti kongenitalni, kada su testisi nespušteni već pri rođenju, ili stečeni, kada su testisi pri rođenju bili spušteni, ali su se tijekom života podigli iz normalnog položaja. Kongenitalni kriptorhizam jedna je od najčešćih kongenitalnih anomalija koja zahvaća više od 4% zdrave terminske novorođenčadi. Incidencija značajno raste kod nedonoščadi i tada iznosi do 45%. Etiologija nije u potpunosti razjašnjena, ali istraživanja pokazuju da se radi o djelovanju raznih okolišnih i genetskih čimbenika. Većinom se pojavljuje izolirano, a u 15-20% slučajeva prisutan je u sklopu nekog od brojnih sindroma. Kriptorhični testisi, ako dugo ostanu u abnormalnom položaju, prolaze kroz određene histološke promjene. One dovode do smanjene plodnosti i povećanog rizika za razvoj malignih tumora testisa. Zbog toga smjernice preporučuju kirurško liječenje koje bi trebalo završiti do navršenih 12, najkasnije 18 mjeseci života. Cilj ovog rada bio je utvrditi prate li se te smjernice na Zavodu za dječju kirurgiju Kliničkog bolničkog centra Zagreb. Proučavali smo razdoblje od početka 2011. do kraja 2020. godine i prikupili podatke svih pacijenata koji su u tom razdoblju operirani zbog kriptorhizma. U istraživanje je uključeno 597 pacijenata koji su u vrijeme obavljanja orhidopeksije imali između 0 i 18 godina. Analizom podataka, utvrđeno je da je prosječna dob pri obavljanju orhidopeksije 57,8 mjeseci. Postoje brojni razlozi koji mogu biti uzrok ovako kasnom liječenju i potrebna su dodatna istraživanja kako bi se oni otkrili i riješili. Osim toga, od velike je važnosti i edukacija roditelja, zdravstvenih djelatnika i pacijenata o rizicima koje ovo stanje nosi.

Abstract (english)

Cryptorchidism (undescended testis) is absence of one or both testicles in the normal scrotal position, and it occurs as a result of the testicle falling behind on its normal path of descent. Depending on the testicle location, it can be located intra-abdominally, inguinally or in a high scrotal position. Cryptorchidism can be congenital, when the testicles are undescended at birth, or acquired, when the testicles were descended at birth, but rose from the normal position during life. Congenital cryptorchidism is one of the most common congenital anomalies affecting more than 4% of healthy term newborns. The incidence increases significantly in prematurity and is up to 45%. The etiology has not been fully elucidated, but research shows that various environmental and genetic factors are involved. Cryptorchidism mostly occurs as isolated condition, but in 15-20% of cases it is the part of one of the many syndromes. Cryptorchid testicles, if remain in an abnormal position for a long time, undergo certain histological changes. They lead to reduced fertility and an increased risk for the malignant testicular tumors development. For this reason, guidelines recommend surgical treatment, which should be completed by the age of 12, at latest 18 months. The aim of this paper was to determine whether these guidelines are followed at the Department of Paediatric Surgery of the University Hospital Center Zagreb. We observed the period from the beginning of 2011 to the end of 2020 and collected data on all patients who were operated on for cryptorchidism during that period. 597 patients, aged 0 – 18 years at the time of orchidopexy, were included in the study. Analyzing the data, the average age of 57,8 months at the time of orchidopexy was determined. There are numerous reasons that can be the cause of such late treatment, and additional research is needed to discover and resolve them. In addition, the education of parents, healthcare professionals and patients about the risks of this condition is of great importance.

• Keywords: kriptorhizam; neplodnost; orhidopeksija; tumori testisa
• Keywords (english): cryptorchidism; infertility; orchiopexy; testicular neoplasms
• Language: croatian
• URN:NBN: urn:nbn:hr:105:456235
• 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; Embargo expiration date: 2023-10-01
• Created on: 2023-01-02 10:00:04