INTRAOPERATIVNI ULTRAZVUK U LOKALIZOVANJU NEPALPABILNIH LEZIJA DOJKE
Sažetak
Uvod: Intraoperativni ultrazvuk u hirurgiji tumora dojke je relativno novi pristup u lokalizovanju nepalpabilnih tumora. Brojne su prednosti ove tehnike u odnosu na mamografsku preoperativnu lokalizaciju žičanom iglom (wire needle localisation - WNL), koja predstavlja standardni pristup u lokalizovanju nepalpabilnih lezija dojke. Pokazalo se da operacije tumora dojke vođene ultrazvukom daju manji procenat pozitivnih ivica resekcije, uz manji volumen ekscidiranog zdravog tkiva dojke oko tumora.
Cilj: Cilj ovog rada je procena uspešnosti ekscizije nepalpabilnih lezija u dojci lokalizovanjem tih lezija intraoperativnim ultrazvukom.
Materijal i metode: Analiza je retrospektivna, obuhvata pacijente operisane na Odeljenju onkološke hirurgije KBC „Bežanijska kosa“ u periodu od januara 2013. do decembra 2017. godine. Inkluzioni kriterijum je nepalpabilna lezija kod koje je intraoperativni ultrazvuk bio jedino sredstvo lokalizovanja. Procena uspešnosti identifikovanja i ekscizije nepalpabilnih lezija izražena je u procentima (namera/uspešna realizacija).
Rezultati: Od 2627 pacijentkinja operisanih u ovom periodu, 317 pacijentkinja (11,9%) je imalo nepalpabilne lezije, od kojih su 173 lokalizovane WNL, a 144 introperativnim ultrazvukom (IOUZ). Od 144 pacijentkinje kod kojih su lezije lokalizovane IOUZ, 61 je imalo karcinom dojke, a 83 benigne lezije. Na osnovu operativnih nalaza sve nepalpabilne lezije u dojkama su uspešno lokalizovane intraoperativnim ultrazvukom i ekscidirane (144/144 – 100%).
Zaključak: Intraoperativni ultrazvuk predstavlja optimalno sredstvo lokalizovanja ultrazvukom vidljivih nepalpabilnih lezija u dojci kod kojih je indikovana hirurška ekscizija.
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