Komplikacije radikalne i parcijalne nefrektomije kod karcinoma bubrežnih ćelija manjih od 7 cm

  • Predrag A. Marić Military Medical Academy, Clinic of Urology, Belgrade, Serbia.
  • Mirko Jovanović Military Medical Academy, Clinic of Urology, Belgrade, Serbia.
  • Novak Milović Military Medical Academy, Clinic of Urology, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia.
  • Dušica Stamenković University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Clinic of Anesthesiology and Intensive Care, Belgrade, Serbia.
  • Branko Košević Military Medical Academy, Clinic of Urology, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia.
  • Predrag Aleksić Military Medical Academy, Clinic of Urology, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia.
  • Snežana Cerović University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Institute for Pathology and Forensic Medicine, Belgrade, Serbia.
  • Aleksandar Spasić Military Medical Academy, Clinic of Urology, Belgrade, Serbia.
  • Dejan Simić Military Medical Academy, Clinic of Urology, Belgrade, Serbia.
  • Jelena Rašković University of Belgrade, School of Economics, ║Department of Statistics, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP151017254M
Ključne reči: kidney neoplasms||, ||bubreg, neoplazme, urologic surgical procedures||, ||hirurgija, urološka, procedure, intraoperative complications||, ||intraoperativne komplikacije, postoperative period||, ||postoperativni period, postoperative complications||, ||postoperativne komplikacije,

Sažetak


Uvod/Cilj. Karcinom renalnih ćelija (real cell carcinoma – RCC) treći je najčešći urološki karcinom. Radikalna nefrektomija (RN) smatra se zlatnim standardom u terapiji lokalizovanog RCC, ali u novije vreme sve češće se koriste minimalno invazivne tehnike. Cilj ove studije bio je da se definiše razlika u incidenci intraoperativnih i postoperativnih komplikacija kod bolesika podvrgnutih RN ili parcijalnoj nefrektomiji (PN) zbog RCC veličine do 7 cm. Metode. Retrospektivno su analizirani podaci iz medicinske dokumentacije bolesnika operisanih u šestogodišnjem vremenskom periodu. Kriterijumi za uključivanje u studiju bili su tumor bubrega veličine do 7 cm i odsustvo metastaza. Kriterijum za isključivanje iz studije bilo je prisustvo bilateralnog tumora. Praćene su intraoperativne i rane postoperativne komplikacije. Clavien-Dindo sistem klasifikacije korišćen je za klasifikaciju komplikacija. Rezultati. U periodu od šest godina urađeno je 481 (76.35%) RN i 149 (23.65%) PN. Bilateralni tumori urađeni su kod 2.06% (13/630) bolesnika, inicijalna metastatska bolest kod 15.87% (100/630) i zahvaćenost limfnih čvorova kod 7.14% (45/630) bolesnika i njihovi podaci nisu uzeti u analizu. Analizom je obuhvaćeno 120 bolesnika sa RN i 97 sa PN koji su ispunjavali kriterijume za uključenje u studiju. Komplikacije su zabeležene kod ukupno 29.5% (64/217) bolesnika. Značajno niži broj bolesnika imao je komplikacije u RN grupi [22.5 % (27/120)] u poređenju sa PN grupom [38.1% (37/97)] (p = 0,006). Komplikacije su uglavnom bile gradusa I i II. Komplikacije gradusa III i IV zabeležene su jedino u PN grupi. Zaključak. Na osnovu analize podataka naših bolesnika, PN je dobar i siguran izbor kod RCC veličine do 7 cm, T1 stadijuma. Bolesnik mora biti uključen u donošenje odluke o hirurškom modalitetu koji će biti primenjen.

Biografije autora

Predrag A. Marić, Military Medical Academy, Clinic of Urology, Belgrade, Serbia.
Urologija, urolog
Mirko Jovanović, Military Medical Academy, Clinic of Urology, Belgrade, Serbia.
Urologija, urolog
Novak Milović, Military Medical Academy, Clinic of Urology, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia.
Urologija, urolog
Dušica Stamenković, University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Clinic of Anesthesiology and Intensive Care, Belgrade, Serbia.
Anesteziologija, anasteziolog
Branko Košević, Military Medical Academy, Clinic of Urology, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia.
Urologija, urolog
Predrag Aleksić, Military Medical Academy, Clinic of Urology, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia.
Urologija, urolog
Snežana Cerović, University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Institute for Pathology and Forensic Medicine, Belgrade, Serbia.
Patologija, patolog
Aleksandar Spasić, Military Medical Academy, Clinic of Urology, Belgrade, Serbia.
Urologija, urolog
Dejan Simić, Military Medical Academy, Clinic of Urology, Belgrade, Serbia.
Urologija, urolog

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Objavljeno
2017/07/07
Broj časopisa
Vol. 74 Br. 7 (2017)
Rubrika
Originalni članak