Naslov (srp)

Procena vrednosti selektivne disekcije vrata u terapiji bolesnika sa karcinomima farinksne i oralne regije : doktorska disertacija

Autor

Trivić, Aleksandar, S. 1971-

Doprinosi

Petrović, Željko, 1952-
Đukić, Vojko, 1955-
Milovanović, Jovica, 1968-
Kosanović, Rade, 1962-

Opis (eng)

There has recently been one hundred years since George Crile demonstrated systematic cervical lymph nodes excision for treatment of patients with head and neck carcinoma. In 1906, George Crile has described surgical operation he called “radical neck dissection”, based on his previous experience and a study of impressive group of 4.500 patients with head and neck carcinoma. Over time, radical neck dissection has became almost standard procedure for patients who required surgical treatment of metastatic deposits combined with primary tumor removal. In the meantime, everyone involved in treatment of patients with head and neck carcinoma began to understand that the radical neck dissection was adequate for treating large palpable lymph nodes, but that it was excessively aggressive in both patients with small palpable lymph nodes, and especially those without palpable lymph nodes or with high risk of metastases. Modified radical neck dissection (MRND) removes “en block” the same lymph nodes and vessels as radical dissection, but by preserving one or more non-lymphatic structures that are being radically removed by radical dissection it decreases postoperative morbidity. Selective neck dissections, which are being preferred by American head and neck surgeons, went even further. Operations include selective removal of individual groups of lymph nodes with risk of metastases and preservation of all non-lymphatic structures and remaining groups of lymph nodes in cases of node-negative neck. It use in cases of node-positive neck is being advocated as well. There are large controversies in this area, especially in patients with evident metastatic neck deposits. The research was performed at Clinic for Otolaryngology and Maxillofacial Surgery of Clinical Center of Serbia in Belgrade. The study included 608 patients treated over a ten year period, from January 1, 1992 to December 31, 2001, who have been followed up for at least 5 years after administered treatment...

Opis (srp)

Skoro se navršilo sto godina od kada je zaslugom George Crile-a opisana sistematska ekscizija cervikalnih limfonodusa u cilju hirurškog lečenja bolesnika sa karcinomima glave i vrata. George Crile je 1906. godine opisao operaciju koju je nazvao "radikalna disekcija vrata", zasnovanu na sopstvenom iskustvu i studiji impozantne serije 4500 bolesnika s karcinomima glave i vrata koji su umrli zbog primarnog tumora ili regionalnih metastaza u vratu i samo 1% zbog udaljenih metastaza. Radikalna disekcija vrata vremenom postaje gotovo standardna procedura za bolesnike kojima je bio potreban hirurški tretman metastatskih depozita u kombinaciji sa uklanjanjem primarnog tumora. U međuvremenu, svima koji su bili angažovani u lečenju bolesnika s karcinomom glave i vrata postalo je jasno da je radikalna disekcija vrata adekvatna u tretiranju velikih palpabilnih limfonodusa, ali i preterano agresivna kako na pacijentima s malim palpabilnim limfonodusima, i naročito na onima bez palpabilnih limfonodusa ili sa visokim rizikom metastaziranja. Modifikovana radikalna disekcija (MRDV) uklanja "en bloc" iste limfonoduse i limfatike kao i radikalna disekcija, ali očuvanjem jedne ili više nelimfatičkih struktura koje se rutinski uklanjaju radikalnom disekcijom, smanjuje postoperativni morbiditet. Još dalje se otišlo selektivnim disekcijama (SDV) koje preferiraju američki hirurzi glave i vrata. Operacije uključuju selektivno uklanjanje pojedinih grupa limfonodusa sa rizikom metastaze i očuvanje svih nelimfatičkih struktura i preostalih grupa nodusa u slučajevima nodus negativnog vrata. Zagovara se njena primena i u slučajevima nodus pozitivnog vrata. Ovde vladaju velike kontroverze posebno kada je u pitanju grupa bolesnika sa evidentnim metastatskim depozitima u vratu...

Opis (srp)

Medicinske nauke - Otorinolaringologija / Medical Science - Otorhynolaryngology Datum odbrane : 26.11.2012

Jezik

srpski

Datum

2012

Licenca

Ovo delo je licencirano pod uslovima licence
Creative Commons CC BY-NC-ND 2.0 AT - Creative Commons Autorstvo - Nekomercijalno - Bez prerada 2.0 Austria License.

http://creativecommons.org/licenses/by-nc-nd/2.0/at/legalcode

Predmet

OSNO - Opšta sistematizacija naučnih oblasti, Otorinolaringologija

Selectiv neck dissection, Modified radical neck dissection, clinical nodusnegative neck, clinival nodus positive neck, regional metastases, reccurence of metastases

OSNO - Opšta sistematizacija naučnih oblasti, Otorinolaringologija

Selektivna disekcija vrata, Modifikovana radikalna disekcija vrata, kliničkinodus negativan vrat, klinički nodus pozitivan vrat, regionalna metastaza, recidiv metastaze

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