14 research outputs found
UROLITHIASIS ā PREVENTION, DIAGNOSIS AND TREATMENT
Broj bolesnika s urolitijazom sve je veÄi. VeÄina kamenaca nastaje kao posljedica metaboliÄke abnormalnosti, ali, unatoÄ tome, u veÄine pacijenata ne može se pronaÄi specifiÄna metaboliÄka abnormalnost. Stoga u veÄini sluÄajeva nije mogu}e kauzalno lijeÄenje veÄ samo simptomatska terapija. Iako veÄina bolesnika izmokri kamence, u preostalih se koriste razliÄite, prije svega, kirurÅ”ke metode uklanjanja kamenca. U prevenciji kamenaca najvažniji su Äimbenici velik unos tekuÄine, uz posljediÄnu obilnu diurezu, te dijetalne mjere.The prevalence of urinary stones is increasing. The majority of stones are caused by metabolic abnormality but, despite this, specific metabolic abnormality cannot be found in most patients. In most cases causal therapy is not possible so that the therapy of symptoms is the only option. Despite the fact that most patients spontaneously eliminate stones, different surgical methods are available. The cornerstone of stone prevention is a high fluid input with increased urine volume as well as diet
UROLITHIASIS ā PREVENTION, DIAGNOSIS AND TREATMENT
Broj bolesnika s urolitijazom sve je veÄi. VeÄina kamenaca nastaje kao posljedica metaboliÄke abnormalnosti, ali, unatoÄ tome, u veÄine pacijenata ne može se pronaÄi specifiÄna metaboliÄka abnormalnost. Stoga u veÄini sluÄajeva nije mogu}e kauzalno lijeÄenje veÄ samo simptomatska terapija. Iako veÄina bolesnika izmokri kamence, u preostalih se koriste razliÄite, prije svega, kirurÅ”ke metode uklanjanja kamenca. U prevenciji kamenaca najvažniji su Äimbenici velik unos tekuÄine, uz posljediÄnu obilnu diurezu, te dijetalne mjere.The prevalence of urinary stones is increasing. The majority of stones are caused by metabolic abnormality but, despite this, specific metabolic abnormality cannot be found in most patients. In most cases causal therapy is not possible so that the therapy of symptoms is the only option. Despite the fact that most patients spontaneously eliminate stones, different surgical methods are available. The cornerstone of stone prevention is a high fluid input with increased urine volume as well as diet
Radical surgical treatment of urinary bladder cancer: our experiences
Svrha rada je analiza bolesnika oboljelih od raka mokraÄnoga mjehura, kod kojih je uÄinjena radikalna operacija. U razdoblju 1972.-2004. lijeÄili smo 1708 bolesnika sa rakom mokraÄnoga mjehura. Radikalnom kirurÅ”kom zahvatu podvrgnuto je 239 (14%) bolesnika. MuÅ”karaca je bilo 188 (78,7%), a žena 51 (21,3%). NajviÅ”e bolesnika bilo je u dobi izmeÄu 60. i 80. godine (171 - 71,5%). AnamnestiÄki je najÄeÅ”Äi i najvažniji simptom tumora mjehura hematurija 213 (89%). U naÅ”ih bolesnika bilo je 220 (92%) karcinoma prijelaznoga epitela, 13 (5,4%) planocelularnih tumora i 6 (2,5%) adenokarcinoma. Prema TNM klasifikaciji prevladava T3 stadij 118 (49,3%) i T2 stadij 94 (39,3%). Prema histoloÅ”kom kriteriju najÄeÅ”Äi je G3 stadij 186 (77,8%). Radikalnu cistektomiju samu ili kombiniranu s uretrektomijom uÄinili smo kod 203 (85%) bolesnika. Nažalost u 13% bolesnika (T3b i T4 stadij) podvezali smo samo unutarnje ilijaÄne žile zbog uznapredovaloga tumora. Vanjsku supravezikalnu derivaciju urina (Bricker, U-tubing nefrostoma) uÄinili smo kod 188 (78,7%) bolesnika. Unutarnju derivaciju (Coffey, Ureteroileosigmoidostomia, Mainz-Pouch II) rabili smo u 23 (9,6%), a neovesiku (Hautmann, Studer) kod 28 (11,7%) bolesnika. Ranih poslijeoperacijskih komplikacija bilo je 83 (34,7%). MeÄu njima prevladavaju kirurÅ”ke 32 (13,4%) i komplikacije udaljenih organa 23 (9,6%). MeÄu kasnim komplikacijama prevladava uroinfekt 11 (4,6%) i ileus 8 (3,3%), koji su lijeÄeni uglavnom konzervativno. U bolesnika s negativnim Ävorovima 72 (30%) preživjelost je nakon pet godina bila 62%. Kod bolesnika s pozitivnim Ävorovima 59 (24,6%), preživjelost nakon pet godina bila je 44%. NajloÅ”iju prognozu imala je skupinabolesnika (13%), gdje zbog opsežnoga procesa nismo uspjeli uÄiniti cistektomiju. Kod njih su podvezane ilijaÄne žile, a lijeÄeni su radioterapijom i kemoterapijom. Nakon godine dana preživjelost je bila oko 9%.In the period from 1972-2004, 1708 patients with bladder cancer were treated. 239 (14 %) of them were treated by means of radical surgical procedures. There were 188 (78.7%) male and 51 (21.3%) female patients. The average age was between 60 and 80 (171 71.5%). The most frequent and the most important symptom of bladder cancer is hematuria 213 (89%). In our patients there were 220 (92%) epithelial cancers, 13 (5.4%) planocellular cancers and 6 (2.5%) adenocarcinomas. According to TNM classification, T3 stage (118 - 49.3%) and T2 stage (94- 39.3%) were predominant in our study. According to histological criteria, the most common was G3 stage (186 -77.8%). Radical cystectomy alone or combined with urethrectomy was done in 203 (85%) patients. Unfortunately, in 13% of patients (T3b and T4 stages) inner iliac blood vessels were tied off due to a progressive cancer. Outer supravesicular urine derivation (Bricker, U-tubing nephrostoma) was done in 188 (78.7%) patients. Inner derivation (Coffey, uretheroileosigmoidostomy, Mainz-Pouch II) was done in 23 (9.6%) and neovesica (Hautmann, Studer) in 28 (11.7%) patients. There were 83 (34.7 %) early postoperative complications. Among them the most dominant ones were surgical 32 (13.4%) and distant organ complications 23 (9.6%). Among late complications, predominant ones were uroinfection 11 (4.6%) and ileus 8 (3.3%), which were treated conservatively. In the patients with negative nodes 72 (30%), the survival rate after five years was 62%. In the patients with positive nodes 59 (24.6%), the survival rate after five years was 44%. The least favorable prognosis was for patients (13%) in whom cystectomy could not be done due to a progressive process. In these patients, iliac blood vessels were tied off and they were treated with radiotherapy and chemotherapy. The survival rate was 9% after one year
Our experiences in treatment of prostate carcinoma
Tijekom 14 godina (1991.-2004.) kod 1082 bolesnika dijagnosticirali smo karcinom prostate. ViÅ”e od 59% bolesnika bili su u dobi iznad 70 godina. NajÄeÅ”Äi simptomi karcinoma prostate bili su uÄestalo mokrenje i križobolja. Kod prvoga pregleda oko 37% bolesnika imalo je zahvaÄena oba lobusa prostate, a kod 39% bolesnika naÄene su metastaze. NajÄeÅ”Äe su metastaze (35%) u koÅ”tanom sustavu (kosti zdjelice i LS kraljeÅ”nica), a samo u 4% bolesnika naÅ”li smo ih u solidnim organima (pluÄa i jetra). Po TNM klasifikaciji stadiji T1 i T2 dijagnosticirani su kod 752 (70%) bolesnika. PatohistoloÅ”kim pregledom kod 56% bolesnika naÄen je Gleason score 2, a Gleason score 3 kod 35%. Kod samo 9% bolesnika uÄnili smo radikalnu prostatektomiju. NajÄeÅ”Äe smo primjenjivali kombinaciju kastracije i antiandrogena (55% bolesnika) te kombinaciju kastracije i Estracyta (20%).In the course of 14 years (from 1991 to 2004) we had diagnosed the prostate carcinoma in 1082 patients. More than 59% patients were over 70 years old. The most frequent symptoms of prostate carcinoma are frequent urination and backache. At first examination 37% of patients had both prostate lobes involved, while in 39% of patients there were metastases. The most frequent (35%) were in bone system (pelvis and spine); while only in 4% we found metastases in solid organs (lungs and liver). According to the TNM classification, T1 and T2 were diagnosed in 752 (70%) of patients. Pathohistological examination discovered Gleason score 2 in 56% of patients and Gleason score 3 in 35%. In 9% of patients we performed radical prostatectomy. Most often we applied the combination of castration and antiandrogen (55%) and combination of castration and Estracyt (20%)
Clinical evaluation of the sonography in patients with malignomas of the testis
U razdoblju od 1. sijeÄnja 1983. do 01. sijeÄnja 1990. godine u Službi za ultrazvuÄnu dijagnostiku KBC Rijeka pregledana su 874 bolesnika zbog razliÄite patologije skrotuma. U 26 bolesnika (2,97%) sonografski je dijagnosticirana fokalna lezija testisa, Å”to je ujedno i bila vodeÄa dijagnostiÄka metoda u indikaciji za operativni zahvat
Clinical evaluation of the sonography in patients with malignomas of the testis
U razdoblju od 1. sijeÄnja 1983. do 01. sijeÄnja 1990. godine u Službi za ultrazvuÄnu dijagnostiku KBC Rijeka pregledana su 874 bolesnika zbog razliÄite patologije skrotuma. U 26 bolesnika (2,97%) sonografski je dijagnosticirana fokalna lezija testisa, Å”to je ujedno i bila vodeÄa dijagnostiÄka metoda u indikaciji za operativni zahvat
Sonographic presentation of the emphysematous pyelonephritis
Prikazan je bolesnik s rijetkom kliniÄkom slikom akutnog emfizematoznog pijelonefritisa. UltrazvuÄnim pregledom dokazana je sonografska slika emfizematoznog pijelonefritisa. Isstaknute su prednosti ultrasonografije u dijagnostici i praÄenju bolesti tijekom terapeutskog postupka
Transplantacijska kirurgija
Rad iz knjige: Zdravstvo u SocijalistiÄkoj Republici Hrvatskoj : razvoj, stanje i perpektive. Knj. 2 : Medicinske struke
Transplantacijska kirurgija
Rad iz knjige: Zdravstvo u SocijalistiÄkoj Republici Hrvatskoj : razvoj, stanje i perpektive. Knj. 2 : Medicinske struke