30 KB211 KB26 KB192920262005Kern, AleksandraRems, Markoštevilka:11letnik:74str. 701-705ISSN:1318-0347COBISSID:20539097URN:URN:NBN:SI:doc-MVLFDHAVslSlovensko zdravniško društvoZdravniški vestnikAnalgesia, EpiduralAnalgezija epiduralnaanketeColonic NeoplasmsColonoscopydebelo črevoDebelo črevo, novotvorbeKirurški oddelek bolnišnicekirurško zdravljenjeKolonoskopijaNeoplasm StagingNovotvorba, stadijQuestionnairesrak (medicina)SurgerySurgery Department, HospitalStandardna kirurška oskrba raka debelega črevesa v Sloveniji 2004| Standard surgical treatment od colon cancer in Slovenia in 2004|Background. Surgical therapy of colon cancer has been changing in direction ofmultimodal treatment with decreasing of surgical stress response. Retrospective analysis of colon cancer surgery shows active surgical strategies in Slovenia and relations to therapeutic modalities of fast track surgery. Methods. All surgical departments in Slovenia received a questionnaire for the last ten treated patients with colon cancer in year 2004. It was oriented towards multimodal treatment of colon cancer. A completeresponse with 120 patients was achieved and all are included in the present analysis. Results. Mean age of patients was 68.7 years, 55% were female, 45% male. For preoperative preparation oral hyperosmolar solution was used in 72.5%. 19.2% of patients did not have any bowel preparation or received only enema. Epidural analgesia was used on average 39.1% of cases. Onfirst postoperative day nasogastric tube was in place in 78% of patients, drinking was allowed in 5% and in fourth day in 74% of cases. Eating of solid food was allowed on average on day 6th, on day 10th were 7% of patients still without slid food. On day four first defecation were in 51% of cases. Mean postoperative hospitalisation was 12.8 days. Conclusions. Surgical treatment of colon cancer in Slovenia at the end of year 2004 is still very traditional.There is much room for improvement especially regarding tubes, epiduralanalgesia, preoperative preparation and early eatingIzhodišča. Operativno zdravljenje raka debelega črevesa doživlja prilagoditve v smeri manjše obremenitve organizma s kirurškim stresom. V retrospektivni analizi zdravljenja bolnikov z rakom debelega črevesa v Sloveniji je prikazan terapevtski model trenutnega stanja in odnos do pristopa s pospešenim okrevanjem (fast tract surgery). Metode. Vsem kirurškim oddelkom je bil poslanvprašalnik o poteku zdravljenja zadnjih desetih bolnikov z rakom debelega črevesa v letu 2004. Vprašalnik je bil usmerjen v pomembne aktivnostiv modelu s pospešenim okrevanjem. Odgovorili so vsi oddelki (12). V analizo je vključenih 120 bolnikov. Rezultati. Povprečna starost vseh bolnikovje bila 68,7 leta. Med vključenimi je bilo 55% žensk in 45% moških. Zapredoperativno čiščenje je bila uporabljena v 72.5% oralna hiperosmolarna tekočina, brez čiščenja in samo s klizmo je bilo pripravljenih 19,2% bolnikov.Epiduralna analgezija je bila uporabljena pri 39,1% bolnikov. Prvi pooperativni dan je imelo nazogastrično sondo vstavljeno 78% bolnikov, pilo jih je 5%. četrti dan pa 74% bolnikov. Z uživanjem hrane so bolniki pričeli povprečno 6. dan, deseti dan še ni jedlo 7% bolnikov, do četrtega pooperativnega dne je odvajalo 51% bolnikov. Povprečna pooperativna hospitalizacija je bila 12,8 dneva. Zaključki. V letu 2004 je operativno zdravljenje raka debelega črevesa še zelo oddaljeno od pristopa s pospešenim okrevanjem. Veliko možnosti za izboljšanje je pri uporabi predoperativnega čiščenja, epiduralne analgezije, nazogastričnih sond in zgodnjega hranjenjaTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo