| Abstract | Cilj ovog istraživanja je istražiti epidemiološka obilježja bolesnika oboljelih od karcinoma bubrega te usporediti razlike u kliničkim parametrima između 2D i 3D laparaskopske parcijalne nefrektomije. U ovom presječnom istraživanju, bilo je uključeno 33 bolesnika koji su u razdoblju od 01. siječnja 2015. do 31. prosinca 2020. godine hospitalizirani na Odjelu za urologiju OB Zadar te imali dijagnozu karcinoma bubrega. Ispitanici koji su imali dijagnozu tumora bubrega koji je liječen kirurškim putem u periodu od šest godina ispunjavali su kriterij uključenja u istraživanje. Hospitalizirani pacijenti su uz to raspodijeljeni prema spolu, životnoj (kronološkoj) dobi, županiji, vremenskom trajanju operacije, trajanju staze ishemije, veličini tumora, tipu tumora, resekcijskom rubu, vrsti operativnog zahvata te danima boravka na odjelu. Podatci su prikupljeni iz bolničkog informacijskog sustava i dokumentacije Odjela za urologiju OB Zadar. Kako bi se prikupili podaci za potrebe ovog presječnog istraživanja, korišten je bolnički informacijski sustav. Kako bi utvrdili deskriptivne parametre korištenih varijabli, korištena je aritmetička sredina (AS). Rezultati su pokazali da je u ovom istraživanju muški spol bio češći. Prosječna dob pacijenata u razdoblju od 2015. do 2017. godine bila je 59 godina, a u razdoblju od 2018. do 2020. godine 58,3 godina. Prosječno trajanje operativnog zahvata u razdoblju od 2015. do 2017. godine bilo je 2 sata i 10 minuta, dok je u razdoblju od 2018. do 2020. godine operativni zahvat trajao prosječno 1 sat i 52 minute. Prosječno trajanje hemostaze u razdoblju od 2015. do 2017. godine bilo je 24 minute a u razdoblju od 2018. do 2020. godine 21,1 minutu. Prosječna veličina tumora u razdoblju od 2015. do 2017. godine iznosila je 2,1 cm a u razdoblju od 2018. do 2020. godine 2,6 cm. Udio maligniteta u patohistološkim nalazima u razdoblju od 2015. do 2017. godine iznosio je 50%, a u razdoblju od 2018. do 2020. godine iznosio je 66%. Prosječno vrijeme boravka na odjelu u razdoblju od 2015. do 2017. godine bilo je 6,6 dana a u razdoblju od 2018. do 2020. godine 5,7 dana. Prosječno procijenjen gubitak krvi za vrijeme operativnog zahvata u razdoblju od 2015. do 2017. godine bio je 90 mililitara, dok je u razdoblju od 2018. do 2020. godine prosječni gubitak krvi iznosio 50 mililitara. Usporedba navedenih čimbenika i dobivenih rezultata pruža izuzetan uvid kod oba kirurška pristupa glede pozitivnih i negativnih strana. Prednosti 3D su kraće trajanje operativnog zahvata, kraće trajanje arterijske staze što je bitno za bolje očuvanje bubrežne funkcije te kraće trajanje hospitalizacije. Gubitak krvi u obje populacije je klinički zaista malen te je zanemariva razlika među njima. Kontinuirano praćenje pacijenta postoperativno s namjerom pravovremenog uočavanja komplikacija te uspješna reakcija s pravom terapijom u skladu s aktualnim potrebama je ključna kako bi ostvarila najbolji mogući ishod. Kljuĉne riječi su laparaskopija, nefrektomija, usporedba, tumor bubrega, liječenje |
| Abstract (english) | The aim of this study is to investigate the epidemiological characteristics of patients with kidney cancer and to compare the differences in clinical parameters between 2D and 3D laparoscopic partial nephrectomy. In this cross-sectional study, 33 patients were included who were hospitalized at the Urology Department of the OB Zadar between January 1, 2015 and December 31, 2020 and were diagnosed with kidney cancer. Respondents who had a diagnosis of a kidney tumor that was treated surgically within a period of six years met the criteria for inclusion in the study. In addition, hospitalized patients were divided according to gender, chronological age, county, duration of surgery, duration of ischemia, tumor size, tumor type, resection margin, type of surgery, and days spent in the ward. The data were collected from the hospital information system and documentation of the Department of Urology, OB Zadar. In order to collect data for the needs of this cross-sectional study, the hospital information system was used. In order to determine the descriptive parameters of the used variables, the arithmetic mean (AS) was used.The results showed that the male gender was more common in this study. The average age of patients in the period from 2015 to 2017 is 59 years, while in the period from 2018 to 2020 it is 58.3. The average duration of the operation in the period from 2015 to 2017 was 2 hours and 10 minutes, while in the period from 2018 to 2020 it was 1 hour and 52 minutes. The average duration of hemostasis in the period from 2015 to 2017 is 24 minutes, while in the period from 2018 to 2020 it is 21.1 minutes. The average tumor size in the period from 2015 to 2017 was 2.1 cm, while in the period from 2018 to 2020 it was 2.6 cm. The share of malignancy in pathohistological findings in the period from 2015 to 2017 is 50%, while in the period from 2018 to 2020 it is 66%. The average length of stay in the department in the period from 2015 to 2017 is 6.6 days, while in the period from 2018 to 2020 it is 5.7 days. The average estimated blood loss during surgery in the period from 2015 to 2017 was 90 milliliters, while in the period from 2018 to 2020 it was 50 milliliters. The results showed that the male gender was more common in this research. The average age of patients in the period from 2015 to 2017 was 59 years, and in the period from 2018 to 2020 it was 58.3 years. The average duration of the operation in the period from 2015 to 2017 was 2 hours and 10 minutes, while in the period from 2018 to 2020 the operation lasted an average of 1 hour and 52 minutes. The average duration of hemostasis in the period from 2015 to 2017 was 24 minutes, and in the period from 2018 to 2020, 21.1 minutes. The average tumor size in the period from 2015 to 2017 was 2.1 cm and in the period from 2018 to 2020 it was 2.6 cm. The share of malignancy in pathohistological findings in the period from 2015 to 2017 was 50%, and in the period from 2018 to 2020 it was 66%. The average length of stay in the department in the period from 2015 to 2017 was 6.6 days, and in the period from 2018 to 2020, 5.7 days. The average estimated blood loss during surgery in the period from 2015 to 2017 was 90 milliliters, while in the period from 2018 to 2020 the average blood loss was 50 milliliters. The comparison of the mentioned factors and the obtained results provides an exceptional insight into the positive and negative aspects of both surgical approaches. The advantages of 3D are a shorter duration of the operative procedure, a shorter duration of the arterial path, which is essential for better preservation of renal function, and a shorter duration of hospitalization. Blood loss in both populations is clinically really small and the difference between them is negligible. Continuous monitoring of the patient postoperatively with the intention of timely detection of complications and a successful response with the right therapy in accordance with the current needs is essential in order to achieve the best possible outcome. |
