Author:
Péter Kupcsulik
Péter Kupcsulik
I. Sz. Sebészeti Klinika, Semmelweis Egyetem, 1082, Budapest, Üllői út 78.
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Absztrakt
A májdaganatok kezelésében a sebészi eltávolítás jelenti a gyógyítás legfontosabb módszerét. A diagnosztika és a sebészi módszerek fejlődése javította az eredményeket és a túlélést. Az utóbbi évtizedben a minimálisan invasiv laparoscopos (LAP) módszereket egyre több májsebészeti centrum alkalmazza. A LAP-technika a korábbi kisebb resectióktól a kiterjesztett műtétek irányába fejlődik. Ez a változás viszonylag lassú, amelynek oka a beavatkozás bonyolultsága és a vérzéstől való félelem. Ennek ellenére a nagy resectiók aránya egyre növekszik. Eddig hozzávetőlegesen 6000 LAP-májresectiót végeztek világszerte, a major műtétek száma 700–800 lehet. A LAP-májresectio esetén a kisebb vérvesztés, fájdalomcsillapító-igény, rövidebb kórházi ápolási idő előnyös a beteg számára, a szövődmények és a halálozás a nyitott műtétekével azonos. Mai álláspont szerint alkalmazható benignus és malignus elváltozások kezelésére. Colorectalis májáttétek késői túlélése tekintetében nincs különbség a LAP- és a nyitott módszer között. A hepatocellularis carcinomás esetek túlélése jobb LAP-resectio után, mint nyitott műtéteket követően.
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Petz Aladár County Teaching Hospital, Surgery
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Kedvezőbb műtéti eredmények „onlay” hálóval, mint „sublay” helyzetben beültetettel
Varrattal, illetve hálóbeültetéssel történő hasfal-rekonstrukció prospektív, randomizált, multicentrikus vizsgálata – ötéves utánkövetés eredményei
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