| Abstract | CILJ ISTRAŽIVANJA: cilj ovog rada bio je usporediti vrijednosti parametara crvene krvne slike, ostatnu bubrežnu funkciju i onkološke karakteristike tumora u bolesnika operiranih parcijalnom i radikalnom operacijom zbog raka bubrega.
MATERIJALI I METODE: Provedeno je retrospektivno kliničko istraživanje na temelju podataka iz operacijskih protokola i pismohrana bolesti Odjela za urologiju Kliničkog bolničkog centra u Splitu u vremenskom periodu od 1. siječnja 2011. do 31. prosinca 2014. godine. Studija je obuhvatila 247 bolesnika. Bolesnici su podijeljeni u dvije skupine, bolesnici operirani parcijalnom nefrektomijom (52 bolesnika) i bolesnici operirani radikalnom nefrektomijom (195 bolesnika). Dob i spol bolesnika, patohistološki nalaz, Fuhrman gradus, prisutnost sarkomske komponente, vrijednosti crvene krvne slike, vrijednosti ureje i kreatinina, transfuzija krvi i plazme, postoperativna temperatura, infekcija kirurške rane, sekrecija na dren, vrijeme uklanjanja drena, vrijeme uklanjanja šavi i vremensko trajanje hospitalizacije su uspoređivani između dvije skupine bolesnika.
REZULTATI: Između operiranih skupina nije bilo značajne razlike u dobi i spolu te vrsti operativnog zahvata. Prije operacije nije bilo razlike ni u vrijednostima crvene krvne slike među skupinama. U skupini radikalno operiranih svi parametri crvene krvne slike su bili značajno niži nakon operativnog zahvata. Kod ovih bolesnika vrijednost kreatinina statistički je značajno porasla nakon radikalne nefrektomije (p<0.001). U skupini parcijalno operiranih vrijednosti broja eritrocita, koncentracije hemoglobina te vrijednosti hematokrita značajno su bili niži nego prije operativnog zahvata. Ostale vrijednosti parametara crvene krvne slike nisu se statistički značajno promijenile, kao ni vrijednosti ureje i kreatinina. Između Fuhrman gradusa tumora i vrste zahvata dokazana je statistički značajna razlika (p=0.001). U obje skupine najviše bolesnika bilo je Fuhrman gradusa 2, dok je zastupljenost višeg gradusa značajno veća u skupini radikalno operiranih.
ZAKLJUČAK: Bolesnici nakon parcijalne nefrektomije imaju bolju ostatnu bubrežnu funkciju, nego bolesnici nakon radikalne nefrektomije. Bolesnici operirani radikalnom nefrektomijom imaju znatno lošije onkološke karakteristike tumora u odnosu na bolesnike operirane parcijalnom nefrektomijom. |
| Abstract (english) | OBJECTIVES: The aim of this study was to compare the values of the parameters of red blood count, residual renal function and oncologic characteristics of tumors in patients treated with partial and radical surgery for kidney cancer.
MATERIALS AND METHODS: A retrospective clinical study based on data from operational protocols and archives disease was conducted in the Department od Urology, University Hospital Center in Split in the period from 1st January 2011 to 31st December 2014. The study included 247 patients. Patients were divided into two groups, patients operated with partial nephrectomy (52 patients) and patients operated with radical nephrectomy (195 patients). Age and sex of patients, histopathologic findings, Fuhrman gradus, presence of sarcoma components, values of red blood count, urea and creatinine values, blood and plasma transfusions, postoperative fever, infections of surgical wounds, the secretion on the drain, the removal time of drainage, the removal time of surgical sutures and weather length of hospitalizaton were compared between the two groups of patients.
RESULTS: Among treated group there was no significant differences in age and sex and the type of surgery. Before the operation there was no difference in the values of red blood count among groups. In the group of radical nephrectomy, all parameters of red blood count were significantly lower after surgery. In these patients, serum creatinine was significantly increased after radical nephrectomy (p<0.001). In the group of partial nephrectomy value of the number of red blood cells, hemoglobin concentrations and hematocrit values were significantly lower than before the surgery. Other parameter values of red blood count were not significantly changed, as well as values of urea and creatinine. Between Fuhrman grade of the tumor and the type of surgery has been demonstrated a statistically significant difference (p=0.001). In both groups, most patients were Fuhrman grade 2, while the presence of a higher grade is significantly higher in the group of radical surgery.
CONCLUSION: Patients after partial nephrectomy have better residual renal function, than patients after radical nephrectomy. The patients who had surgery with radical nephrectomy have significantly worse oncologic characteristics of the tumor compared to patients operated with partial nephrectomy. |
