Details

Autor(en) / Beteiligte

• Ivanovic, S.
• Slavik, Eugen
• Spaic, M.
• Antic, Branislav
• Samardzic, M.
• Rasulic, L.

Titel

Hordotomija u lecenju bolnih stanja

Ist Teil von

• Acta chirurgica Iugoslavica, 2004, Vol.51 (4), p.49-51

Erscheinungsjahr

2004

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• During the time interval from January 1978 to January 2003, total of 128 chordotomy procedures have been done due to cancer?s pain at the Institute of neurosurgery in Clinical Center of Serbia. That pain has been mostly of uncontrolled intensity and it was resistant on applied conservative treatment. Bilateral chordotomy has been performed in 6 patients only in exceptional cases when fixed paraplegia has proved; unilateral chordotomy has been performed in 122 cases. Bilateral chordotomy is much more dangerous than unilateral one because of greater possibility of appearance of motor deficits, sphincteral disturbances or subsequent formed pain. This procedure has several negative aspects. Firstly, it is an opened surgical intervention in general anesthesia and therefore, there is no communication with patient. We had a habit to perform DREZ surgery rather than chordotomy when ever it has been indicated. In 80.1% of all cases, the successfulness of surgery has been marked as excellent, in 15.2% of all cases, it has been marked as good, and in 4.7% of all cases, bad outcome has been detected. The rate of complication was 4.4%. U periodu od januara 1978. do januara 2003., u Institutu za neurohirurgiju Klinickog centra Srbije uradjeno je 128 hordotomija kod kancerskog bola. Uglavnom je to bio nekontrolisani bol koji se nije mogao kupirati medikamentima i drugim konzervativnim sredstvima. Samo cest puta smo bili u prilici da uradimo obostranu hordotomiju kod instalirane paraplegije; 122 puta je hordotomija uradjena unilateralno. Opasnost od bilateralne hordotomije je mnogo veca usled verovatnog nastanka motornih ispada, sfinkterijalnih smetnji i naknadno oformljenog bola. Procedura ima i svojih negativnih strana. Prvo, radi se o otvorenoj hirurgiji, bez komunikacije sa bolesnikom u toku same procedure, jer je bolesnik u opstoj anesteziji. Kad god smo bili u situaciji, zamenili smo hordotomiju DREZ operacijom, ako je ova bila indikovana. U 80.1% uspeh operacije je bio odlican, dobar u 15.2% i los u 4.7%. Komplikacije su se javile u 4.4%.