Utjecaj sternokleidomastoidnoga mišića na protočnost unutarnje jugularne vene nakon disekcije vrata

Sauerborn, Damir

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doctoral thesis

Utjecaj sternokleidomastoidnoga mišića na protočnost unutarnje jugularne vene nakon disekcije vrata

Zagreb: University of Zagreb, School of Medicine, 2017. urn:nbn:hr:105:834372

Sauerborn, Damir

University of Zagreb
School of Medicine

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APA 6th Edition

Sauerborn, D. (2017). Utjecaj sternokleidomastoidnoga mišića na protočnost unutarnje jugularne vene nakon disekcije vrata (Doctoral thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:834372

MLA 8th Edition

Sauerborn, Damir. "Utjecaj sternokleidomastoidnoga mišića na protočnost unutarnje jugularne vene nakon disekcije vrata." Doctoral thesis, University of Zagreb, School of Medicine, 2017. https://urn.nsk.hr/urn:nbn:hr:105:834372

Chicago 17th Edition

Harvard

Sauerborn, D. (2017). 'Utjecaj sternokleidomastoidnoga mišića na protočnost unutarnje jugularne vene nakon disekcije vrata', Doctoral thesis, University of Zagreb, School of Medicine, accessed 20 April 2024, https://urn.nsk.hr/urn:nbn:hr:105:834372

Vancouver

Sauerborn D. Utjecaj sternokleidomastoidnoga mišića na protočnost unutarnje jugularne vene nakon disekcije vrata [Doctoral thesis]. Zagreb: University of Zagreb, School of Medicine; 2017 [cited 2024 April 20] Available at: https://urn.nsk.hr/urn:nbn:hr:105:834372

IEEE

D. Sauerborn, "Utjecaj sternokleidomastoidnoga mišića na protočnost unutarnje jugularne vene nakon disekcije vrata", Doctoral thesis, University of Zagreb, School of Medicine, Zagreb, 2017. Available at: https://urn.nsk.hr/urn:nbn:hr:105:834372

Cite this item: https://urn.nsk.hr/urn:nbn:hr:105:834372

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Title	Utjecaj sternokleidomastoidnoga mišića na protočnost unutarnje jugularne vene nakon disekcije vrata
Author	Damir Sauerborn
Mentor	Mihajlo Virag (mentor)
Committee member	nije dostupno (član povjerenstva)
Granter	University of Zagreb School of Medicine Zagreb
Defense date and country	2017-06-13, Croatia
Scientific / art field, discipline and subdiscipline	BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences
Universal decimal classification (UDC)	61 - Medical sciences
Abstract	Klasicna radikalna disekcija vrata je metoda kojom se odstranjuje limfni sustav vrata zajedno sa unutarnjom jugularnom venom, akcesornim živcem te sternokleidomastoidnim mišicem (SCM) zbog lijecenja i kontrole metastatske bolesti u vratu. Suvremeno shvacanje disekcije vrata podrazumijeva cuvanje svih važnijih anatomskih struktura u vratu u svrhu smanjenja morbiditeta i povecanja kvalitete života. Brojne su prednosti cuvanja unutarnje jugularne vene tijekom disekcije, iako jednostrano podvezivanje vene nije popraceno znacajnijim morbiditetom. Cuvanjem vene produžuje se operativni zahvat dok je u mnogim radovima opisana tromboza vene u kasnijem postoperativnom tijeku (od 0 do 30% slucajeva). U dosadašnjim radovima opisani su razliciti faktori koji mogu dovesti do tromboze unutarnje jugularne vene. Temeljitom analizom dostupne literature, na pocetku našeg istraživanja, nije na�ena niti jedna studija koja uzima u obzir cuvanje ili žrtvovanje SCM u odnosu na pojavu tromboze unutarnje jugularne vene. U ovom prospektivnom istraživanju usporedili smo utjecaj cuvanja i žrtvovanja SCM na protocnost i pojavu tromboze unutarnje jugularne vene nakon disekcije vrata. Tako�er smo analizirali utjecaj postoperativne radioterapije i mikrovaskularne rekonstrukcije na protocnost i pojavu tromboze unutarnje jugularne vene nakon disekcije. U studiju je ukljuceno ukupno 70 unutarnjih jugularnih vena koje su podijeljene u 2 skupine. U prvoj skupini imali smo 47 slucajeva kod kojih je ucinjena selektivna ili modificirana radikalna disekcija sa cuvanjem SCM, dok smo u drugoj skupini imali 23 slucaja kod kojih je ucinjena selektivna ili modificirana radikalna disekcija sa žrtvovanjem SCM. Za mjerenje protocnosti korišten je Doppler ultrazvuk i to neposredno prije operacije (1. mjerenje), 1 do 2 tjedna nakon operacije (2. mjerenje), 3 do 4 mjeseca nakon operacije (3. mjerenje) i 9 do 12 mjeseci nakon operacije (4. mjerenje). Analizom dobivenih rezultata utvrdili smo znacajno manji broj tromboza u skupini sa cuvanim SCM. Najveci broj tromboza nastao je u ranom postoperativnom periodu. U postoperativnom pracenju došlo je do ponovne uspostave protocnosti u velikom broju tromboziranih vena. Brzine protoka nisu se znacajnije mijenjale. Volumni protok je bio znacajno niži u ranom postoperativnom periodu u obje skupine te se postupno oporavljao u obje skupine. Postoperativna radioterapija i mikrovaskularna rekonstrukcija nisu utjecale na pojavu tromboze, na promjene brzine protoka niti na promjene volumnog protoka u obje skupine.
Abstract (english)	Classic radical neck dissection is a procedure that removes all lymphatic tissue of the neck together with internal jugular vein, accessory nerve and sternocleidomastoid muscle (SCM) for treatment and control of metastatic disease in the neck. Modern perception of the neck dissection includes preservation of all important neck structures with the purpose of minimizing morbidity and increasing quality of life. There are numerous advantages of preservation of internal jugular vein during neck dissection, although unilateral ligation of the vein is not associated with severe morbidity. Preservation of vein prolongs surgical procedure while, in many studies, vein becomes thrombotic in postoperative period (from 0 to 30% of cases). According the literature, many different factors may cause internal jugular vein thrombosis. After a literature review, at the beginning of our study, we did not find any study that relates internal jugular vein thrombosis to preservation or sacrifice of SCM. In this prospective study, we compared preservation and sacrifice of SCM according to patency and thrombosis of the internal jugular vein after neck dissection. We also analysed influence of postoperative radiotherapy and microvascular reconstruction on internal jugular vein patency and thrombosis after neck dissection. We included 70 internal jugular veins that were divide in 2 groups. The first group included 47 cases with selective or modified radical neck dissection and preservation of the SCM, while second group included 23 cases with selective or modified radical neck dissection and resection of the SCM. For measurement of patency we used Doppler ultrasound, with first measurement being preoperative, second measurement 1 to 2 weeks postoperative, third measurement 3 to 4 months postoperative and fourth measurement 9 to 12 months postoperative. In our analysis, we found significant lower proportion of thrombosis in the group with preserved SCM. Major number of thrombosis occurred in the early postoperative period. In follow up, large number of thrombosed veins underwent recanalization. Flow speed did not change significantly. Flow volume was significantly lower in early postoperative period in both groups and recovered in postoperative period in both groups. Postoperative radiotherapy and microvascular reconstruction did not have impact on thrombosis, change of flow speed and flow volume in both groups.
Keywords
Keywords (english)
Language	croatian
URN:NBN	urn:nbn:hr:105:834372
Study programme	Title: Biomedicine and Health Sciences Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstva (doktor/doktorica znanosti, područje biomedicine i zdravstva)
Type of resource	Text
Extent	90 str.
File origin	Born digital
Access conditions	Open access
Terms of use
Repository	Dr Med - University of Zagreb School of Medicine Digital Repository
Created on	2023-05-05 07:57:54

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