{"id":204376,"date":"2020-10-03T12:39:31","date_gmt":"2020-10-03T11:39:31","guid":{"rendered":"http:\/\/zakrasnejsivimperk.cz\/?p=204376"},"modified":"2020-10-03T18:25:03","modified_gmt":"2020-10-03T17:25:03","slug":"ceske-budejovice-lekari-zdejsi-nemocnice-provedli-unikatni-operaci-prvni-sveho-typu-v-ceske-republice","status":"publish","type":"post","link":"https:\/\/zakrasnejsivimperk.cz\/?p=204376","title":{"rendered":"\u010cESK\u00c9 BUD\u011aJOVICE: L\u00e9ka\u0159i zdej\u0161\u00ed nemocnice provedli unik\u00e1tn\u00ed operaci. Prvn\u00ed sv\u00e9ho typu v \u010cesk\u00e9 republice"},"content":{"rendered":"

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Na Odd\u011blen\u00ed kardiochirurgie a hrudn\u00ed chirurgie Nemocnice \u010cesk\u00e9 Bud\u011bjovice byla v r\u00e1mci pilotn\u00ed studie provedena unik\u00e1tn\u00ed operace, p\u0159i kter\u00e9 byl b\u011bhem jednoho chirurgick\u00e9ho z\u00e1kroku odstran\u011bn plicn\u00ed n\u00e1dor a z\u00e1rove\u0148 byla zal\u00e9\u010dena srde\u010dn\u00ed arytmie. Jednalo se o v\u016fbec prvn\u00ed operaci tohoto typu v \u010cesk\u00e9 republice.<\/h6>\n

\"\"\u201eZhoubn\u00e1 onemocn\u011bn\u00ed plic jsou prov\u00e1zena \u0159adou komplikac\u00ed a pat\u0159\u00ed k nim i poruchy krevn\u00ed sr\u00e1\u017elivosti,\u201c<\/em> popisuje Vojt\u011bch Kurfirst, autor projektu a dod\u00e1v\u00e1: \u201eNemocn\u00ed maj\u00ed bu\u010f sklon ke krv\u00e1cen\u00ed, nebo naopak k tvorb\u011b tromb\u00f3zy a plicn\u00ed nebo syst\u00e9mov\u00e9 embolie. Toto riziko je je\u0161t\u011b vystup\u0148ov\u00e1no u pacient\u016f s fibrilac\u00ed s\u00edn\u00ed. Nejvy\u0161\u0161\u00ed riziko c\u00e9vn\u00ed mozkov\u00e9 p\u0159\u00edhody maj\u00ed pacienti s n\u00e1dorov\u00fdm onemocn\u011bn\u00edm pankreatu, plic a tlust\u00e9ho st\u0159eva. Nej\u010dast\u011bj\u0161\u00edm zdrojem tromboembolismu je potom ou\u0161ko lev\u00e9 s\u00edn\u011b.\u201c<\/em><\/p>\n

Fibrilace s\u00edn\u00ed je nej\u010dast\u011bj\u0161\u00ed arytmi\u00ed, jej\u00ed\u017e v\u00fdskyt \u010din\u00ed v evropsk\u00e9 populaci jedno a\u017e dv\u011b procenta. V\u00fdskyt v populaci onkologick\u00fdch pacient\u016f je je\u0161t\u011b vy\u0161\u0161\u00ed (podle n\u011bkter\u00fdch \u00fadaj\u016f t\u00e9m\u011b\u0159 10 procent). \u201eVznik fibrilace s\u00edn\u00ed je tak\u00e9 u onkologick\u00fdch pacient\u016f odli\u0161n\u00fd. Vzhledem k prokoagula\u010dn\u00edmu lad\u011bn\u00ed organizmu je u t\u011bchto pacient\u016f automaticky indikovan\u00e1 trval\u00e1 antikoagula\u010dn\u00ed terapie. Obecn\u011b lze konstatovat, \u017ee pacienti s fibrilac\u00ed s\u00edn\u00ed a onkologick\u00fdm onemocn\u011bn\u00edm jsou z hlediska tromboembolie vysoce rizikovou skupinou,\u201c<\/em> \u0159\u00edk\u00e1 Ale\u0161 Mokr\u00e1\u010dek, prim\u00e1\u0159 odd\u011blen\u00ed kardiochirurgie.<\/p>\n

\u201eU nemalobun\u011b\u010dn\u00fdch karcinom\u016f plic ve stadiu I, II, IIIa je metodou volby radik\u00e1ln\u00ed resekce n\u00e1doru. Operace je standardizov\u00e1na a b\u011b\u017en\u011b pou\u017e\u00edvan\u00e1 jak v klasick\u00e9 form\u011b, tak i pomoc\u00ed minim\u00e1ln\u011b invazivn\u00edch, tzn. pro pacienta \u0161etrn\u00fdch metod,\u201c<\/em> dod\u00e1v\u00e1 Ji\u0159\u00ed Krbec, prim\u00e1\u0159 odd\u011blen\u00ed hrudn\u00ed chirurgie.<\/p>\n

L\u00e9\u010dbu fibrilace s\u00edn\u00ed lze tak\u00e9 prov\u00e9st chirurgicky s velmi dobr\u00fdmi dlouhodob\u00fdmi v\u00fdsledky. Tato operace se naz\u00fdv\u00e1 MAZE procedura a jej\u00ed princip spo\u010d\u00edv\u00e1 v proveden\u00ed p\u0159esn\u011b ur\u010den\u00fdch chirurgick\u00fdch \u201e\u0159ez\u016f\u201c v srde\u010dn\u00edch s\u00edn\u00edch a uz\u00e1v\u011bru ou\u0161ka lev\u00e9 s\u00edn\u011b, kter\u00fdm se sn\u00ed\u017e\u00ed poopera\u010dn\u00ed riziko vzniku c\u00e9vn\u00ed mozkov\u00e9 p\u0159\u00edhody. \u201eV tomto p\u0159\u00edpad\u011b se jednalo o pacienta s karcinomem plic a fibrilac\u00ed s\u00edn\u00ed, kter\u00fd byl ji\u017e po c\u00e9vn\u00ed mozkov\u00e9 p\u0159\u00edhod\u011b. V r\u00e1mci jedn\u00e9 operace jsme u n\u011bho provedli odstran\u011bn\u00ed plicn\u00edho laloku s n\u00e1dorem a z\u00e1rove\u0148 uz\u00e1v\u011br ou\u0161ka lev\u00e9 s\u00edn\u011b, kter\u00e9 by m\u011blo pacienta chr\u00e1nit p\u0159ed dal\u0161\u00ed mozkovou p\u0159\u00edhodou. V\u0161e ze \u0161etrn\u00e9ho mal\u00e9ho \u0159ezu na lev\u00e9 stran\u011b hrudn\u00edku. Operace se povedla bez komplikac\u00ed a pacientovi se m\u011bs\u00edc po operaci da\u0159\u00ed velmi dob\u0159e. Na vzniku tohoto projektu se spolupod\u00edlel Vladislav Hytych z odd\u011blen\u00ed hrudn\u00ed chirurgie Thomayerovy nemocnice v Praze, kter\u00fd p\u0159ijel vypomoci s operac\u00ed\u00a0<\/em>a kter\u00fd m\u00e1 s t\u00edmto \u0161etrn\u00fdm chirurgick\u00fdm postupem l\u00e9\u010dby plicn\u00edch n\u00e1dor\u016f v \u010cech\u00e1ch nejv\u011bt\u0161\u00ed zku\u0161enosti,”<\/em> \u0159\u00edk\u00e1 Vojt\u011bch Kurfirst.<\/p>\n

\u201eTento zp\u016fsob l\u00e9\u010dby nab\u00edz\u00ed Odd\u011blen\u00ed kardiochirurgie a hrudn\u00ed chirurgie jako jedin\u00e9 v \u010cesk\u00e9 republice. Je v\u00fdsledkem \u00fazk\u00e9 mezioborov\u00e9 spolupr\u00e1ce mezi ob\u011bma specializacemi,\u201c<\/em> dod\u00e1v\u00e1 Ladislav Pe\u0161l, \u0159editel kardiocentra, pod kter\u00e9 v\u00fd\u0161e zm\u00edn\u011bn\u00e9 odd\u011blen\u00ed spad\u00e1.<\/p>\n

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