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Risks and limits of laparoscopy in the treatment of gynecological cancers
Charvát, Martin ; Robová, Helena (advisor) ; Kužel, David (referee) ; Mlynček, Miloš (referee)
The thesis evaluates the results of experimental protocol involving the fertility sparing treatment procedure in early stage cervical carcinoma (LAP I protocol). Sentinel lymph node detection and experimental extirpation of afferent channels using laparoscopy and its technical aspects were analysed in prospective group of 85 women. The oncologic results and early/late morbidity show that established surgical procedures can be considered safe with minimal morbidity, provided that the indication criteria are met. The second part analyses the results of 148 women with no further pregnancy plans suffering from cervical tumors less than 2 cm in size with invasion less than half of the stroma (LAP II protocol). The oncological results in our defined group are very good and comparable to 'standard' procedure of modified radical hysterectomy type B or C with lower morbidity. In the separate section the thesis analyses the possibilities of laparoscopy in endometrial cancer treatment including the potentials of use of sentinel lymph node detection and technical aspects of laparoscopy in obese women. Currently the biggest controversy is the use of laparoscopy in malignant ovarian tumors. Our oncogynaecological study group at FN Motol prefers the laparotomic approach and we chose to include the set of advanced...
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Risks and limits of laparoscopy in the treatment of gynecological cancers
Charvát, Martin ; Robová, Helena (advisor) ; Kužel, David (referee) ; Mlynček, Miloš (referee)
The thesis evaluates the results of experimental protocol involving the fertility sparing treatment procedure in early stage cervical carcinoma (LAP I protocol). Sentinel lymph node detection and experimental extirpation of afferent channels using laparoscopy and its technical aspects were analysed in prospective group of 85 women. The oncologic results and early/late morbidity show that established surgical procedures can be considered safe with minimal morbidity, provided that the indication criteria are met. The second part analyses the results of 148 women with no further pregnancy plans suffering from cervical tumors less than 2 cm in size with invasion less than half of the stroma (LAP II protocol). The oncological results in our defined group are very good and comparable to 'standard' procedure of modified radical hysterectomy type B or C with lower morbidity. In the separate section the thesis analyses the possibilities of laparoscopy in endometrial cancer treatment including the potentials of use of sentinel lymph node detection and technical aspects of laparoscopy in obese women. Currently the biggest controversy is the use of laparoscopy in malignant ovarian tumors. Our oncogynaecological study group at FN Motol prefers the laparotomic approach and we chose to include the set of advanced...
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Lymphedema of the upper extremity as a complication after breast tumour curative radiotherapy.
LOUDA, Marek
Lymphedema of the upper extremity is a serious complication after breast cancer treatment. This thesis concerns lymphedema of the upper extremity after a curative treatment for breast cancer. Describes breast cancer therapy, its methods and curative purposes. Explain what sentinel node disection is and what compliactins expect after its removal. Becouse essential part in breast cancer treatment také radiotherapy, thesis intoduces radiation dozes, radiation volums and radiation therapy technique. The goal of this thesis was to evaluate number of lymphedema of the upper extremity at patients after axilary node disection and at patients after sentinel node disection and adjuvant radiation therapy treatment. The explorative question was whether a sentinel node disection reduces origin of lymphedema upper extremity independently on radiation therapy extent and iradiation volum. The metholodgy was based on collecting data of patients with breast cancer tumour from register of oncological patients in Hospital České Budějovice joint stock company. Data were subsequently processed and compared to data obtained from vocational literature.
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Lymphoscintigraphy {--} the posibility of detection of sentinel lymph node
SVOBODOVÁ, Petra
At present, sentinel node identification through the use of lymphoscintigraphy is one of the standard methods of tumor diagnosis and treatment. The most frequent indications for the sentinel node are breast cancer and malignant melanoma. Lymphoscintigraphy is a noninvasive method enabling imaging lymph flow from the injection site through lymphatic vessels via catchment nodes onwards. In fact, the sentinel node detection method is just a specialized part of the general lymphoscintigraphy. The objective of this thesis was to assess sentinel lymph nodes imaging using lymphoscintigraphy and using agamasonde. I made up a group of 77 patients from the Regional Hospital Kolín as a research sample that underwent the sentinel lymph node detection in the nuclear medicine department. In the cases of breast cancer, the sentinel lymph node was imaged in 95% by using lymphoscintigraphy. Without the possibility of using the gamasonde measurement that figure would be 91%. By combining the both methods the reliability of detection is increased.
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