| Abstract | Cilj: Cilj ovog istraživanje bio je prikaz utjecaja dobi dana na poslijeoperacijske ishode
bolesnika operiranih zbog mehaničke opstrukcije debelog crijeva uzrokovane karcinomom.
Ispitanici i postupci: 132 punoljetna bolesnika operirana zbog mehaničke opstrukcije kolona
uzrokovane karcinomom tijekom 2020. i 2021. Od toga 54 žene, odnosno 40,9%. Desna
hemikolektomija urađena je kod 46 operiranih ili 35,6%, a stoma je formirana u ukupno 60
bolesnika ili 45,5%. Uspoređivana je dob, spol, vrijeme početka, trajanje i vrsta zahvata,
patohistološka dijagnoza, transfuzija i otpust.
Rezultati: Umrlo je ukupno 9 bolesnika, odnosno 6,8%, a transfuziju je primilo 18 ili 13,6%.
Medijan duljine boravka u bolnici bio je 6,0 dana (IQR 5,0-8,0 dana), odstranjenih limfnih
čvorova 15,0 (IQR 9,3-21,0) i trajanja operacijskog zahvata 107,5 min (IQR 80,0-130,0 min).
Trajanje hospitalizacije kod muškaraca bilo je statistički dulje za 1,0 dan (95%CI: 0,00-2,0;
P=0,018). Medijan trajanja zahvata kod muškaraca bio je 110 min (90-135), a kod žena 95min
(80-116; P=0,033). Od dva do osam sati nije se pristupalo operacijama. Broj limfnih čvorova
nije u korelaciji s vremenom početka zahvata (Pearsov koeficijent korelacije r=0,042;
95%CI:0,133-0,215; P=0,640). U popodnevnoj smjeni (14-22h) medijan odstranjenih limfnih
čvorova je 18,0 (IQR 11-22), a u noćnoj (22-6h) je 12 (IQR 7-0). Trajanje operacije nije se
razlikovalo ovisno o dobu dana, no rangiranje medijana upućuje na razliku popodnevne i noćne
smjene (P=0,387). Formiranje stome nije se razlikovalo u smjenskim skupinama (P=0,156).
Zaključak: Broj odstranjenih limfnih čvorova nije povezan s vremenom početka operativnog
zahvata, no pri podjeli smjenskog rada postoje naznake o određenim razlikama. Veći broj
odstranjen je u popodnevnoj smjeni u odnosu na noćnu. Trajanje zahvata također nije u
korelaciji s vremenom početka zahvata, ali postoje naznake da noćni zahvati traju duže od
popodnevnih. Formiranje stome neovisno je o dobu dana. |
| Abstract (english) | Objectives: 132 adults operated because of mehanical bowel obstruction caused by colorectal
cancer during 2020 and 2021. There were 54 women or 40.9%. Right hemicolectomy was
performed in 46 operated patients (35.4%) and in 60 patients (45.5%) stoma was formed. We
compared age, sex, start time, duration and type of procedure, PHD, transfusion and discharge.
Subjects and methods: A total of 9 patients died, or 6.8%, and 18 or 13.6% patients recieved
blood transfusion. The median length of hospital stay was 6.0 days (IQR 5.0-8.0 days), number
of removed lymph nodes was 15.0 (IQR 9.3-21.0) and duration of surgery 107.5 min (IQR 80.0-
130.0). The duration of hospitalisation in men was statistically longer by 1.0 day (95%CI: 0.00-
2.0; P=0.018). The median duration of procedure in men was 110min (90-135), and in women
95 (85-116; P=0.033). There were no operations between 2 and 8 o“clock. The number of
removed lymph nodes does not correlate with the start time of procedure (Pears correlation
coefficient r=0.042; 95%CI: 0.133-0.215; P=0.640). In the afternoon shift (14-22h) median of
lymph nodes is 18.0 (IQR 11-22), and in the night shift (22-6h) it is 12.0 (IQR7-0). The duration
of operation does not depend on time of day, but median ranking indicates a difference between
afternoon and night shift (P=0.387). There was no difference in stoma formation between shifts
(P=0,156).
Results: The number of removed lymph nodes is not related to the start time of operation, but
there are some indications of certain differences between shift work. There was higher number
of removed nodes during afternoon shift compared to the night shift. The duration of procedure
is also not correlated with the start time, but there are some indications that night procedures
last longer than afternoon ones. The stoma formation does not depend on time of the day. |
