{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T14:03:45Z","timestamp":1766066625604},"reference-count":0,"publisher":"Akademiai Kiado Zrt.","issue":"4","content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["MaSeb"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:title>Absztrakt<\/jats:title>\n        <jats:p>\n          <jats:italic>Bevezet\u00e9s:<\/jats:italic> B\u00e1r a stomak\u00e9pz\u0151 m\u0171t\u00e9tek sz\u00e1ma napjainkban egyre\n                    cs\u00f6kken, azonban amennyiben valamilyen okn\u00e1l fogva m\u00e9gis erre k\u00e9nyszer\u00fcl\u00fcnk,\n                    akkor ak\u00e1r 50%-ot el\u00e9r\u0151 gyakoris\u00e1ggal sz\u00e1molhatunk parastomalis s\u00e9rv\n                    kialakul\u00e1s\u00e1val. Az esetek mintegy harmad\u00e1ban ezek m\u0171t\u00e9ti korrekci\u00f3ra szorulnak,\n                    gyakran s\u00fcrg\u0151ss\u00e9ggel, \u00fcgyeleti k\u00f6r\u00fclm\u00e9nyek k\u00f6z\u00f6tt. Az alkalmazott m\u0171t\u00e9tt\u00edpusok\n                    nem egys\u00e9gesek \u00e9s a nemritk\u00e1n nagy kih\u00edv\u00e1st jelent\u0151 elj\u00e1r\u00e1sok komplik\u00e1ci\u00f3r\u00e1t\u00e1ja\n                    magas. Oszt\u00e1lyunkon 2003 \u00f3ta alkalmazunk speci\u00e1lis h\u00e1romdimenzi\u00f3s h\u00e1l\u00f3kat a\n                    parastomalis s\u00e9rvek megel\u0151z\u00e9s\u00e9re \u00e9s megold\u00e1s\u00e1ra. <jats:italic>Betegek \u00e9s\n                        m\u00f3dszerek:<\/jats:italic> 2012. janu\u00e1r 1-j\u00e9t\u0151l 2016. j\u00fanius 1-j\u00e9ig prospekt\u00edv,\n                    kontroll\u00e1lt, randomiz\u00e1lt vizsg\u00e1lat keret\u00e9ben abdominoperinealis exstirpati\u00f3val\n                    egyidej\u0171leg 38 esetben v\u00e9gezt\u00fcnk prevent\u00edv h\u00e1l\u00f3be\u00fcltet\u00e9st, illetve 14 esetben\n                    m\u00e1r meglev\u0151 parastomalis s\u00e9rvet korrig\u00e1ltunk h\u00e1l\u00f3be\u00fcltet\u00e9ssel. A\n                    kontrollcsoportokban eddig 46, illetve 18 beteg szerepel a prevent\u00edv, illetve\n                    rekonstrukci\u00f3s \u00e1gon. A bevon\u00e1st 2017-ig v\u00e9gezz\u00fck. A prevent\u00edv csoportban 22\n                    esetben laparoszk\u00f3posan, 62 esetben nyitottan v\u00e9gezt\u00fck a Miles-m\u0171t\u00e9tet. A\n                    rekonstrukci\u00f3s csoportban hat esetben laparoszk\u00f3posan, 26 esetben nyitottan\n                    v\u00e9gezt\u00fck a k\u00fcl\u00f6nb\u00f6z\u0151 t\u00edpus\u00fa hasfal-rekonstrukci\u00f3kat. A vizsg\u00e1lt id\u0151szakban az\n                    \u00e1tlag ut\u00e1nk\u00f6vet\u00e9si id\u0151 19,2 h\u00f3nap volt a h\u00e1l\u00f3s \u00e9s 22,6 h\u00f3nap volt a nem h\u00e1l\u00f3s\n                    alcsoportokban a prevent\u00edv \u00e1gon, \u00e9s 25,9 h\u00f3nap, illetve 20,4 h\u00f3nap volt a h\u00e1l\u00f3s,\n                    illetve h\u00e1l\u00f3 n\u00e9lk\u00fcli alcsoportokban a rekonstrukci\u00f3s \u00e1gon.\n                        <jats:italic>Eredm\u00e9nyek:<\/jats:italic> Az eredm\u00e9nyek r\u00e9szletes statisztikai anal\u00edzis\u00e9t\n                    a vizsg\u00e1lat lez\u00e1rult\u00e1val fogjuk elv\u00e9gezni. Az interim eredm\u00e9nyek alapj\u00e1n a\n                    komplik\u00e1ci\u00f3ar\u00e1nyok nem k\u00fcl\u00f6nb\u00f6znek sz\u00e1mottev\u0151en a h\u00e1l\u00f3s, illetve a nem h\u00e1l\u00f3s\n                    csoportok k\u00f6z\u00f6tt. Az eddig vizsg\u00e1lt id\u0151szakban a prevent\u00edv vizsg\u00e1lati \u00e1gon\n                    parastomalis s\u00e9rv kialakul\u00e1s\u00e1t a nem h\u00e1l\u00f3s csoportban 18 esetben (39.1%), a\n                    h\u00e1l\u00f3s csoportban h\u00e1rom esetben (7,8%) \u00e9szlelt\u00fck. A rekonstrukci\u00f3s \u00e1gon\n                    rekurrenci\u00e1t a nem h\u00e1l\u00f3s csoportban nyolc esetben (44%), a h\u00e1l\u00f3s csoportban\n                    pedig egy esetben (7,1%) \u00e9szlelt\u00fcnk. <jats:italic>K\u00f6vetkeztet\u00e9sek:<\/jats:italic>\n                    Eredm\u00e9nyeink korrel\u00e1lnak az irodalomban egyre szaporod\u00f3 k\u00fcl\u00f6nb\u00f6z\u0151\n                    h\u00e1l\u00f3be\u00fcltet\u00e9ses elj\u00e1r\u00e1sokkal. Ezt els\u0151sorban a parastomalis s\u00e9rvek kialakul\u00e1si\n                    patomechanizmus\u00e1nak meg\u00e9rt\u00e9s\u00e9n alapul\u00f3 egyedi h\u00e1l\u00f3konstrukci\u00f3nak\n                    tulajdon\u00edtjuk.<\/jats:p>","DOI":"10.1556\/1046.69.2016.4.2","type":"journal-article","created":{"date-parts":[[2016,12,17]],"date-time":"2016-12-17T15:35:26Z","timestamp":1481988926000},"page":"150-158","update-policy":"http:\/\/dx.doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":4,"title":["Parastomalis s\u00e9rvek megel\u0151z\u00e9se \u00e9s megold\u00e1sa: a h\u00e1romdimenzi\u00f3s h\u00e1l\u00f3kkal szerzett eddigi tapasztalataink"],"prefix":"10.1556","volume":"69","author":[{"given":"Zolt\u00e1n","family":"J\u00e1n\u00f3","sequence":"first","affiliation":[{"name":"\u00c1ltal\u00e1nos \u00e9s \u00c9rseb\u00e9szeti Centrum, Veszpr\u00e9m Megyei Csolnoky Ferenc K\u00f3rh\u00e1z8200 Veszpr\u00e9m, K\u00f3rh\u00e1z u. 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