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Abstract: Thrombotic events, arterial or venous in origin, still remain a source of substantial morbidity and mortality in cancer patients. The propensity for their development in oncology patients is partially a consequence of the disease itself and partially a result of our attempts to treat it. One of the rarest and deadliest thromboembolic complications is arterial mesenteric ischemia. The high mortality rate is caused by its rarity and by its non-specific clinical presentation, both of which make early diagnosis and treatment difficult. Hence, most diagnoses and treatments occur late in the course of the disease. The issue survivors of arterial mesenteric ischemia may face is short bowel syndrome, which has become a chronic condition after the introduction of parenteral nutrition at home. We present a 73-year-old rectal cancer patient who developed acute arterial mesenteric thrombosis at the beginning of the pre-operative radiochemotherapy. Almost the entire length of his small intestine, except for the proximal 50 cm of it, and the ascending colon had to be resected. After multiorgan failure his condition improved, and he was able to successfully complete radical treatment (preoperative radiotherapy and surgery) for the rectal carcinoma, despite developing short bowel syndrome (SBS) and being dependent upon home-based parenteral nutrition to fully cover his nutritional needs. Mesenteric ischemia and resultant short bowel syndrome are not absolute contraindications for radical oncological treatment since such patients can still achieve long-term remission.
Keywords: acute mesenteric ischemia, capecitabine, multiorgan failure, rectal cancer, short bowel syndrome
Published in DiRROS: 23.04.2024; Views: 4; Downloads: 2
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Abstract: Rakasta kaheksija je presnovna motnja, ki je povezana s slabšo kakovostjo življenja, slabšim odzivom na zdravljenje, številnejšimi zapleti med zdravljenjem in krajšim preživetjem. Rakasta bolezen je za človeško telo stres, ki mu sledi celoviti nevroendokrini in vnetni odziv. Spremeni se potreba po posameznih hranilih in uporaba hranil, presnovne spremembe so še dodatno poglobijo zaradi zdravljenja. Zato bolniki potrebujejo presnovnim potrebam prilagojeno prehrano. Ta se doseže z opredelitvijo njihovega prehranskega stanja. Prehransko stanje se lahko opredeli s prehranskim presejanjem ali natančnejšo oceno prehranskega stanja, katerega izvede ustrezno izobražen zdravnik, medicinska sestra ali klinični dietetik. S prehransko podporo onkoloških bolnikov preprečujemo podhranjenost bolnikov, katera močno pospeši kahektične procese, z njo poskušamo čim dlje ohranjati funkcionalno mišično maso ter s tem bolnikovo kondicijo in kvaliteto življenja. Prehranska podpora in terapije motenj prehranskega stanja predstavljajo del sodobne multidisciplinarne terapije onkoloških bolnikov, ki se izvaja po modelu vzporednih terapevtskih poti.
Keywords: onkološki bolniki, klinična prehrana, klinične smernice
Published in DiRROS: 16.01.2023; Views: 554; Downloads: 161
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Keywords: rak požiralnika, rak ezofagogastritičnega stika, smernice, zdravljenje
Published in DiRROS: 07.09.2022; Views: 681; Downloads: 263
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Keywords: rak debelega črevesa, rak danke, bolniki, zdravljenje
Published in DiRROS: 18.03.2022; Views: 789; Downloads: 432
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Keywords: rak dojke, bolniki, celostna rehabilitacija, klinične poti
Published in DiRROS: 14.03.2022; Views: 783; Downloads: 370
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