1. Uterine perforation - 5-year experience in 3-D image guided gynaecological brachytherapy at Institute of Oncology LjubljanaBarbara Šegedin, Jasenka Gugić Kevo, Primož Petrič, 2013, original scientific article Abstract: Background. Accurate applicator placement is a precondition for the success of gynaecological brachytherapy (BT). Unrecognized uterine perforation can lead to bleeding, infection, high doses to pelvic organs and underdosage of the target volume, resulting in acute morbidity, long-term complications and reduced chance of cure. We aimed to assess the incidence and clinical characteristics of our cases with uterine perforation, review their management and impact on the treatment course. Patinets and methods. In all patients, treated with utero-vaginal image guided BT for gynaecological cancer between January 2006 and December 2011, the CT/MR images with the applicator in place were reviewed. The incidence of uterine perforations was recorded. Clinical factors that may have predisposed to increased risk of perforation were recorded. Management of perforations and their impact on treatment course was assessed. Results. 219 patients (428 applications) were suitable for analysis. Uterine perforation was found in 13 (3.0%) applications in 10 (4.6%) patients. The most frequent perforation site was posterior uterine wall (n = 9), followed by anterior wall (n = 2) and fundus (n = 2). All cases were managed conservatively, without complications. Prophylactic antibiotics were administered in 8 cases. In 4 patients, abdominal and/or transrectal ultrasound (US) guidance was used on subsequent applications for applicator insertion; adequate applicator placement was achieved and treatment completed as planned in all cases. Conclusions. 3D imaging for BT planning enables accurate identification of uterine perforations. The incidence of perforations at our department is one of the lowest reported in the literature. US guidance of applicator insertion is useful and feasible, allowing to complete the planned treatment even in challenging cases. Keywords: uterine perforation, brachytherapy, 3D imaging, ultrasound guidance Published in DiRROS: 22.03.2024; Views: 38; Downloads: 15 Full text (367,57 KB) |
2. |
3. |
4. |
5. 1. Šola maligne utesnitve hrbtenjače : [strokovno srečanje]2023, not set Abstract: Izidi zdravljenja maligne utesnitve hrbtenjače (MUH) v Sloveniji trenutno niso najboljši. Obravnava bolnikov je kompleksna, multidisciplinarna in večnivojska. Takoj ko bolnik zazna znake MUH, mora stanje prepoznati zdravnik družinske medicine, hitro ukrepati ter ga napotiti na nevrološki pregled oziroma k lečečemu onkologu. Namen 1. Šole maligne utesnitve hrbtenjače je, da se zdravniki, ki sodelujemo pri prepoznavi in zdravljenju MUH pogovorimo o trenutnem stanju obravnave in vseh dilemah, ki jih imamo. Keywords: maligna utesnitev Published in DiRROS: 29.11.2023; Views: 233; Downloads: 105 Full text (2,46 MB) This document has many files! More... |
6. Obsevanje ginekoloških tumorjevBarbara Šegedin, Helena Barbara Zobec Logar, Manja Šešek, Ana Perpar, Blaž Grošelj, Miha Oražem, 2023, professional monograph Keywords: teleterapija, brahiterapija, prehrana, kemoterapija, stranski učinki Published in DiRROS: 22.11.2023; Views: 291; Downloads: 90 Full text (1,18 MB) |
7. Stresni zlomi medenice po zdravljenju z obsevanjem : pregled literatureJan Žagar, Barbara Šegedin, 2023, review article Abstract: Stresni zlomi medenice po obsevanju so že dolgo znana posledica obsevanja tumorjev v področju medenice. Čeprav so zlasti v področju sakruma relativno pogost pojav, je njihova diagnostika zaradi nespecifičnosti simptomov težavna. V tem preglednem članku smo pregledali literaturo, ki zajema etiologijo, incidenco, dejavnike tveganja, simptome in diagnostiko ter zdravljenje in preprečevanje stresnih zlomov medenice po obsevanju. Na podlagi pridobljenih podatkov smo poskušali strniti in predstaviti najdene ugotovitve z navedenih področij, ki bi nam bile lahko v pomoč v vsakodnevni radioterapevtski klinični praksi, saj standardiziranih priporočil na tem področju nismo našli. Keywords: stresni zlomi medenice, obsevanje, incidenca Published in DiRROS: 27.07.2023; Views: 277; Downloads: 69 Full text (231,02 KB) |
8. Kazalniki kakovosti v radioterapijiAna Perpar, Barbara Šegedin, 2023, review article Abstract: Zagotovitev kakovosti v zdravstvu postaja pomembnejša dejavnost plačnikov in ponudnikov zdravstvenih storitev, prav tako mednarodne organizacije uspešno akreditacijo pogojujejo z izvajanjem programov nadzora kakovosti. Za analizo pomanjkljivosti v zagotavljanju storitev se uporabljajo kazalniki kakovosti, ki analizirajo strukture, procese in izide v zdravstvenem sistemu in s tem omogočijo načrtovanje in izvedbo izboljšav zdravstvenih storitev. V radioterapiji je tradicija nadzora kakovosti, ki se razvija vzporedno s tehnološkimi in metodološkimi spremembami na tem področju. Pri analizi izidov zdravljenja, ki so najbolj poveden kazalnik kakovosti onkoloških zdravstvenih storitev, se velikokrat srečujemo z nezanesljivostjo podatkov oz. zapletenim dostopom do njih, kar zmanjšuje ažurnost in verodostojnost rezultatov. Keywords: zdravstveni sistem, zdravstvene storitve, radioterapija Published in DiRROS: 27.07.2023; Views: 237; Downloads: 75 Full text (141,06 KB) |
9. Porast incidence debelosti : možnosti ne-kirurškega zdravljenja raka endometrijaBlaž Grošelj, Barbara Šegedin, 2023, published scientific conference contribution Abstract: Rak endometrija je v zahodnem svetu najpogostejši ginekološki rak. Debelost je eden glavnih rizičnih faktorjev za razvoj raka endometrija. V zahodnem svetu se incidenca debelosti epidemično strmo povečuje. 10 % bolnic z rakom endometrija je zaradi debelosti oziroma pridruženih bolezni nesposobnih za primarno operativno zdravljenje. Alternativa je zdravljenje z obsevanjem. V članku navajamo nekaj novejših spoznanj s področja obsevanja raka endometrija in dokaze, da je tovrstno zdravljenje lahko enakovredno kirurškemu. Keywords: rak maternice, ginekološki raki, ginekološka onkologija Published in DiRROS: 01.06.2023; Views: 328; Downloads: 116 Full text (272,76 KB) This document has many files! More... |
10. |