Sažetak | Parcijalna laringektomija kirurški je zahvat kojim u karcinomima grkljana nastojimo sačuvati dio grkljana i time izbjeći trajnu traheostomu u bolesnika. Zloćudne novotvorine grkljana najčešće se javljaju kod muškaraca prosječne dobi 50 – 70 godina, te se kao najčešći uzročnici spominju konzumacija alkohola i duhanskih proizvoda, izloženost otrovnim tvarima te ionizirajuće zračenje. Zloćudna se novotvorina grkljana prvenstveno manifestira promuklošću, otežanim disanjem i gutanjem, suhim i nadražajnim kašljem kod kojeg se može kasnije pojaviti sukrvavi sadržaj. Kako bi se dijagnosticirala ova bolest potrebno je obaviti opći
klinički pregled, palpaciju i inspekciju vrata, laringoskopski pregled, napraviti biopsiju tkiva te obaviti radiološku dijagnostiku. Liječenje se vrši ovisno o stadiju bolesti, te može biti kirurškim ili onkološkim putem u ranim stadijima bolesti, odnosno u uznapredovalom stadiju kombinacija ova dva pristupa liječenja. Predoperativna priprema bolesnika za parcijalnu laringektomiju iziskuje multidisciplinarni pristup liječnika specijalista otorinolaringologije, onkologa, medicinskih sestara / tehničara, logopeda, psihologa i drugih. Uloga je medicinskih sestara / tehničara ključna radi svog rada i pristupa bolesniku gdje nastoje smanjiti
razinu prisutnog straha, tjeskobe i zabrinutosti, te pomažu bolesniku izgraditi samopouzdanje i povjerenje kao i pomoći mu u usvajanju poželjnog ponašanja. Postoperativno je iznimno važno da medicinske sestre / tehničari prate stanje bolesnika, promatraju i preveniraju eventualne komplikacije postupka, te u kasnijim fazama oporavka educiraju ga o pravilnom ponašanju, o njezi traheostome i trahealne kanile, vode brigu o pravilnoj prehrani bolesnika te ga upute gdje može potražiti adekvatnu logopedsku pomoć. |
Sažetak (engleski) | Surgical procedure where we try to save a part of the larynx in laryngeal cancers and thus avoid a permaneng tracheostomy in the patient is called partial laryngectomy. Malignant neoplasms of the larynx most often occur in men with an average age of 50-70 years, and the most common causes are the consumption of alcohol and tobacco products, exposure to toxic substances and ionizing radiation. A malignant neoplasm of the larynx is primarily manifested by hoarseness, difficulty breathing and swallowing, a dry and irritating cough, which may later contain bloody contents. In order to diagnose this disease, it is necessary to perform a general clinical examination, palpation and inspection of the neck, a laryngoscopic examination, a tissue biopsy and a radiological diagnostics. Treatment is carried out depending on the stage of the cancer, and can be surgical or oncological in the early stages of the disease, or in the advanced stage, a combination of these two treatment approaches. Preoperative preparation of patients for partial laryngectomy requires a multidisciplinary approach of doctors specializing in otorhinolaryngology, oncologists, nurses/technicians, speech therapists, psychologists and others. The role of nurses/technicians is crucial for their work and approach to the patient, where they try to reduce the level of fear, anxiety and concern present, and help the patient build self-confidence and trust, as well as help him adopt desirable behavior. Postoperatively, it is extremely important that nurses/technicians monitor the patient's condition, observe and prevent possible complications of the procedure, and in the later stages of recovery educate him about proper behavior, care for the tracheostomy and tracheal cannula, take care of the patient's proper nutrition, and direct him where he can look for adequate speech therapy assistance. |