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Uspješna operacija našeg pruđanina Ivice Barukčić PDF Ispis

VELIKI USPJEH KIRURGA NA REBRU Dok su mi lije?nici uklanjali tumor s mozga, bio sam budan i s njima sam razgovarao

  • Operacije tumora na mozgu u budnom stanju. Na fotografiji: Pacijent Ivica Baruk?i?, Goran Mrak, Marin Lozi?, Andreja Bujan Kova?, Tereza Gabeli?, Dinah Vodanovi?.

    Biljana Gaurina/CROPIX

Objavljeno: prije 4 h i 54 min

Zahvat je trajao vie od est sati i izveo ga je osmero?lani lije?ni?ki tim KBC-a Zagreb

Da, tijekom operacije na mozgu vie od dva sata bio sam budan i razgovarao s lije?nicima. Istina, bilo je naporno, ali isplatilo se. Poslije samo tri dana u potpunosti mi se vratila mogu?nost govora. Nemam nikakvih problema, kae 39-godinjiIvica Baruk?i? iz Odaka kojem je osmero?lani lije?ni?ki tim KBC-a Zagreb prolog tjedna operirao tumor na mozgu tzv. Awake kraniotomijom, odnosno operacijom u budnom stanju, koja se obavlja u jo samo tridesetak centara u svijetu.

Za koji dan ku?i

Sve je s Ivi?inimzdravljem krenulo po zlu tijekom prologodinjih poplava.

- Pomagao sam sestri pa sam tako jednog poslijepodneva legao i zaspao. No, kako se nisam mogao probuditi, sestra je zaklju?ila da neto nije u redu i pozvala je Hitnu. Odveli su me u bolnicu u Slavonski Brod. Dijagnoza je bila modani udar ili epilepti?ki napad. Vukao sam se tako posljednjih godinu dana, ali nije mi bilo nita bolje. Onda je na jednom kontrolnom pregledu magnetska rezonanca pokazala da se zapravo radi o tumoru na mozgu. Poslali su me u Zagreb, adoc. dr. Goran Mrakobjasnio mi je da imam modani tumor na temporalnom renju, i to u podru?ju centra za govor. Rekao mi je da je mogu?a operacija u punoj anesteziji kod koje postoji rizik da ostanem bez mogu?nosti govora ili, pak, da jedan dio zahvata budem budan s mnogo manjim rizikom. Odabrao sam operaciju u budnom stanju. Bio sam budan vie od dva sata i cijelo vrijeme razgovarao s lije?nicima. Bilo je naporno, ali isplatilo se jer mi se govor potpuno vratio. Od petka govorim normalno po nekoliko sati. Sretan sam i zadovoljan - rekao je Ivica, kojeg smo zatekli na putu u bolni?ki kafi?. Za koji dan ?e ku?i - put Odaka.

- Ova je operacija, tzv. Awake ili kraniotomija u budnom stanju, trajala vie od est sati, od ?ega je Ivica bio budan gotovo dva i pol. To je jedini na?in za kirurko uklanjanje tumora na mozgu koji se nalaze u tzv. elokventnim regijama, osobito u podru?jima zaduenima za govor i motoriku koji osigurava da ?e te funkcije ostati aktivne - objasnio je doc. dr. Goran Mrak, predstojnik Klinike za neurokirugiju koji je s timom neurologa, anesteziologa i logopeda prolog tjedna obavio tu zahtjevnu operaciju.

KBC Rebro, operacija mozga, pacijent budan

Operacijsko polje

- Samo tako neurolozi tijekom operacije mogu kontrolirati govor pacijenta. U budnom stanju radimo selekcionirane neuroloko-psiholoke te logopedske testove i moemo to?no lokalizirati i prepoznati razli?ite poreme?aje govora od izgovora do ponavljanja re?enica, razumijevanja, pa ?ak i smetnji u ra?unanju te orijentaciji lijevo - desno, kao i poreme?aje motorike ruku i nogu - rekla je neurologinjadr. Tereza Gabeli?.

- Tijekom operacije pratimo govor pacijenta i sve biljeimo kako bismo to mogli usporediti s postoperativnim stanjem - izjavila je logopedicaDinah Vodanovi?.

- Na operacijskom stolu pacijent se namjeta na lijevi ili desni bok, ovisno o tome na kojoj je strani tumor. Anesteziolozi ga uvode u op?u anesteziju, a lokalni se anestetik stavlja na mjesto operacije kako pacijent kod bu?enja ne bi osje?ao bol. Slijedi priprema operacijskog polja i otvaranje glave. Pacijent se tada budi kako bi se mogla kontrolirati funkcija govora tijekom odstranjivanja tumora. U trenutku kad pacijent bude potpuno u mogu?nosti sura?ivati s lije?nicima, otvara se ovojnica mozga i po?inje operacija.

Prvi neurokirurki korak je mapiranje tzv. elokventnih podru?ja, pri ?emu se koriste bipolarne elektrode kako bi se mogla stimulirati kora mozga i duboka podru?ja, odnosno kako ne bi dolo do ote?enja tzv. dubokih bijelih putova, to bi bio nepovratni gubitak - objanjava doc. dr. Mrak.

U?enje u Montpellieru

- Nakon to se tumor ukloni, pacijent se ponovno uvodi u op?u anesteziju, a kirurzi rekonstruiraju tvrdu mozgovnu ovojnicu i kotane dijelove fiksiraju titanskom plo?icom i vijcima - rekao je neuroanesteziologdr. Vasilije Stambolija.

- Ovu smo metodu lije?enja u?ili kodprof. dr Huguesa Duffaua u klinici u Montpellieru, a primjenjuje se za operacije difuznog glioma niskog stupnja. Naalost, nisu svi pacijenti s tumorom na mozgu kandidati za tu operaciju, ve? samo oni koji imaju male tumore, na to moe upu?ivati oteani govor, slabost u ekstremitetima, epilepti?ki napad... Naprosto, to je tumor manji, to ?e se lake ukloniti, a ne?e trebati radio ni kemoterapija - izjavio je doc. dr. Mrak. Zaklju?uje kako je Awake kraniotomija primjer sve ?e?e nunosti multidisciplinarnosti u suvremenoj medicini.

doc. dr. Goran Mrak, foto: Biljana Gaurina/CROPIX



Mapiranjem mozga do sigurnijeg zahvata

DoktoricaAndreja Bujan Kova? ustvrdila je kako se u budnom stanju selekcionirani neuroloko-psiholoki i logopedski testovi provode zato da se to to?nije napravi tzv. mapiranje mozga, odnosno odre?ivanje funkcionalnih regija modane kore kako bi se to sigurnije odstranio tumor i sa?uvala, primjerice, funkcija govora.

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