{"id":3223,"date":"2023-08-17T16:20:20","date_gmt":"2023-08-17T14:20:20","guid":{"rendered":"https:\/\/www.ptc.cz\/co-liecime\/zazivaci-trakt\/jak-poznat-rakovinu-zazivaciho-traktu\/"},"modified":"2024-06-11T10:38:20","modified_gmt":"2024-06-11T08:38:20","slug":"rakovina-traviaceho-traktu","status":"publish","type":"page","link":"https:\/\/www.ptc.cz\/sk\/co-liecime\/traviaci-trakt\/rakovina-traviaceho-traktu\/","title":{"rendered":"Rakovina tr\u00e1viaceho traktu"},"content":{"rendered":"<h2><strong>N\u00e1dory pa\u017eer\u00e1ka<\/strong><\/h2>\n<div class=\"gdc_row\">\n<div class=\"gdc_column gdc_chalf\">\n<div class=\"gdc_inner\">\n<p>N\u00e1dory pa\u017eer\u00e1ka s\u00fa z\u00e1va\u017en\u00e9 ochorenie, ktor\u00e9 vych\u00e1dza z&nbsp;vn\u00fatorn\u00e9ho povrchu pa\u017eer\u00e1ka a&nbsp;ktor\u00e9ho lie\u010dba je enormne n\u00e1ro\u010dn\u00e1, ale m\u00f4\u017ee by\u0165 ve\u013emi \u00faspe\u0161n\u00e1, tzn. m\u00f4\u017ee chor\u00e9ho dovies\u0165 k&nbsp;\u00fapln\u00e9mu vylie\u010deniu.<\/p>\n<p>V&nbsp;lie\u010dbe sa uplat\u0148uje chemoterapia, o\u017earovanie a&nbsp;oper\u00e1cia v&nbsp;r\u00f4znom porad\u00ed. Obvykl\u00fd postup je v&nbsp;prvom rade s\u00fa\u010dasn\u00e1 chemoterapia a&nbsp;o\u017earovanie, potom nasleduje chirurgick\u00fd v\u00fdkon. V&nbsp;\u010cR ro\u010dne ochorie n\u00e1dorom pa\u017eer\u00e1ka cez 500 os\u00f4b. Naj\u010dastej\u0161ie sa ochorenie diagnostikuje medzi 50.&nbsp;a&nbsp;70.&nbsp;rokom \u017eivota.<\/p>\n<p>K&nbsp;rizikov\u00fdm faktorom patr\u00ed faj\u010denie, konzum\u00e1cia destil\u00e1tov, alkoholizmus a&nbsp;bezozbytkov\u00e1 nevyv\u00e1\u017een\u00e1 strava. Pr\u00edznaky n\u00e1doru pa\u017eer\u00e1ka s\u00fa skor\u00e9 &#8211; poruchy preh\u013atania, bolestiv\u00e9 preh\u013atanie, r\u00fdchle chudnutie, vracanie, pr\u00edpadne krv\u00e1canie, resp. zvracanie natr\u00e1venej krvi, trval\u00e9 bolesti v&nbsp;hrudn\u00edku. N\u00e1dorov\u00e9 ochorenia pa\u017eer\u00e1ka sa lie\u010dia r\u00f4znymi met\u00f3dami (odborne \u201emodalitami\u201c), ktor\u00fdch vo\u013eba a&nbsp;poradie m\u00e1 pevn\u00e9 z\u00e1konitosti. Lie\u010debn\u00fd postup sa v\u017edy ur\u010duje pri spolo\u010dnom konsiliu chirurga a&nbsp;onkol\u00f3ga.<\/p>\n<h3><strong>Chirurgick\u00e1 lie\u010dba, tzn. r\u00f4zne druhy v\u00fdkonov, oper\u00e1ci\u00ed<\/strong><\/h3>\n<p>N\u00e1dory sa lie\u010dia oper\u00e1ciou, resekciou, bu\u010f v&nbsp;prvej dobe (pri mal\u00fdch inici\u00e1lnych n\u00e1lezoch), alebo po pr\u00edprave o\u017earovan\u00edm alebo chemoterapiou (pri pokro\u010dilej\u0161\u00edch n\u00e1lezoch). Resekcia je ve\u013emi zlo\u017eit\u00fd a&nbsp;n\u00e1ro\u010dn\u00fd v\u00fdkon, bli\u017e\u0161ie ho pop\u00ed\u0161e chirurg. Vo\u013eba medzi o\u017earovan\u00edm a&nbsp;chemoterapiou sa rob\u00ed na&nbsp;z\u00e1klade lokaliz\u00e1cie postihnutia. (Chemoterapia sa preferuje pri n\u00e1doroch vych\u00e1dzaj\u00facich z&nbsp;prechodu pa\u017eer\u00e1ka do \u017eal\u00fadka.) Pri n\u00e1doroch vych\u00e1dzaj\u00facich z&nbsp;kr\u010dn\u00e9ho \u00faseku pa\u017eer\u00e1ka nemo\u017eno oper\u00e1ciu vykona\u0165.<\/p>\n<\/div>\n<\/div>\n<div class=\"gdc_column gdc_chalf\">\n<div class=\"gdc_inner\">\n<h3>R\u00e1dioterapia n\u00e1dorov pa\u017eer\u00e1ka sa uplat\u0148uje ako:<\/h3>\n<ul>\n<li>Predopera\u010dn\u00e9, tzn. o\u017earuje sa s&nbsp;v\u00fdh\u013eadom nasleduj\u00faceho chirurgick\u00e9ho v\u00fdkonu v&nbsp;presnej \u010dasovej nadv\u00e4znosti.<\/li>\n<li>Samostatn\u00e1, o\u017earuje sa bez v\u00fdh\u013eadu chirurgick\u00e9ho v\u00fdkonu a&nbsp;to v&nbsp;pr\u00edpade v\u00fdskytu n\u00e1doru v&nbsp;kr\u010dnom \u00faseku pa\u017eer\u00e1ka, alebo pokia\u013e z&nbsp;ak\u00fdchko\u013evek d\u00f4vodov nemo\u017eno uva\u017eova\u0165 o&nbsp;oper\u00e1cii.<\/li>\n<li>Ojedinele je indikovan\u00e1 r\u00e1dioterapia poopera\u010dn\u00e1, obvykle ke\u010f bola vykonan\u00e1 resekcia n\u00e1doru, ktor\u00fd bol v&nbsp;opera\u010dnom n\u00e1leze rozsiahlej\u0161\u00ed, ne\u017e sa p\u00f4vodne predpokladalo. Anatomick\u00e9 ulo\u017eenie pa\u017eer\u00e1ka \u2013 medzi oboma p\u013e\u00facami a&nbsp;v&nbsp;bl\u00edzkosti srdca vy\u017eaduje aplik\u00e1ciu do geometricky zlo\u017eit\u00e9ho priestoru medzi org\u00e1nmi, ktor\u00fdch o\u017eiarenie mus\u00ed by\u0165 minim\u00e1lne. Preto sa s&nbsp;v\u00fdhodou vyu\u017e\u00edva prot\u00f3nov\u00e1 r\u00e1dioterapia.<\/li>\n<\/ul>\n<h3><strong>Chemoterapia<\/strong><\/h3>\n<p>Chemoterapia sa u&nbsp;n\u00e1dorov pa\u017eer\u00e1ka uplat\u0148uje preva\u017ene s\u00fa\u010dasne s&nbsp;o\u017earovan\u00edm. Jej cie\u013eom je zv\u00fd\u0161i\u0165 senzitivitu n\u00e1doru na&nbsp;o\u017earovanie. T\u00e1to chemoterapia m\u00e1 ni\u017e\u0161ie d\u00e1vky a&nbsp;u\u017e\u00edva sa menej l\u00e1tok s\u00fa\u010dasne, maxim\u00e1lne 2. Je preto dobre tolerovan\u00e1. Samostatn\u00e1 chemoterapia sa uplat\u0148uje pri n\u00e1doroch vych\u00e1dzaj\u00facich z&nbsp;prechodu pa\u017eer\u00e1ka a&nbsp;\u017eal\u00fadka<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/www.ptc.cz\/wp-content\/uploads\/2023\/08\/shutterstock-1104818837-1200x1200-1.jpg\" data-rel=\"lightbox-image-0\" data-rl_title=\"\" data-rl_caption=\"\" title=\"\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-880\" src=\"https:\/\/www.ptc.cz\/wp-content\/uploads\/2023\/08\/shutterstock-1104818837-1200x1200-1.jpg\" alt=\"\" width=\"1200\" height=\"786\" srcset=\"https:\/\/www.ptc.cz\/wp-content\/uploads\/2023\/08\/shutterstock-1104818837-1200x1200-1.jpg 1200w, https:\/\/www.ptc.cz\/wp-content\/uploads\/2023\/08\/shutterstock-1104818837-1200x1200-1-300x197.jpg 300w, https:\/\/www.ptc.cz\/wp-content\/uploads\/2023\/08\/shutterstock-1104818837-1200x1200-1-768x503.jpg 768w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><\/a><\/p>\n<h2><\/h2>\n<p>&nbsp;<\/p>\n<h2>N\u00e1dory pankreasu<\/h2>\n<div class=\"gdc_row\">\n<div class=\"gdc_column gdc_chalf\">\n<div class=\"gdc_inner\">\n<p>N\u00e1dory slinivky bru\u0161nej (pankreasu) vznikaj\u00fa preva\u017ene z&nbsp;v\u00fdvodn\u00e9ho syst\u00e9mu \u017e\u013eazy. Zriedka vznikaj\u00fa z&nbsp;endokrinnej \u010dasti pankreasu (ktor\u00e1 produkuje radu horm\u00f3nov, mimo in\u00fdch aj napr. inzul\u00edn), potom sa ozna\u010duj\u00fa \u201eP-NET\u201c, maj\u00fa lep\u0161iu progn\u00f3zu a&nbsp;ich lie\u010dba m\u00e1 zvl\u00e1\u0161tne pravidl\u00e1 a&nbsp;postupy. N\u00e1dor pankreasu je ve\u013emi z\u00e1va\u017en\u00e9 ochorenie, ktor\u00e9 m\u00e1 zvy\u010dajne \u0165a\u017ek\u00fd priebeh. M\u00e1 ve\u013ek\u00fa tendenciu k&nbsp;skor\u00e9mu zakladaniu \u010fal\u0161\u00edch lo\u017e\u00edsk \u2013 metast\u00e1z, najm\u00e4 v&nbsp;pe\u010deni a&nbsp;na&nbsp;pobru\u0161nici. Lie\u010dba n\u00e1dorov pankreasu je ve\u013emi n\u00e1ro\u010dn\u00e1 a&nbsp;\u010dasto nie je \u00faspe\u0161n\u00e1.<\/p>\n<p>V&nbsp;SR ochorie n\u00e1dorom pankreasu ro\u010dne cez 2000 os\u00f4b. V\u00fdskyt st\u00fapa po 50.&nbsp;roku veku. Rizikov\u00e9 faktory pre vznik n\u00e1doru pankreasu nie s\u00fa jednozna\u010dne ur\u010den\u00e9. Ur\u010dite k&nbsp;nim patr\u00ed faj\u010denie, alkoholizmus a&nbsp;opakovan\u00e9 z\u00e1paly pankreasu (\u201epankreatit\u00edda\u201c). Ochorenie nem\u00e1 skor\u00e9 pr\u00edznaky. Obvykle je preto diagnostikovan\u00e1 v&nbsp;pokro\u010dilom \u0161t\u00e1diu. \u010casto je za prv\u00fd pr\u00edznak pova\u017eovan\u00e9 zo\u017eltnutie (\u201e\u017elta\u010dka\u201c \u2013 v&nbsp;zmysle pr\u00edznaku, nemo\u017eno zamie\u0148a\u0165 s&nbsp;\u201einfek\u010dnou \u017elta\u010dkou\u201c \u2013 hepatit\u00eddou v&nbsp;zmysle v\u00edrusov\u00e9ho z\u00e1palu pe\u010dene). \u010eal\u0161ie pr\u00edznaky s\u00fa \u00faporn\u00e9 bolesti v&nbsp;hornej \u010dasti brucha, nechutenstvo (\u010dast\u00fd je odpor k&nbsp;m\u00e4su) a&nbsp;v\u00fdrazn\u00e9 chudnutie.<\/p>\n<p>K&nbsp;pr\u00edznakom pokro\u010dil\u00e9ho ochorenia patr\u00ed aj dlhodob\u00e1 nevo\u013enos\u0165 a&nbsp;opakovan\u00e9 zvracanie. N\u00e1dorov\u00e9 ochorenia pankreasu sa lie\u010dia r\u00f4znymi met\u00f3dami (odborne \u201emodalitami\u201c), ktor\u00fdch vo\u013eba a&nbsp;poradie m\u00e1 pevn\u00e9 z\u00e1konitosti. V&nbsp;lie\u010dbe n\u00e1dorov pankreasu je prvorad\u00e1 oper\u00e1cia \u2013 resekcia pankreasu (cel\u00e9ho alebo polovice) vr\u00e1tane resekcie dvan\u00e1storn\u00edka a&nbsp;\u00fapravy priebehu tenk\u00e9ho \u010dreva. Pokia\u013e nie je mo\u017en\u00e9 vykona\u0165 (z&nbsp;ak\u00fdchko\u013evek pr\u00ed\u010din), rie\u0161i sa ochorenie z\u00e1sadne chemoterapiou, po ktorej m\u00f4\u017ee nasledova\u0165 o\u017earovanie \u2013 r\u00e1dioterapia. O\u017earovanie m\u00e1 v\u00fdznam iba v&nbsp;kontexte chemoterapie, tzn. v&nbsp;nadv\u00e4znosti na&nbsp;chemoterapiu. Po \u00faspe\u0161nej resekcii nasleduje poopera\u010dn\u00e1 chemoterapia, tie\u017e doplnen\u00e1 o\u017eiaren\u00edm. Poopera\u010dn\u00e9 o\u017eiarenie m\u00e1 \u0161peci\u00e1lne z\u00e1konitosti.<\/p>\n<h3>Chirurgick\u00e1 lie\u010dba, tzn. r\u00f4zne druhy v\u00fdkonov, oper\u00e1ci\u00ed<\/h3>\n<p><span style=\"font-size: 16px;\">U n\u00e1dorov pankreasu plat\u00ed, \u017ee chirurgick\u00e1 radik\u00e1lna lie\u010dba je v\u017edy prvorad\u00e1, pokia\u013e ju mo\u017eno vykona\u0165. In\u00fdmi slovami \u2013 pokia\u013e m\u00e1 chirurg mo\u017enos\u0165 vykona\u0165 radik\u00e1lny v\u00fdkon, je optim\u00e1lne ho vykona\u0165, a&nbsp;to \u010do najsk\u00f4r. (Mo\u017enosti s\u00fa dan\u00e9 rozsahom postihnutia a&nbsp;stavom chor\u00e9ho. Radik\u00e1lny v\u00fdkon znamen\u00e1 kompletn\u00e9 odstr\u00e1nenie v&nbsp;ur\u010ditom danom rozsahu.). Pokia\u013e chirurg nem\u00f4\u017ee realizova\u0165 radik\u00e1lny v\u00fdkon, m\u00f4\u017ee urobi\u0165 v\u00fdkon \u201eod\u013eah\u010dovac\u00ed\u201c pod\u013ea situ\u00e1cie (napr. prepojenie \u017eal\u00fadka a&nbsp;tenk\u00e9ho \u010dreva, ktor\u00fdm dosiahne \u00fa\u013eavu v&nbsp;za\u017e\u00edvac\u00edch \u0165a\u017ekostiach).<\/span><\/p>\n<\/div>\n<\/div>\n<div class=\"gdc_column gdc_chalf\">\n<div class=\"gdc_inner\">\n<h3>R\u00e1dioterapia n\u00e1dorov pankreasu sa uplat\u0148uje ako:<\/h3>\n<ul>\n<li>Poopera\u010dn\u00e9, nasleduj\u00face po radik\u00e1lnom v\u00fdkone. Cie\u013e je likvid\u00e1cia mo\u017en\u00fdch mikroskopick\u00fdch zvy\u0161kov n\u00e1doru.<\/li>\n<li>Samostatn\u00e1. V&nbsp;pr\u00edpade, \u017ee nemo\u017eno vykona\u0165 chirurgick\u00fd v\u00fdkon. Cie\u013e je maxim\u00e1lne zlikvidova\u0165 n\u00e1dor.<\/li>\n<li>Predopera\u010dn\u00e9. Pokia\u013e chirurg prip\u00fa\u0161\u0165a mo\u017enos\u0165 radik\u00e1lneho v\u00fdkonu po zmen\u0161en\u00ed n\u00e1lezu.<\/li>\n<li>Zvl\u00e1\u0161tne uplatnenie je o\u017earovanie recid\u00edvy po u\u017e vykonanej radik\u00e1lnej oper\u00e1cii.<\/li>\n<\/ul>\n<h3>O\u017earovanie m\u00e1 nieko\u013eko pevn\u00fdch pravidiel<\/h3>\n<p>Spr\u00e1vna \u00fa\u010dinnos\u0165 sa dosahuje, iba ak je o\u017earovanie aplikovan\u00e9 \u201ev kontexte\u201c chemoterapie. Tzn. aplikuje sa najprv chemoterapia, po ur\u010ditej dobe chemoterapie sa realizuje o\u017eiarenie.<\/p>\n<p>O\u017earovanie pankreasu predstavuje po technickej a&nbsp;biologickej str\u00e1nke dos\u0165 \u0165a\u017ek\u00fa \u201e\u00falohu\u201c. Pankreas je toti\u017e obklopen\u00fd viacer\u00fdmi org\u00e1nmi, ktor\u00e9 mo\u017eno o\u017eiaren\u00edm po\u0161kodi\u0165 (pe\u010de\u0148, dvan\u00e1storn\u00edk, obli\u010dky, \u017eal\u00fadok a&nbsp;\u010fal\u0161ie). Preto sa uplat\u0148uje o\u017earovanie prot\u00f3nov\u00e9, s&nbsp;ktor\u00e9ho pomocou je mo\u017eno dan\u00fa \u00falohu rie\u0161i\u0165.<\/p>\n<h3>Chemoterapia predstavuje z\u00e1kladn\u00fa met\u00f3du lie\u010dby n\u00e1dorov pankreasu. M\u00e1 indik\u00e1cie:<\/h3>\n<ul>\n<li>Poopera\u010dn\u00e9 \u2013 po radik\u00e1lnom v\u00fdkone (s&nbsp;cie\u013eom likvid\u00e1cie mikroskopick\u00fdch zvy\u0161kov postihnutia).<\/li>\n<li>Predopera\u010dn\u00e9 \u2013 rovnako ako pri r\u00e1dioterapii s&nbsp;cie\u013eom dosiahnu\u0165 mo\u017enos\u0165 radik\u00e1lneho v\u00fdkonu.<\/li>\n<li>Samostatn\u00e9 \u2013 pokia\u013e nemo\u017eno realizova\u0165 radik\u00e1lny chirurgick\u00fd v\u00fdkon a&nbsp;nie je v\u00fdh\u013ead, \u017ee by to mo\u017en\u00e9 bolo.<\/li>\n<li>V t\u00fdchto indik\u00e1ci\u00e1ch po ur\u010ditom po\u010dte cyklov chemoterapie nadv\u00e4zuje o\u017earovanie<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h3><a href=\"https:\/\/www.ptc.cz\/wp-content\/uploads\/2023\/08\/shutterstock-583668982-1200x1200-1.jpg\" data-rel=\"lightbox-image-1\" data-rl_title=\"\" data-rl_caption=\"\" title=\"\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-881 size-full\" src=\"https:\/\/www.ptc.cz\/wp-content\/uploads\/2023\/08\/shutterstock-583668982-1200x1200-1.jpg\" alt=\"\" width=\"1200\" height=\"799\" srcset=\"https:\/\/www.ptc.cz\/wp-content\/uploads\/2023\/08\/shutterstock-583668982-1200x1200-1.jpg 1200w, https:\/\/www.ptc.cz\/wp-content\/uploads\/2023\/08\/shutterstock-583668982-1200x1200-1-300x200.jpg 300w, https:\/\/www.ptc.cz\/wp-content\/uploads\/2023\/08\/shutterstock-583668982-1200x1200-1-768x511.jpg 768w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><\/a><\/h3>\n<h2><\/h2>\n<p>&nbsp;<\/p>\n<h2><strong>Rakovina pe\u010dene<\/strong><\/h2>\n<div class=\"gdc_row\">\n<div class=\"gdc_column gdc_chalf\">\n<div class=\"gdc_inner\">\n<p>Prim\u00e1rne n\u00e1dory pe\u010dene (tzn. nie druhotn\u00e9 lo\u017eisk\u00e1 in\u00fdch n\u00e1dorov v&nbsp;pe\u010deni) s\u00fa v&nbsp;oblasti Eur\u00f3py pomerne vz\u00e1cne ochorenia. Lie\u010debn\u00fd postup je \u00faplne \u0161peci\u00e1lny. Naj\u00fa\u010dinnej\u0161ia met\u00f3da lie\u010dby je transplant\u00e1cia pe\u010dene. Menej \u00fa\u010dinn\u00e9 met\u00f3dy s\u00fa \u010diasto\u010dn\u00e1 resekcia pe\u010dene, r\u00e1dioterapia, chemoterapia pod\u00e1van\u00e1 do pe\u010de\u0148ovej tepny a&nbsp;rada \u0161pecifick\u00fdch met\u00f3d, napr. r\u00e1diofrekven\u010dn\u00fd ohrev n\u00e1dorov\u00e9ho lo\u017eiska, a&nbsp;fin\u00e1lne biologick\u00e1 lie\u010dba. Prim\u00e1rnym n\u00e1dorom pe\u010dene ochorie v&nbsp;SR ro\u010dne cca 400 os\u00f4b, \u0161tatistika nie je presn\u00e1. K&nbsp;rizikov\u00fdm faktorom patr\u00ed jednozna\u010dne prebehnut\u00e1 infek\u010dn\u00e1 \u017elta\u010dka (hepatit\u00edda), \u010falej cirh\u00f3za pe\u010dene a&nbsp;alkoholizmus.<\/p>\n<p>Pr\u00edznaky prim\u00e1rneho n\u00e1doru pe\u010dene s\u00fa zvy\u010dajne neskor\u00e9. Skor\u00e9 pr\u00edznaky \u010dasto \u00faplne ch\u00fdbaj\u00fa &#8211; preto je ochorenie \u010dasto diagnostikovan\u00e9 ako pokro\u010dil\u00e9. K&nbsp;pr\u00edznakom patria neur\u010dit\u00e9 bolesti v&nbsp;pravej hornej \u010dasti brucha, neur\u010dit\u00e9 za\u017e\u00edvacie \u0165a\u017ekosti, \u017elta\u010dka (ako pr\u00edznak, nie \u201ehepatit\u00edda\u201c), pr\u00edpadne zhor\u0161en\u00e1 zr\u00e1\u017eanlivos\u0165 krvy. Prim\u00e1rne n\u00e1dory pe\u010dene, tzn. nie druhotn\u00e9 lo\u017eisk\u00e1 n\u00e1dorov in\u00fdch lokaliz\u00e1ci\u00ed (metast\u00e1zy) sa lie\u010dia trochu odli\u0161n\u00fdmi met\u00f3dami ako in\u00e9 n\u00e1dorov\u00e9 ochorenia. Naj\u00fa\u010dinnej\u0161ia met\u00f3da lie\u010dby je transplant\u00e1cia pe\u010dene. Menej \u00fa\u010dinn\u00e9 met\u00f3dy s\u00fa \u010diasto\u010dn\u00e1 resekcia pe\u010dene, r\u00e1dioterapia, chemoterapia pod\u00e1van\u00e1 do pe\u010de\u0148ovej tepny a&nbsp;rada \u0161pecifick\u00fdch met\u00f3d, napr. r\u00e1diofrekven\u010dn\u00fd ohrev n\u00e1dorov\u00e9ho lo\u017eiska, a&nbsp;fin\u00e1lne biologick\u00e1 lie\u010dba. Transplant\u00e1cia pe\u010dene (pod\u013ea jasne dan\u00fdch krit\u00e9ri\u00ed) a&nbsp;mo\u017enos\u0165 oper\u00e1cie (\u010diasto\u010dn\u00e1 resekcia pe\u010dene)<\/p>\n<ul>\n<li>Mo\u017enosti posudzuje jedno z&nbsp;2 transplanta\u010dn\u00fdch pracov\u00edsk v&nbsp;CR &#8211; IKEM Praha, FN Brno. (V&nbsp;\u010cR je jeden z&nbsp;naj\u00faspe\u0161nej\u0161\u00edch transplanta\u010dn\u00fdch programov na&nbsp;svete.)<\/li>\n<li>Ak nie je mo\u017en\u00e9 transplantova\u0165 alebo resekova\u0165 \u010das\u0165 pe\u010dene, uva\u017euje sa o&nbsp;mo\u017enostiach o\u017earovania a&nbsp;cielenej chemoterapie podanej do pe\u010de\u0148ovej tepny.<\/li>\n<li>O\u017earovanie je technicky n\u00e1ro\u010dn\u00e1 met\u00f3da. \u010casto nie je mo\u017en\u00e9 s&nbsp;oh\u013eadom na&nbsp;lokaliz\u00e1ciu a&nbsp;rozsah postihnutia \u00fa\u010dinn\u00fa d\u00e1vku aplikova\u0165 inak ako o\u017earovan\u00edm prot\u00f3nmi.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"gdc_column gdc_chalf\">\n<div class=\"gdc_inner\">\n<h3><strong>Chirurgick\u00e1 lie\u010dba, transplant\u00e1cia, \u010diasto\u010dn\u00e1 resekcia<\/strong><\/h3>\n<p>Chirurgick\u00e9 met\u00f3dy maj\u00fa najlep\u0161iu \u00fa\u010dinnos\u0165. Iba ak chirurg jednozna\u010dne zamietne transplant\u00e1ciu alebo resekciu, s\u00fa indikovan\u00e9 \u010fal\u0161ie lie\u010debn\u00e9 modality. (Prirodzene u&nbsp;ve\u013emi pokro\u010dil\u00fdch ochoren\u00ed, napr. s&nbsp;mnohopo\u010detn\u00fdmi metast\u00e1zami, je stanovisko vopred jasn\u00e9 a&nbsp;nie je nutn\u00e9 za\u0165a\u017eova\u0165 \u0161pi\u010dkov\u00e9 pracovisk\u00e1 nevyhnutnou konzult\u00e1ciou.)<\/p>\n<h3><strong>R\u00e1dioterapia<\/strong><\/h3>\n<p>R\u00e1dioterapia prim\u00e1rnych n\u00e1dorov pe\u010dene je pomerne nov\u00e1 met\u00f3da, zatia\u013e m\u00e1lo vyu\u017e\u00edvan\u00e1. Je to dan\u00e9 t\u00fdm, \u017ee be\u017en\u00fdmi metodikami fot\u00f3nov\u00e9ho (gama) \u017eiarenia nebolo mo\u017en\u00e9 o\u017eiarenie n\u00e1doru pe\u010dene do \u00fa\u010dinnej d\u00e1vky bezpe\u010dne vykona\u0165. A\u017e n\u00e1stup pokro\u010dil\u00fdch met\u00f3d r\u00e1dioterapie, napr. prot\u00f3novej r\u00e1dioterapie, umo\u017e\u0148uje o\u017eiari\u0165 prim\u00e1rny n\u00e1dor pe\u010dene s&nbsp;vysokou \u00fa\u010dinnos\u0165ou. O\u017earuje sa n\u00e1dorov\u00e9 postihnutie, ktor\u00e9 chirurg neur\u010dil ako vhodn\u00e9 na&nbsp;resekciu alebo transplant\u00e1ciu a&nbsp;ktor\u00e9 nepostihuje tkaniv\u00e1 mimo pe\u010dene. Postihnutie tie\u017e nesmie zauj\u00edma\u0165 viac ako polovicu pe\u010dene.<\/p>\n<h3><strong>Chemoterapia, biologick\u00e1 terapia a&nbsp;ostatn\u00e9 met\u00f3dy<\/strong><\/h3>\n<p><span style=\"font-size: 16px;\">\u00da\u010dinn\u00e1 chemoterapia prim\u00e1rnych n\u00e1dorov pe\u010dene nebola vyvinut\u00e1. \u00da\u010dinnos\u0165 m\u00e1 iba \u0161peci\u00e1lna chemoterapia pod\u00e1van\u00e1 priamo do pe\u010de\u0148ovej tepny, ozna\u010dovan\u00e1 term\u00ednom \u201eTACE\u201c. Niektor\u00e9 prim\u00e1rne n\u00e1dory pe\u010dene sa tie\u017e daj\u00fa lie\u010di\u0165 priamou intervenciou, zvy\u010dajne cez ihlu zaveden\u00fa do n\u00e1doru pod&nbsp;kontrolou CT \u2013 s\u00fahrnne \u201eabla\u010dn\u00e9 met\u00f3dy\u201c. Pri pokro\u010dil\u00fdch n\u00e1lezoch sa u\u017e\u00edva cielen\u00e1 biologick\u00e1 lie\u010dba vo forme tabliet.<\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-1884 size-full\" src=\"https:\/\/www.ptc.cz\/wp-content\/uploads\/2024\/01\/shutterstock_1877565325-s.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https:\/\/www.ptc.cz\/wp-content\/uploads\/2024\/01\/shutterstock_1877565325-s.jpg 1920w, https:\/\/www.ptc.cz\/wp-content\/uploads\/2024\/01\/shutterstock_1877565325-s-300x200.jpg 300w, https:\/\/www.ptc.cz\/wp-content\/uploads\/2024\/01\/shutterstock_1877565325-s-1400x933.jpg 1400w, https:\/\/www.ptc.cz\/wp-content\/uploads\/2024\/01\/shutterstock_1877565325-s-768x512.jpg 768w, https:\/\/www.ptc.cz\/wp-content\/uploads\/2024\/01\/shutterstock_1877565325-s-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\" \/><\/p>\n<h2><\/h2>\n<p>&nbsp;<\/p>\n<h2><strong>N\u00e1dory an\u00e1lneho otvoru<\/strong><\/h2>\n<div class=\"gdc_row\">\n<div class=\"gdc_column gdc_chalf\">\n<div class=\"gdc_inner\">\n<p>N\u00e1dory an\u00e1lu s\u00fa \u00faplne \u0161pecifick\u00e9 ochorenie, ktor\u00e9 vych\u00e1dza z&nbsp;oblasti zviera\u010da, pr\u00edpadne a\u017e z&nbsp;oblasti prechodu zviera\u010da do ko\u017ee. V&nbsp;lie\u010dbe n\u00e1dorov an\u00e1lu v&nbsp;s\u00fa\u010dasnej dobe prevl\u00e1da r\u00e1dioterapia nad&nbsp;chirurgick\u00fdm v\u00fdkonom, ktor\u00fd vy\u017eaduje zavedenie trval\u00e9ho (do\u017eivotn\u00e9ho) v\u00fdvodu \u010dreva \u2013 kolost\u00f3mie. R\u00e1dioterapia samotn\u00e1 sta\u010d\u00ed na&nbsp;\u00fapln\u00e9 vylie\u010denie cca u&nbsp;90% chor\u00fdch a&nbsp;ide o&nbsp;lie\u010dbu ve\u013emi n\u00e1ro\u010dn\u00fa a&nbsp;rizikov\u00fa. Pri prot\u00f3novej r\u00e1dioterapii je n\u00e1ro\u010dnos\u0165 men\u0161ia. V&nbsp;\u010cR ro\u010dne ochorie n\u00e1dorom an\u00e1lu 170-190 os\u00f4b. V\u00fdskyt narast\u00e1 po 40.&nbsp;roku veku. K&nbsp;rizikov\u00fdm faktorom n\u00e1dorov an\u00e1lu patr\u00ed infekcia v\u00edrusom HPV (teraz je mo\u017enos\u0165 vakcin\u00e1cie), faj\u010denie a&nbsp;neobvykl\u00e9 sexu\u00e1lne praktiky. Pr\u00edznaky n\u00e1doru s\u00fa s\u00edce skor\u00e9, ale \u010dasto s\u00fa mylne diagnostikovan\u00e9 iba hemoroidy.<\/p>\n<p>Hlavn\u00fd pr\u00edznak je krv\u00e1canie, \u010falej neur\u010dit\u00e9 bolesti vo zviera\u010di, dr\u00e1\u017edenie, bolestiv\u00e9 vypr\u00e1zd\u0148ovanie stolice, pr\u00edpadne n\u00e1lez zv\u00e4\u010d\u0161en\u00fdch uzl\u00edn v&nbsp;slabin\u00e1ch. Lie\u010dba n\u00e1dorov\u00fdch ochoren\u00ed an\u00e1lneho otvoru \u2013 anu sa riadi \u0161pecifick\u00fdmi pravidlami. Vo\u013eba lie\u010debn\u00fdch modal\u00edt je \u00faplne odli\u0161n\u00e1 od n\u00e1dorov susednej anatomickej lokaliz\u00e1cie \u2013 kone\u010dn\u00edka. Je preto potrebn\u00e9 celkom jednozna\u010dne (a&nbsp;samozrejme spr\u00e1vne) ur\u010di\u0165 diagn\u00f3zu: n\u00e1dor ritn\u00e9ho otvoru &#8211; anu vers. n\u00e1dor kone\u010dn\u00edka \u2013 rekta. Lie\u010debn\u00fd postup sa v\u017edy rozhoduje pri konzult\u00e1cii s&nbsp;chor\u00fdm, ktor\u00fd m\u00e1 na&nbsp;v\u00fdber medzi chirurgick\u00fdm v\u00fdkonom a&nbsp;o\u017earovan\u00edm. O\u017earovanie sa v\u017edy dop\u013a\u0148a s\u00fa\u010dasnou chemoterapiou.<\/p>\n<p>R\u00e1dioterapia je ve\u013emi n\u00e1ro\u010dn\u00e1 a&nbsp;je sprev\u00e1dzan\u00e1 radom ne\u017eiaducich efektov v&nbsp;oblasti ko\u017ee a&nbsp;slizn\u00edc zviera\u010da a&nbsp;okolia, ale aj ne\u017eiaducimi efektmi, ktor\u00e9 sa manifestuj\u00fa v&nbsp;krvnom obraze. Preto boli vyvinut\u00e9 techniky prot\u00f3novej r\u00e1dioterapie, ktor\u00e9 obmedzuj\u00fa ne\u017eiaduce efekty a&nbsp;umo\u017e\u0148uj\u00fa obvykle aplikova\u0165 o\u017earovanie bez nutnosti zavies\u0165 do\u010dasn\u00fa (od\u013eah\u010dovaciu) kolost\u00f3miu.<\/p>\n<\/div>\n<\/div>\n<div class=\"gdc_column gdc_chalf\">\n<div class=\"gdc_inner\">\n<h3><strong>Chirurgick\u00e1 lie\u010dba, tzn. r\u00f4zne druhy v\u00fdkonov, oper\u00e1ci\u00ed<\/strong><\/h3>\n<p>Chirurgick\u00e1 lie\u010dba n\u00e1dorov anu sa od 80.&nbsp;rokov 20.&nbsp;stor. prim\u00e1rne neuplat\u0148uje. Bol toti\u017e objaven\u00fd v\u00fdrazn\u00fd efekt \u017eiarenia, ktor\u00fd vedie pri vysokom podiele chor\u00fdch (pod\u013ea \u0161t\u00e1dia ochorenia 80% &#8211; 95%) k&nbsp;\u00fapln\u00e9mu vylie\u010deniu bez chirurgick\u00e9ho v\u00fdkonu. Av\u0161ak ako alternat\u00edva k&nbsp;o\u017earovaniu je chirurgick\u00fd v\u00fdkon st\u00e1le v&nbsp;r\u00e1mci \u0161tandardn\u00e9ho postupu k&nbsp;dispoz\u00edcii. Spo\u010d\u00edva v&nbsp;odstr\u00e1nen\u00ed cel\u00e9ho zviera\u010da, tzn. vy\u017eaduje zavedenie trval\u00e9ho v\u00fdvodu. V&nbsp;s\u00fa\u010dasnej dobe s\u00fa hlavn\u00fdmi indik\u00e1ciami k&nbsp;chirurgick\u00e9mu v\u00fdkonu (z\u00e1chrannej lie\u010dbe) situ\u00e1cie, kedy ochorenie bu\u010f recidivuje, alebo nebolo o\u017earovan\u00edm kompletne vylie\u010den\u00e9 (pod\u013ea \u0161t\u00e1dia ochorenia je riziko 5-15%). Do oblasti chirurgickej lie\u010dby tie\u017e patr\u00ed ot\u00e1zka do\u010dasn\u00e9ho zavedenia v\u00fdvodu na&nbsp;dobu r\u00e1dioterapie, ktor\u00e1 umo\u017en\u00ed lep\u0161ie tolerova\u0165 poradia\u010dn\u00e9 ko\u017en\u00e9 a&nbsp;slizni\u010dn\u00e9 reakcie.<\/p>\n<h3><strong>R\u00e1dioterapia<\/strong><\/h3>\n<p>R\u00e1dioterapia n\u00e1dorov an\u00e1lu je prioritn\u00e1 lie\u010dba, pokia\u013e sa chor\u00fd nerozhodne pre chirurgick\u00fa alternat\u00edvu. R\u00e1dioterapia n\u00e1dorov an\u00e1lu je ve\u013emi n\u00e1ro\u010dn\u00e1 lie\u010dba. Jej neoddelite\u013enou s\u00fa\u010das\u0165ou je s\u00fa\u010dasn\u00e9 podanie \u0161tandardnej chemoterapie. Je sprev\u00e1dzan\u00e1 mno\u017estvom ne\u017eiaducich efektov v&nbsp;oblasti ko\u017ee, slizn\u00edc, urogenit\u00e1lneho traktu a&nbsp;tie\u017e krvn\u00e9ho obrazu. Preto sa uplat\u0148uje r\u00e1dioterapia prot\u00f3nov\u00e1, ktor\u00e1 m\u00e1 priaznivej\u0161ie rozlo\u017eenie d\u00e1vok ako konven\u010dn\u00e1 r\u00e1dioterapia fot\u00f3nov\u00e1, a&nbsp;ne\u017eiaduce efekty sa dar\u00ed sk\u00f4r zmier\u0148ova\u0165, ale nie eliminova\u0165. Vo v\u00e4\u010d\u0161ine pr\u00edpadov je mo\u017en\u00e9 prot\u00f3nov\u00fa r\u00e1dioterapiu aplikova\u0165 bez zavedenia do\u010dasn\u00e9ho v\u00fdvodu \u010dreva, tzv. kolost\u00f3mie. Protin\u00e1dorov\u00e1 \u00fa\u010dinnos\u0165 prot\u00f3novej a&nbsp;fot\u00f3novej r\u00e1dioterapie je rovnak\u00e1.<\/p>\n<h3><strong>Chemoterapia<\/strong><\/h3>\n<p>Je indikovan\u00e1 pri rozmern\u00fdch n\u00e1doroch pred r\u00e1dioterapiou s&nbsp;cie\u013eom zmen\u0161i\u0165 o\u017earovan\u00fa masu. Je tie\u017e indikovan\u00e1 pri recid\u00edve vo forme vzdialen\u00fdch metast\u00e1z (lok\u00e1lne recid\u00edva je mo\u017en\u00e9 rie\u0161i\u0165 \u201ez\u00e1chrannou\u201c oper\u00e1ciou).<\/p>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>N\u00e1dory pa\u017eer\u00e1ka &nbsp; &nbsp; N\u00e1dory pankreasu &nbsp; &nbsp; Rakovina pe\u010dene &nbsp; &nbsp; N\u00e1dory an\u00e1lneho otvoru<\/p>\n","protected":false},"author":1,"featured_media":2897,"parent":3217,"menu_order":247,"comment_status":"closed","ping_status":"closed","template":"template-service-detail-with-sidebar.php","meta":{"footnotes":""},"class_list":["post-3223","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.ptc.cz\/sk\/wp-json\/wp\/v2\/pages\/3223","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ptc.cz\/sk\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ptc.cz\/sk\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ptc.cz\/sk\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ptc.cz\/sk\/wp-json\/wp\/v2\/comments?post=3223"}],"version-history":[{"count":3,"href":"https:\/\/www.ptc.cz\/sk\/wp-json\/wp\/v2\/pages\/3223\/revisions"}],"predecessor-version":[{"id":3417,"href":"https:\/\/www.ptc.cz\/sk\/wp-json\/wp\/v2\/pages\/3223\/revisions\/3417"}],"up":[{"embeddable":true,"href":"https:\/\/www.ptc.cz\/sk\/wp-json\/wp\/v2\/pages\/3217"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.ptc.cz\/sk\/wp-json\/wp\/v2\/media\/2897"}],"wp:attachment":[{"href":"https:\/\/www.ptc.cz\/sk\/wp-json\/wp\/v2\/media?parent=3223"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}