{"id":4006,"date":"2018-02-15T16:09:41","date_gmt":"2018-02-15T16:09:41","guid":{"rendered":"https:\/\/www.cgs-cls.cz\/?page_id=4006"},"modified":"2018-11-05T22:37:45","modified_gmt":"2018-11-05T22:37:45","slug":"barrettuv-jicen","status":"publish","type":"page","link":"https:\/\/www.cgs-cls.cz\/dispenzarni-gastroskopie\/barrettuv-jicen\/","title":{"rendered":"Barrett\u016fv j\u00edcen"},"content":{"rendered":"
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Barrett\u016fv j\u00edcen – vstupn\u00ed endoskopie<\/th>\nvstupn\u00ed terapie<\/th>\nterm\u00edny kontrol p\u0159i absenci dyspl\u00e1zie<\/th>\n<\/tr>\n
bez dyspl\u00e1zie<\/td>\ndo 3 cm d\u00e9lky<\/td>\nbez<\/td>\nza 6-12 M<\/td>\n\u00e1 3-5 R1<\/sup><\/td>\n<\/td>\n<\/td>\n<\/tr>\n
nad 3 cm d\u00e9lky<\/td>\nbez<\/td>\nza 6-12 M<\/td>\n\u00e1 2-3 R1<\/sup><\/td>\n<\/td>\n<\/td>\n<\/tr>\n
s dyspl\u00e1zi\u00ed<\/td>\nlehk\u00e9ho stupn\u011b2<\/sup><\/td>\nRFA3<\/sup>, EMR3, 4<\/sup><\/td>\nza 3-6 M<\/td>\nza 3-6 M<\/td>\nza 3 R<\/td>\n\u00e1 3-5 R<\/td>\n<\/tr>\n
t\u011b\u017ek\u00e9 stupn\u011b<\/td>\nEMR\/ESD\/RFA5<\/sup><\/td>\nza 3-6 M<\/td>\nza 3-6 M<\/td>\nza 6-12 M<\/td>\n\u00e1 1-2 R<\/td>\n<\/tr>\n
s \u010dasn\u00fdm adenokarcinomem<\/td>\nEMR\/ESD5<\/sup><\/td>\n\u00e1 3 M 1. R<\/td>\n\u00e1 6 M 2. R<\/td>\n\u00e1 1 R6<\/sup><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div>\n<\/div>\n
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Z\u00e1kladem je kvalitn\u00ed vy\u0161et\u0159en\u00ed p\u0159\u00edstrojem s vysok\u00fdm rozli\u0161en\u00edm s mo\u017enost\u00ed elektronick\u00e9ho zv\u00fdrazn\u011bn\u00ed slizni\u010dn\u00edho reli\u00e9fu po dobu nejm\u00e9n\u011b 1 min\/cm cirkumferentn\u00edho posti\u017een\u00ed, v\u010detn\u011b biopsi\u00ed v\u0161ech viditeln\u00fdch l\u00e9z\u00ed a n\u00e1hodn\u00fdch biopsii dle Seattle protokolu (\u010dty\u0159kvadrantov\u00e1 biopsie \u00e1 2 cm).
\nNutn\u00e1 detekce, staging a p\u0159\u00edpadn\u011b resekce v\u0161ech viditeln\u00fdch l\u00e9z\u00ed.
\n1<\/sup>pokud trv\u00e1 benefit pro pacienta (v\u011bt\u0161inou do 75 let)
\n2<\/sup>nutn\u00e9 potvrzen\u00ed druh\u00fdm \u010dten\u00edm patologem centra z biopsi\u00ed velkokapacitn\u00edmi kle\u0161t\u011bmi nejm\u00e9n\u011b p\u0159i 2 endoskopi\u00edch p\u0159i absenci viditeln\u00fdch z\u00e1n\u011btliv\u00fdch zm\u011bn
\n3<\/sup>alternativou pouze sledov\u00e1n\u00ed \u00e1 6 M u pacient\u016f s vysok\u00fdm rizikem endoskopick\u00e9 terapie
\n4<\/sup>viditeln\u00e9 l\u00e9ze\/individu\u00e1ln\u011b u kr\u00e1tk\u00e9ho segmentu
\n5<\/sup>alternativou chirurgick\u00e1 terapie<\/p>\n

Literatura: Mart\u00ednek J et al. Standardy \u010cGS – endoskopick\u00e1 l\u00e9\u010dba pacient\u016f s Barrettov\u00fdm j\u00edcnem a \u010dasn\u00fdmi neopl\u00e1ziemi j\u00edcnu. Gastroent Hepatol 2013;67:479-87.
\n\t6<\/sup>National Comprehensive Cancer Network. NCCN Guidelines Version 2.2018 Esophageal and Esophagogastric Junction Cancers 05\/22\/2018.
\nZp\u011btn\u00e1 vazba: jiri.cyrany@fnhk.cz<\/a><\/em><\/p>\n

EMR – endoskopick\u00e1 slizni\u010dn\u00ed resekce, ESD – endoskopick\u00e1 submuk\u00f3zn\u00ed disekce, RFA – radiofrekven\u010dn\u00ed ablace, M – m\u011bs\u00edc, R – rok<\/em><\/small>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Barrett\u016fv j\u00edcen – vstupn\u00ed endoskopie vstupn\u00ed terapie term\u00edny kontrol p\u0159i absenci dyspl\u00e1zie bez dyspl\u00e1zie do 3 cm d\u00e9lky bez za 6-12 M \u00e1 3-5 R1 nad 3 cm d\u00e9lky bez za 6-12 M \u00e1 2-3 R1 s dyspl\u00e1zi\u00ed lehk\u00e9ho stupn\u011b2 RFA3, EMR3, 4 za 3-6 M za 3-6 M za 3 R \u00e1 3-5 R t\u011b\u017ek\u00e9 stupn\u011b EMR\/ESD\/RFA5 za […]<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":4004,"menu_order":1,"ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-4006","page","type-page","status-publish","hentry"],"acf":[],"lang":"cs","translations":{"cs":4006},"pll_sync_post":[],"_links":{"self":[{"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/pages\/4006","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/users\/1"}],"version-history":[{"count":21,"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/pages\/4006\/revisions"}],"predecessor-version":[{"id":4824,"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/pages\/4006\/revisions\/4824"}],"up":[{"embeddable":true,"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/pages\/4004"}],"wp:attachment":[{"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/media?parent=4006"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}