{"id":173,"date":"2013-03-14T09:33:03","date_gmt":"2013-03-14T09:33:03","guid":{"rendered":"https:\/\/eportal.chirurgie.upol.cz\/portal_final\/?page_id=173"},"modified":"2013-06-10T16:59:40","modified_gmt":"2013-06-10T16:59:40","slug":"1-3","status":"publish","type":"page","link":"https:\/\/eportal.chirurgie.upol.cz\/portal_final\/?page_id=173","title":{"rendered":"1 \u00davod"},"content":{"rendered":"

J\u00edcen \u2013 ezofagus<\/strong> (z \u0159eck\u00e9ho oisofagos: oiso = n\u00e9st, fago = j\u00edst), esofagus, oesophagus (anglicky), die Speiser\u00f6hre, \u00f6sophagus (n\u011bmecky), pa\u017eer\u00e1k (slovensky), przelyk (polsky), pi\u0161\u010devod (rusky), oesophage (francouzsky), esofago (italsky), es\u00f3fagao (\u0161pan\u011blsky).<\/span><\/p>\n

J\u00edcen je pro sv\u00e9 anatomick\u00e9 ulo\u017een\u00ed p\u0159ed p\u00e1te\u0159\u00ed na krku a v zadn\u00edm mediastinu v hrudn\u00edku nep\u0159\u00edstupn\u00fd b\u011b\u017en\u00e9mu klinick\u00e9mu vy\u0161et\u0159en\u00ed a vedle rozboru anamn\u00e9zy byly dlouho mo\u017enosti jeho vy\u0161et\u0159en\u00ed velmi omezen\u00e9. Stejn\u011b komplikovan\u00fd je i chirurgick\u00fd p\u0159\u00edstup k ezofagu, a z\u016fst\u00e1val proto dlouho na okraji z\u00e1jmu gastroenterolog\u016f i chirurg\u016f. Tato situace se postupn\u011b m\u011bnila a\u017e ve druh\u00e9 polovin\u011b minul\u00e9ho stolet\u00ed, kdy s prudk\u00fdm rozvojem diagnostick\u00fdch a l\u00e9\u010debn\u00fdch metod byly sumarizov\u00e1ny a vyhodnoceny zku\u0161enosti center zab\u00fdvaj\u00edc\u00edch se touto problematikou, a sedmdes\u00e1t\u00e1 a osmdes\u00e1t\u00e1 l\u00e9ta minul\u00e9ho stolet\u00ed lze pova\u017eovat za obdob\u00ed, kdy do\u0161lo ke standardizaci diagnostick\u00fdch i l\u00e9\u010debn\u00fdch metod v ezofagologii <\/b>[1, 2, 3]. V tomto procesu z\u00edskala olomouck\u00e1 j\u00edcnov\u00e1 \u0161kola <\/b>d\u016fstojn\u00e9 m\u00edsto p\u0159esahuj\u00edc\u00ed v\u00fdznam na\u0161\u00ed zem\u011b [4, 5].<\/p>\n

D\u00edky prof. Rapantovi a jeho spolupracovn\u00edk\u016fm se brzy po jeho p\u0159\u00edchodu do Olomouce v roce 1945 za\u010dala provozovat i j\u00edcnov\u00e1 chirurgie. Prvn\u00ed ezofagektomie a pneumonektomie byla v Olomouci provedena za \u00fa\u010dasti prof. Brunschwiga z USA 2. 8. 1946. Prvn\u00ed ezofagokardi\u00e1ln\u00ed myotomie pro achal\u00e1zii byla u n\u00e1s provedena 17. 6. 1948, co\u017e bylo d\u0159\u00edve ne\u017e na Mayo klinice v Rochesteru v USA [6]. J\u00e1 s\u00e1m jsem se za\u010dal zab\u00fdvat j\u00edcnovou chirurgi\u00ed po p\u0159\u00edchodu na I. chirurgickou kliniku od roku 1970. P\u0159i hodnocen\u00ed v\u00fdsledk\u016f v j\u00edcnov\u00e9 chirurgii na po\u010d\u00e1tku osmdes\u00e1t\u00fdch let minul\u00e9ho stolet\u00ed jsem m\u011bl mo\u017enost hodnotit soubor v\u00edce ne\u017e 1000 operovan\u00fdch od roku 1945 do roku 1982, z \u010deho\u017e bylo 798 operovan\u00fdch pro funk\u010dn\u00ed onemocn\u011bn\u00ed. V\u00fdsledky byly publikov\u00e1ny v \u0159ad\u011b prac\u00ed, kter\u00e9 jsou uvedeny v dal\u0161\u00edch kapitol\u00e1ch, a ve dvou monografi\u00edch [4, 5], z nich\u017e jedna, vydan\u00e1 v n\u011bmeck\u00e9m jazyce, si z\u00edskala i mezin\u00e1rodn\u00ed ohlas. V t\u00e9 dob\u011b se jednalo i v mezin\u00e1rodn\u00edm m\u011b\u0159\u00edtku o jednu z nejv\u011bt\u0161\u00edch sestav operovan\u00fdch v Evrop\u011b. Olomouck\u00e9 pracovi\u0161t\u011b bylo v dob\u011b po druh\u00e9 sv\u011btov\u00e9 v\u00e1lce prakticky jedin\u00fdm pracovi\u0161t\u011bm v \u010cech\u00e1ch a na Morav\u011b, kde se velk\u00e9 j\u00edcnov\u00e9 operace prov\u00e1d\u011bly. Na dobu po\u010d\u00e1tk\u016f j\u00edcnov\u00e9 chirurgie v Olomouci vzpom\u00edn\u00e1 tehdej\u0161\u00ed asistent kliniky doc. MUDr. Emil Holub, CSc. [7]: \u201eD\u00edky profesoru Rapantovi na\u0161e klinika doh\u00e1n\u011bla, co bylo v\u00e1lkou v chirurgii odlo\u017eeno, a aktivn\u011b se \u00fa\u010dastnila dal\u0161\u00edho rozvoje chirurgie. Nap\u0159\u00edklad chirurgie j\u00edcnu se ji\u017e v Olomouci prov\u00e1d\u011bla, ale v Praze je\u0161t\u011b ne. Tak se stalo, \u017ee k n\u00e1m poslali slovensk\u00e9ho p\u0159edv\u00e1le\u010dn\u00e9ho ministra zdravotnictv\u00ed, l\u00e9ka\u0159e s karcinomem j\u00edcnu, kter\u00e9ho profesor operoval. Le\u017eel u mne na odd. 26 a hl\u00eddali ho ve dne v noci dva p\u0159\u00edslu\u0161n\u00edci StB, kte\u0159\u00ed si vynutili i p\u0159\u00edstup na s\u00e1l (aby se snad n\u011bco ,nevhodn\u00e9ho\u2018 nestalo). V\u00fdkon se zda\u0159il, bohu\u017eel pacient byl dlouholet\u00fd siln\u00fd ku\u0159\u00e1k (a to i v dob\u011b nemoci na klinice) a kardiak\u2026\u201c
\n\"\"<\/span><\/p>\n

Po penzionov\u00e1n\u00ed prof. Rapanta v prvn\u00ed polovin\u011b roku 1970 v tradici j\u00edcnov\u00e9 chirurgie d\u00e1le pokra\u010doval jeho n\u00e1stupce prof. MUDr. Zden\u011bk \u0160er\u00fd, DrSc. Rozv\u00edjel zejm\u00e9na mezin\u00e1rodn\u00ed spolupr\u00e1ci s p\u0159edn\u00edmi sv\u011btov\u00fdmi j\u00edcnov\u00fdmi chirurgy, co\u017e bylo v t\u00e9 dob\u011b vzhledem k politick\u00e9 situaci velmi sv\u00edzeln\u00e9. P\u0159\u00ednos pro rozvoj chirurgie to byl velk\u00fd, proto\u017ee se tak aspo\u0148 \u010d\u00e1ste\u010dn\u011b da\u0159ilo vymanit se z izolovanosti, kterou v t\u00e9 dob\u011b na\u0161e v\u011bda trp\u011bla. I jeho z\u00e1sluhou mi byla v letech 1985\u20131986 umo\u017en\u011bna studijn\u00ed cesta do USA, kter\u00e1 byla zam\u011b\u0159ena hlavn\u011b na chirurgii j\u00edcnu. Znamenala pro m\u011b velk\u00fd impulz pro dal\u0161\u00ed rozvoj ezofage\u00e1ln\u00ed chirurgie, kterou jsem pak provozoval od roku 1986 na II. chirurgick\u00e9 klinice v Olomouci, ji\u017e jsem a\u017e do konce roku 2006 vedl. V t\u00e9 dob\u011b se j\u00edcnov\u00e1 chirurgie provozovala na obou olomouck\u00fdch chirurgick\u00fdch pracovi\u0161t\u00edch. \u00dasp\u011b\u0161n\u011b se n\u00e1m poda\u0159ilo zachytit a rozv\u00edjet od po\u010d\u00e1tku devades\u00e1t\u00fdch let minul\u00e9ho stolet\u00ed i n\u00e1stup miniivazivn\u00edch metod, kter\u00e9 v\u00fdznamn\u011b ovlivnily i p\u0159\u00edstup k j\u00edcnov\u00fdm onemocn\u011bn\u00edm [8], stejn\u011b jako realizovat \u00fazkou interdisciplin\u00e1rn\u00ed spolupr\u00e1ci s dal\u0161\u00edmi obory, bez nich\u017e dnes nelze modern\u00ed ezofagologii rozv\u00edjet [9, 10]. Je samoz\u0159ejm\u00e9, \u017ee s rozvojem chirurgie a medic\u00edny v\u016fbec se po druh\u00e9 sv\u011btov\u00e9 v\u00e1lce na problematiku j\u00edcnov\u00e9 chirurgie zam\u011b\u0159ila i dal\u0161\u00ed pracovi\u0161t\u011b v \u010cech\u00e1ch, na Morav\u011b i Slovensku, zejm\u00e9na to byla III. chirurgick\u00e1 klinika v Praze. Tradici j\u00edcnov\u00e9 chirurgie se i dal\u0161\u00edm generac\u00edm chirurg\u016f da\u0159\u00ed v Olomouci udr\u017eet, o \u010dem\u017e sv\u011bd\u010d\u00ed vysok\u00e1 opera\u010dn\u00ed i v\u011bdeck\u00e1 aktivita trvaj\u00edc\u00ed do sou\u010dasnosti.<\/p>\n

Literatura<\/h3>\n
    \n
  1. Vantrapen G, Hellemans J, editors. Diseases of the Esophagus. 1st ed. Berlin Heidelberg New York: Springer Verlag; 1974.<\/li>\n
  2. Siewert RJ, Blum AL, Waldeck F, editors. Funktionssterungen der Speiser\u00f6hre. 1st ed. Berlin Heidelberg New York: Springer Verlag; 1976.<\/li>\n
  3. Jamieson GG, editors. Surgery of the Oesophagus. 1st ed. Edinburgh London Melbourne and New York: Churchill Livingstone; 1988.<\/li>\n
  4. Duda M. Chirurgische Behandlung der Funktionssterungen der Speiser\u00f6hre. 1st ed. Olomouc: Univerzita Palack\u00e9ho; 1984.<\/li>\n
  5. Duda M. Chirurgick\u00e1 l\u00e9\u010dba funk\u010dn\u00edch poruch gastroezofage\u00e1ln\u00edho spojen\u00ed a j\u00edcnu. 1st ed. Bratislava: Veda Vydavatelstvo Slovenskej akademie ved; 1984.<\/li>\n
  6. Ellis FH Jr., Olsen AM. Achalasia of the oesophagus. 1st ed. Philadelphia: WB Saunders; 1969.<\/li>\n
  7. Holub E. in: Duda M, a kolektiv. Historie chirurgie, vybran\u00e9 stat\u011b olomouck\u00e9 a moravsk\u00e9 chirurgie. 2. vyd\u00e1n\u00ed. Olomouc: Univerzita Palack\u00e9ho; 2009.<\/li>\n
  8. Duda M, Czudek S, et al. Miniinvazivn\u00ed chirurgie. 1st ed. T\u0159inec: Nemocnice Podles\u00ed T\u0159inec; 1996.<\/li>\n
  9. K\u00f6cher M, Dlouh\u00fd M, Neoral \u010c, Buri\u00e1nkov\u00e1 E, Gryga A, Duda M, et al. Esophageal Stent with Antireflux Valve for Tumors Involving the Cardia: Work in Progress. J VIR. 1998; 9: 1007\u20131010.<\/li>\n
  10. Duda M. Kap. 5: Duda M, Hildebrand T: J\u00edcen a kardie, Kap. 6: Duda M, Hildebrand T: Neu- romuskul\u00e1rn\u00ed poruchy j\u00edcnu, Kap. 7: Duda M: Hi\u00e1tov\u00e9 k\u00fdly, Kap. 8: Duda M, Hildebrand T:Z\u00e1n\u011bty j\u00edcnu, Kap. 9: Duda M, Hildebrand T: Refluxn\u00ed nemoc j\u00edcnu, Kap. 10: Duda M, Hildebrand T: N\u00e1dory j\u00edcnu, Kap. 11: Duda M, Hildebrand T: Jin\u00e9 nemoci j\u00edcnu in: Zden\u011bk Ma\u0159atka a kolektiv: Gastroenterologie. 1. vyd\u00e1n\u00ed. Praha: Nakladatelstv\u00ed Karolinum; 1999.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    J\u00edcen \u2013 ezofagus (z \u0159eck\u00e9ho oisofagos: oiso = n\u00e9st, fago = j\u00edst), esofagus, oesophagus (anglicky), die Speiser\u00f6hre, \u00f6sophagus (n\u011bmecky), pa\u017eer\u00e1k (slovensky), przelyk (polsky), pi\u0161\u010devod (rusky), oesophage (francouzsky), esofago (italsky), es\u00f3fagao (\u0161pan\u011blsky). J\u00edcen je pro sv\u00e9 anatomick\u00e9 ulo\u017een\u00ed p\u0159ed p\u00e1te\u0159\u00ed na krku a v zadn\u00edm mediastinu v hrudn\u00edku nep\u0159\u00edstupn\u00fd b\u011b\u017en\u00e9mu klinick\u00e9mu vy\u0161et\u0159en\u00ed a vedle rozboru anamn\u00e9zy […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":65,"menu_order":15,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-173","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/eportal.chirurgie.upol.cz\/portal_final\/index.php?rest_route=\/wp\/v2\/pages\/173","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/eportal.chirurgie.upol.cz\/portal_final\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/eportal.chirurgie.upol.cz\/portal_final\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/eportal.chirurgie.upol.cz\/portal_final\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/eportal.chirurgie.upol.cz\/portal_final\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=173"}],"version-history":[{"count":12,"href":"https:\/\/eportal.chirurgie.upol.cz\/portal_final\/index.php?rest_route=\/wp\/v2\/pages\/173\/revisions"}],"predecessor-version":[{"id":945,"href":"https:\/\/eportal.chirurgie.upol.cz\/portal_final\/index.php?rest_route=\/wp\/v2\/pages\/173\/revisions\/945"}],"up":[{"embeddable":true,"href":"https:\/\/eportal.chirurgie.upol.cz\/portal_final\/index.php?rest_route=\/wp\/v2\/pages\/65"}],"wp:attachment":[{"href":"https:\/\/eportal.chirurgie.upol.cz\/portal_final\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=173"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}