{"id":21646,"date":"2015-09-28T07:58:58","date_gmt":"2015-09-28T05:58:58","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=21646"},"modified":"2015-09-28T11:15:07","modified_gmt":"2015-09-28T09:15:07","slug":"na-ortopedickou-operaci-cekaji-pacienti-v-pelhrimovske-nemocnici-zhruba-pul-roku","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=21646","title":{"rendered":"Na ortopedickou operaci \u010dekaj\u00ed pacienti v pelh\u0159imovsk\u00e9 nemocnici zhruba p\u016fl roku"},"content":{"rendered":"

Na ortopedii m\u011b bav\u00ed, \u017ee je to \u010dist\u00fd obor, \u010dist\u00e9 operov\u00e1n\u00ed, \u0159\u00edk\u00e1 prim\u00e1\u0159 ortopedick\u00e9ho odd\u011blen\u00ed Nemocnice Pelh\u0159imov Jaroslav Letocha
\nRozhovor <\/strong><\/p>\n

ilustra\u010dn\u00ed foto: Adam-Ciesielski-sxc.hu<\/p>\n

Pelh\u0159imov \u2013 \u010cty\u0159icetilet\u00fd prim\u00e1\u0159 ortopedick\u00e9ho odd\u011blen\u00ed pelh\u0159imovsk\u00e9 nemocnice Jaroslav Letocha by z profesn\u00edho hlediska r\u00e1d udr\u017eel kredit tamn\u00ed ortopedie, kter\u00fd je u\u017e \u0159adu let nastaven.
\n„Pokud se mi ho poda\u0159\u00ed pro pacienty, ale i odborn\u00edky, nav\u00fd\u0161it, tak to bude jenom dob\u0159e,“ \u0159\u00edk\u00e1 uzn\u00e1van\u00fd l\u00e9ka\u0159, otec \u010dtrn\u00e1ctilet\u00e9 dcery a desetilet\u00e9ho syna, kter\u00fd Den\u00edku poskytl rozhovor. V n\u011bm mimo jin\u00e9 uv\u00e1d\u00ed, o kolik se za posledn\u00edch deset let zv\u00fd\u0161il po\u010det pacient\u016f v ortopedick\u00e9 ambulanci, nebo kterou z ortopedick\u00fdch operac\u00ed pokl\u00e1d\u00e1 za nejn\u00e1ro\u010dn\u011bj\u0161\u00ed. <\/p>\n

– Kdy jste zjistil, \u017ee v\u00e1s l\u00e1k\u00e1 medic\u00edna, a co v\u00e1s p\u0159ivedlo k ortopedii? <\/p>\n

J\u00e1 jsem se medic\u00ednou za\u010d\u00ednal zab\u00fdvat n\u011bkdy koncem t\u0159et\u00edho a za\u010d\u00e1tkem \u010dtvrt\u00e9ho ro\u010dn\u00edku na gymn\u00e1ziu. Nejsem z l\u00e9ka\u0159sk\u00e9 rodiny a rozhodnut\u00ed vydat se touto cestou vzniklo tak n\u011bjak spont\u00e1nn\u011b. P\u016fvodn\u011b jsem necht\u011bl b\u00fdt ortopedem, ale chirurgem. Jako chirurg jsem vlastn\u011b i za\u010d\u00ednal v po\u010d\u00e1teck\u00e9 nemocnici, dokud je\u0161t\u011b existovala. N\u00e1sledn\u011b, kdy\u017e se uvolnilo m\u00edsto na ortopedii v Pelh\u0159imov\u011b, jsem nastoupil sem. V Pelh\u0159imovsk\u00e9 nemocnici jsem od 1.b\u0159ezna 2001 a prim\u00e1\u0159em ortopedie od 1. z\u00e1\u0159\u00ed 2013. <\/p>\n

– Jak\u00e1 je va\u0161e specializace v r\u00e1mci ortopedie a co v\u00e1s na n\u00ed nejv\u00edc p\u0159itahuje? <\/p>\n

Jsme relativn\u011b mal\u00e9 odd\u011blen\u00ed, tak\u017ee specializace u n\u00e1s nen\u00ed tak rozli\u0161ov\u00e1na jako na klinik\u00e1ch nebo v krajsk\u00fdch nemocnic\u00edch. Spektrum diagn\u00f3z a pacient\u016f tu nen\u00ed tak \u0161irok\u00e9, a tak \u010dlov\u011bk d\u011bl\u00e1 „skoro v\u0161echno“. Ne\u017e jsem se stal prim\u00e1\u0159em, v\u011bnoval jsem se prakticky cel\u00e9mu oboru. Pot\u00e9 jsem n\u011bkter\u00e9 oblasti ortopedie m\u00edrn\u011b opustil, jako nap\u0159\u00edklad ortopedii nohy \u010di ruky. Nyn\u00ed se v\u011bnuji zejm\u00e9na kloubn\u00edm n\u00e1hrad\u00e1m, artroskopii a traumatologii. Na ortopedii m\u011b bav\u00ed, \u017ee je to \u010dist\u00fd obor, \u010dist\u00e9 operov\u00e1n\u00ed. <\/p>\n

– Jste erudovan\u00fd operat\u00e9r. Chr\u00e1n\u00edte si v b\u011b\u017en\u00e9m \u017eivot\u011b ruce, kter\u00e9 v\u00e1s vlastn\u011b \u017eiv\u00ed? <\/p>\n

D\u0159\u00edv jsem to n\u011bjak ne\u0159e\u0161il. Co bylo pot\u0159eba doma ud\u011blat, to se ud\u011blalo. Ob\u010dasn\u00e9 \u0161r\u00e1my na rukou vad\u00ed, ale p\u0159i o\u0161et\u0159ov\u00e1n\u00ed pacient\u016f nav\u00edc „ne\u010dist\u00e9“ ruce ned\u011blaj\u00ed dobr\u00fd dojem. V sou\u010dasn\u00e9 dob\u011b u\u017e ale v\u011bt\u0161inu rizikov\u00fdch v\u011bc\u00ed d\u011bl\u00e1m v rukavic\u00edch. D\u016fle\u017eit\u00e9 je i poji\u0161t\u011bn\u00ed rukou (sm\u00edch). <\/p>\n

– Poj\u010fme k va\u0161emu odd\u011blen\u00ed. \u010c\u00edm v\u0161\u00edm se ortopedi v Pelh\u0159imov\u011b zab\u00fdvaj\u00ed? <\/p>\n

Dominantn\u00ed pod\u00edl, kdy\u017e pominu \u010dinnosti v souvislosti s ortopedickou ambulanc\u00ed, zauj\u00edmaj\u00ed kloubn\u00ed n\u00e1hrady, a\u0165 u\u017e prim\u00e1rn\u00ed, nebo revizn\u00ed. Kolenn\u00ed, ky\u010deln\u00ed klouby, v men\u0161\u00ed m\u00ed\u0159e ramenn\u00ed klouby. Ojedin\u011ble prov\u00e1d\u00edme operace jin\u00fdch velk\u00fdch kloub\u016f, t\u0159eba lokt\u016f, hlezen, tam spolupracujeme s vy\u0161\u0161\u00edmi pracovi\u0161ti v republice. Druhou podskupinou jsou artroskopie \u2013 kolenn\u00edch, ramenn\u00edch, v men\u0161\u00ed m\u00ed\u0159e pak hlezenn\u00edch a ky\u010deln\u00edch kloub\u016f. Ve spolupr\u00e1ci s chirurgick\u00fdm odd\u011blen\u00edm participujeme na traumatologii, a to zejm\u00e9na na zlomenin\u00e1ch horn\u00edho konce stehenn\u00ed kosti. \u010ctvrtou skupinou je komplexn\u00ed ortopedie nohy a p\u0159edno\u017e\u00ed. Samoz\u0159ejm\u011b nemohu opominout ambulantn\u00ed \u010dinnost, kde se zab\u00fdv\u00e1me „v\u0161\u00edm, co p\u0159ijde“ a podle povahy bu\u010f sami \u0159e\u0161\u00edme, nebo odes\u00edl\u00e1me na vy\u0161\u0161\u00ed pracovi\u0161t\u011b. <\/p>\n

– Kolik l\u00e9ka\u0159\u016f se o pacienty star\u00e1? <\/p>\n

V sou\u010dasn\u00e9 dob\u011b pracuje na ortopedii osm kmenov\u00fdch l\u00e9ka\u0159\u016f, i kdy\u017e ne v\u0161ichni maj\u00ed pln\u00fd \u00favazek. K tomu n\u00e1m v r\u00e1mci \u00fastavn\u00ed pohotovostn\u00ed slu\u017eby vypom\u00e1haj\u00ed kolegov\u00e9 nap\u0159\u00edklad z rehabilitace. <\/p>\n

– Pro\u010d byste doporu\u010dil pacientovi podstoupit operaci pr\u00e1v\u011b v Pelh\u0159imov\u011b? <\/p>\n

Nejsem \u010dlov\u011bk, kter\u00fd by se vychloubal. Prim\u00e1\u0159em jsem relativn\u011b kr\u00e1tce. Funkci jsem p\u0159evzal po prim\u00e1\u0159i B\u011bhounkovi, kter\u00fd zde vybudoval velmi siln\u00e9 a \u00fasp\u011b\u0161n\u00e9 odd\u011blen\u00ed s velmi dobrou reputac\u00ed v okol\u00ed. R\u00e1d bych na n\u011bj nav\u00e1zal, pokra\u010doval v jeho pr\u00e1ci, udr\u017eel kvalitu a v\u00fdsledky p\u0159i l\u00e9\u010db\u011b na\u0161ich pacient\u016f. To pro n\u00e1s bude tou nejlep\u0161\u00ed reklamou. <\/p>\n

– Kolik pacient\u016f o\u0161et\u0159\u00edte v pr\u016fm\u011bru za den a kolik operac\u00ed se stihne b\u011bhem opera\u010dn\u00edho dne? <\/p>\n

Prov\u00e1d\u00edme okolo 1100 operac\u00ed ro\u010dn\u011b, tedy okolo sto operac\u00ed za m\u011bs\u00edc. Denn\u011b m\u00e1me zhruba 4 a\u017e 6 p\u0159\u00edjm\u016f, stejn\u00fd po\u010det propu\u0161t\u011bn\u00ed. V ambulanci vy\u0161et\u0159\u00edme za rok p\u0159ibli\u017en\u011b \u010dtrn\u00e1ct tis\u00edc pacient\u016f. <\/p>\n

– Byl jste n\u011bkdy s\u00e1m v roli ortopedick\u00e9ho pacienta? <\/p>\n

Ano, byl, asi t\u0159ikr\u00e1t za posledn\u00edch deset let. <\/p>\n

– Jak\u00e9 opera\u010dn\u00ed v\u00fdkony prov\u00e1d\u00edte takzvan\u011b jak na b\u011b\u017e\u00edc\u00edm p\u00e1su? <\/p>\n

Ned\u011blejme z ortopedick\u00e9 operativy p\u00e1sovou v\u00fdrobu. Ka\u017ed\u00e1 operace m\u00e1 sv\u00e1 specifika, z\u00e1konitosti, pravidla. Nav\u00edc zde p\u0159istupuje individualita ka\u017ed\u00e9ho jednotliv\u00e9ho pacienta. \u0158adu operac\u00ed prov\u00e1d\u00edme samoz\u0159ejm\u011b \u010dast\u011bji a dost\u00e1vaj\u00ed n\u00e1dech rutiny, nap\u0159\u00edklad artroskopie kolene a TEP ky\u010deln\u00edho kloubu. <\/p>\n

– Kterou z ortopedick\u00fdch operac\u00ed naopak pokl\u00e1d\u00e1te za nejn\u00e1ro\u010dn\u011bj\u0161\u00ed, nejslo\u017eit\u011bj\u0161\u00ed? <\/p>\n

Velmi slo\u017eit\u00e9 jsou reoperace a zlomeniny v oblasti kloubn\u00edch n\u00e1hrad, \u0159ada prim\u00e1rn\u00edch operac\u00ed v ter\u00e9nu po\u00farazov\u00fdch stav\u016f, revmatismu. V podstat\u011b v\u0161ude tam, kde jen defekt kosti, kter\u00fd n\u00e1m st\u011b\u017euje ukotven\u00ed kloubn\u00ed n\u00e1hrady. <\/p>\n

– Jak\u00e1 je u v\u00e1s pr\u016fm\u011brn\u00e1 \u010dekac\u00ed doba na operaci a jak\u00e1 je optim\u00e1ln\u00ed? <\/p>\n

Zhruba p\u016fl roku na implantaci kloubn\u00edch n\u00e1hrad, 3\u00ac 4 t\u00fddny na “ mal\u00e9“ operace. Tyto \u010dasy pova\u017euji za optim\u00e1ln\u00ed. Akutn\u00ed operace samoz\u0159ejm\u011b prov\u00e1d\u00edme co nejd\u0159\u00edve. <\/p>\n

– Je to hodn\u011b nebo m\u00e1lo? <\/p>\n

P\u016flro\u010dn\u00ed doba na implantaci kloubn\u00ed n\u00e1hrady je „pr\u016fm\u011brn\u00e1“. M\u00e1me pacienty, kte\u0159\u00ed maj\u00ed posti\u017een\u00ed kloubu v\u00fdrazn\u00e9, t\u0159eba „rozpadl\u00fd“ p\u0159i nekrose. Tam p\u016flro\u010dn\u00ed \u010dek\u00e1n\u00ed je velmi nep\u0159\u00edjemn\u00e9 jak pro pacienta, tak pro n\u00e1s, proto\u017ee b\u011bhem t\u00e9 doby m\u016f\u017ee doj\u00edt k v\u00fdrazn\u00e9 struktur\u00e1ln\u00ed zm\u011bn\u011b kloubu a k daleko n\u00e1ro\u010dn\u011bj\u0161\u00edm technick\u00fdm probl\u00e9m\u016fm p\u0159i samotn\u00e9 operaci. Jinak se sna\u017eme do p\u016fl roku vyj\u00edt v\u0161em pacient\u016fm vst\u0159\u00edc. <\/p>\n

– Na odd\u011blen\u00ed jste nastoupil v roce 2001. Pozorujete za tu dobu, \u017ee je v\u00edce ortopedick\u00fdch pacient\u016f? <\/p>\n

Kdy\u017e porovn\u00e1m \u010dist\u011b ambulantn\u00ed \u010dinnost, tak v roce 2005 ortopedick\u00e1 ambulance o\u0161et\u0159ila asi 8800 pacient\u016f. Za deset let se po\u010det pacient\u016f zv\u00fd\u0161il zhruba o \u0161est tis\u00edc. Na odd\u011blen\u00ed je situace jin\u00e1. Po\u010dty operac\u00ed jsou rok od roku podobn\u00e9, proto\u017ee jsme jednak limitov\u00e1ni l\u016f\u017eky, jednak poji\u0161\u0165ovnou. <\/p>\n

– Je v dne\u0161n\u00ed dob\u011b v\u00edce ortopedick\u00fdch probl\u00e9m\u016f nap\u0159\u00edklad u d\u011bt\u00ed ne\u017e v minulosti? <\/p>\n

U d\u011bt\u00ed n\u00e1m funguje specializovan\u00e1 ambulance, kde se doktor Skot\u00e1k zab\u00fdv\u00e1 r\u016fzn\u00fdmi vadami \u2013 plochou nohou, vadn\u00fdm dr\u017een\u00edm t\u011bla, skoli\u00f3zou p\u00e1te\u0159e, mezi dal\u0161\u00ed \u010dast\u00e9 diagn\u00f3zy pat\u0159\u00ed reaktivn\u00ed otoky kloub\u016f a\u0165 u\u017e p\u0159i, nebo po infek\u010dn\u00edch chorob\u00e1ch. Po\u010dty d\u011btsk\u00fdch pacient\u016f v na\u0161\u00ed ambulanci z\u016fst\u00e1vaj\u00ed meziro\u010dn\u011b podobn\u00e9. <\/p>\n

– Co pova\u017eujete za sv\u016fj nejv\u011bt\u0161\u00ed \u00fasp\u011bch, t\u0159eba i mimo medic\u00ednsk\u00fd obor? <\/p>\n

Z profesn\u00edho hlediska je pro mne \u00fasp\u011bchem m\u00e1 nyn\u011bj\u0161\u00ed pozice. Nen\u00ed to ten nejv\u011bt\u0161\u00ed \u00fasp\u011bch, na ten sp\u00ed\u0161e je\u0161t\u011b \u010dek\u00e1m. T\u00edm by mohlo pro mne b\u00fdt udr\u017een\u00ed \u010di nav\u00fd\u0161en\u00ed kreditu pelh\u0159imovsk\u00e9 ortopedie. V soukrom\u00e9m \u017eivot\u011b pak rodina \u2013 man\u017eelka a d\u011bti, zdrav\u00ed. Bez t\u011bchto „pomocn\u00edk\u016f“ se vrcholov\u00e1 medic\u00edna ned\u00e1 d\u011blat. <\/p>\n

– Jak odpo\u010d\u00edv\u00e1te? Kde nab\u00edr\u00e1te s\u00edlu? <\/p>\n

Okruhy jsou dva \u2013 sport, kter\u00fd mi ob\u010das p\u0159in\u00e1\u0161\u00ed i n\u011bkter\u00e9 ortopedick\u00e9 bol\u00edstky, a zejm\u00e9na rodina. Tr\u00e1vit \u010das s man\u017eelkou, d\u011btmi, v\u00fdlety, hrami, p\u00e9\u010d\u00ed o chalupu \u010di zahradu, to m\u011b bav\u00ed a napl\u0148uje.<\/p>\n

ALEXANDRA KNAPOV\u00c1
\nPelh\u0159imovsk\u00fd den\u00edk
\nhttp:\/\/www.pelhrimovsky.denik.cz\/<\/p>\n","protected":false},"excerpt":{"rendered":"

Na ortopedii m\u011b bav\u00ed, \u017ee je to \u010dist\u00fd obor, \u010dist\u00e9 operov\u00e1n\u00ed, \u0159\u00edk\u00e1 prim\u00e1\u0159 ortopedick\u00e9ho odd\u011blen\u00ed Nemocnice Pelh\u0159imov Jaroslav Letocha Rozhovor<\/p>\n<\/div>","protected":false},"author":1,"featured_media":14511,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-21646","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/21646","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=21646"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/21646\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14511"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=21646"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=21646"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=21646"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}