Oktojeneryanlarda kolorektal kanser cerrahisi
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Date
2015
Authors
Gülcü, Barış
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Amaç: Yaşlanan insan nüfusu ile birlikte en önemli risk faktörü yaş olan kolorektal kanserli hastaların sıklığı da artmaktadır. Çalışmamızda kolorektal kanser nedeniyle ameliyat edilen oktojeneryanların klinik sonuçlarının sunulması amaçlanmıştır. Gereç ve Yöntem: Uludağ Üniversitesi Genel Cerrahi Anabilim Dalı'nda 1 Ocak 2010 ile 31 Aralık 2013 tarihleri arasında kolorektal kanser nedeniyle ameliyat olmuş 63 oktojeneryan hastanın verileri retrospektif olarak incelenmiştir. Hastaların demografik verileri, yandaş hastalıkları, ASA (American Society of Anesthesiologists) skoru, preoperatif, peroperatif ve postoperatif parametreleri göz önünde bulundurularak değerlendirilmiştir. Bulgular: Hastaların 36'sı erkek, 27'si kadındır. Ortanca yaş 81(80-89)'dir. Hastaların %73,4'ünde kardiyak kökenli yandaş hastalık vardır.Tümör yerleşimi gelişmiş ülkelerden farklı olarak %17,5 sağ kolon, %50,8 sol kolon ve %31,7 ile rektum yerleşimlidir Gelişmiş ülkelerden farklı olarak en sık rektum kanseri görülmüştür. Acil/acele başvurup kardiyoloji tarafınca değerlendirilmeden ameliyat edilen hastaların sonuçları kardiyoloji tarafınca değerlendirilenler ile benzerdir. Preoperatif eritrosit süspansiyonu verilmesi morbiditeyi arttırır. MBT(mekanik bağırsak temizliği) yapılıp/yapılmaması arasında fark yoktur. Elektif ameliyatlarda en çok low anterior rezeksiyon ve anterior rezeksiyon, acil ameliyatlarda ise en çok Hartmann prosedürü uygulanmaktadır. Ostomi açılmasında acil başvuru istatiksel anlamlıdır. Adjuvan kemoterapinin nüks ve uzak organ metastazında etkisi saptanmamıştır. Rektum yerleşimli kanseri olanlarda yapılan rektum cerrahisi cerrahi morbidite gelişiminde anlamlıdır. Hastanede yatış süresini yalnızca gelişen cerrahi/medikal morbidite etkilemektedir. Çalışmamınızın cerrahi morbidite oranı %19, medikal morbidite oranı %15,9, nüks oranları %19 ve mortalite oranı %1,58'dir Sonuç: Oktojeneryanlarda kolorektal kanser cerrahisi bu konuda özelleşmiş kolorektal cerrahların olduğu merkezlerde kabul edilebilir morbidite ve mortalite oranları ile güvenle yapılabilir.
Aim: Prevalence of the colorectal cancer has been progressively increasing due to the most important risk factor as age along with the world population which has become older. In our study, presentation of clinical results of octogenerians operated due to the colorectal cancer was aimed. Materials and Methods: A total of 63 octogenerian patient who underwent operation due to the colorectal cancer in Uludağ University Department of General Surgery between January 1, 2010 and December 31, 2010 were retrospectively evaluated from their patient records. Demographics, concomittant diseases, ASA (American Society of Anesthesiologists) scores, preoperative, perioperative and postoperative properties were evaluated with the consideration of these parameters. Results: 36 and 27 of the patients were male and female patients, respectively. Mean age of the sample was 81(80-89) years.%73,4 of the patients had concomittant disease related with cardiac problems. As different from the developed countries, localizations of the tumours were as: %17.5 in right colon, %50.8 in left colon and %31.7 in rectum. Patients operated without evaluated by cardiology had similar results with patients operatied with evaluation by cardiology. Administration of preoperavite red blood package increases morbidity. There is no difference between performing/not performing MBP(mechanical bowel preparation). Low anterior resection and anterior resection was the most commonly performed in elective operations, whereas Hartmann procedure was most commonly used in urgent operations. Urgent admission statistics of the ostomy opening was significant. There were no effects of the adjuvant chemotherapy on the reccurence and peripheral organ metastase. Rectal surgery performed on patients with rectal cancers was significant for development of surgical morbidity. Duration of hospitalization was only affected by occurence of surgical/medical morbidity. Rate of surgical morbidity was %19, rate of medical morbidity was %15.9, recurrence rate was %19 and mortality rate was %1.58 in our study. Conclusiton: Colorectal cancer surgery in octogenerians can be safely performed in centers which have specialized colorectal surgeons about this issue with acceptable morbidity and mortality rates.
Aim: Prevalence of the colorectal cancer has been progressively increasing due to the most important risk factor as age along with the world population which has become older. In our study, presentation of clinical results of octogenerians operated due to the colorectal cancer was aimed. Materials and Methods: A total of 63 octogenerian patient who underwent operation due to the colorectal cancer in Uludağ University Department of General Surgery between January 1, 2010 and December 31, 2010 were retrospectively evaluated from their patient records. Demographics, concomittant diseases, ASA (American Society of Anesthesiologists) scores, preoperative, perioperative and postoperative properties were evaluated with the consideration of these parameters. Results: 36 and 27 of the patients were male and female patients, respectively. Mean age of the sample was 81(80-89) years.%73,4 of the patients had concomittant disease related with cardiac problems. As different from the developed countries, localizations of the tumours were as: %17.5 in right colon, %50.8 in left colon and %31.7 in rectum. Patients operated without evaluated by cardiology had similar results with patients operatied with evaluation by cardiology. Administration of preoperavite red blood package increases morbidity. There is no difference between performing/not performing MBP(mechanical bowel preparation). Low anterior resection and anterior resection was the most commonly performed in elective operations, whereas Hartmann procedure was most commonly used in urgent operations. Urgent admission statistics of the ostomy opening was significant. There were no effects of the adjuvant chemotherapy on the reccurence and peripheral organ metastase. Rectal surgery performed on patients with rectal cancers was significant for development of surgical morbidity. Duration of hospitalization was only affected by occurence of surgical/medical morbidity. Rate of surgical morbidity was %19, rate of medical morbidity was %15.9, recurrence rate was %19 and mortality rate was %1.58 in our study. Conclusiton: Colorectal cancer surgery in octogenerians can be safely performed in centers which have specialized colorectal surgeons about this issue with acceptable morbidity and mortality rates.
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Keywords
Cerrahi, Kolorektal, Morbidite, Mortalite, Oktojeneryan, Surgery, Colorectal, Morbidity, Mortality, Octogenerian
Citation
Gülcü, B. (2015). Oktojeneryanlarda kolorektal kanser cerrahisi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.