Nisan 2017
Mide kanseri deneyimlerimiz: Tani ve tedavide geç mi kaliyoruz?
Our stomach cancer experiences: Is there any retardation in diagnosis or treatment?
- Ana Sayfa
- Sayılar
- Nisan 2017
- Mide kanseri deneyimlerimiz: Tani ve tedavide geç mi kaliyoruz? ...
2Istanbul Medeniyet Üniversitesi Göztepe Egitim Arastirma Hastanesi, Genel Cerrahi Klinigi, Istanbul
Özet
Giris ve Amaç: Mide kanserinin erken taninmasi tedavide daha sinirlirezeksiyonlarin yapilmasina ve sag kalimin iyilesmesine olanak saglar.Amacimiz mide kanserli hastalarimizin semptomlari, endoskopik bulgulari ve ameliyat piyeslerini degerlendirerek hangi evrelerde basvurduklarini saptamaktir. Gereç ve Yöntem: Mide kanseri nedeniyle elektifopere edilen 77 hastanin verileri retrospektif olarak degerlendirildi.Hastalarin demografik verileri, ko-morbiditeleri, tümör lokalizasyonlari,pasaj geçisinin olup olmadigi, semptomlar ve süreleri, endoskopik patoloji sonuçlari, Amerikan Anesteziyoloji Dernegi siniflamasi, uygulananrezeksiyon tipleri, patolojik evreler, tümör büyüklügü, çikarilan ortalama lenf nodu ve metastatik lenf nodu sayisi ve evreleri degerlendirildi.Bulgular: Çalismamizda, olgularin 55’i (%71,4) erkek, 22’si (%28,6)kadin idi. Olgularin 46’sina (%59,8) total gastrektomi,16’sina (%20,8)subtotal gastrektomi ve 15’ine de (%19,4) eksploratif laparotomi uy-gulandi. Laparoskopik yaklasimla 2 (%2,6) olguya total gastrektomi, 2(%2,6) olguya subtotal gastrektomi yapildi. Olgularin 9’unda (%11,68)ek organ rezeksiyonu yapildi. Morbidite 9 (%11,6) olguda görüldü.Mortalite 3 (%3,9) olguda görüldü. En sik saptanan T patolojik evresipT3 ve pT4 idi (sirasiyla %18,2 ve %55,8). Olgularimizin büyük çogunlu-gunun Evre 3 (%61) olduklari görüldü. Sonuç: Mide kanseri nedeniyleile ameliyat edilen hastalarimiz tani sirasinda genellikle ileri evrede olup,bu hastalara genis çapli mide rezeksiyonlari ve lenf nodu diseksiyonlariyapilmaktadir. Minimal cerrahi girisimlerin veya endoskopik girisimlerinuygulanabilmesi için tarama programlari ile olgularin erken evrede saptanmasi gereklidir.
Abstract
Background and Aims: Theearly diagnosis of gastric cancer allows limited resection and improved survival. Our aim was to evaluate symptoms, endoscopic findings, and surgical procedures in patients with stomach cancer andto determine at which pathologic stage they applied for treatment. Materials and Methods: The data of 77 patients who were operated for gastric cancer were retrospectively evaluated. The demographic data of the patients, comorbidities, tumor localization, presence or absence of passage obstruction, symptoms and their duration, endoscopic pathology results, American Society of Anesthesiologists (ASA) score, type and method of resection applied, pathologic stage, tumor size, number of lymph nodes removed, and number of metastatic lymph nodes and stages were evaluated. Results: In our study, 55 (71.4%) males and 22 (28.6%) females were included. Total gastrectomy was performed in 46 patients (59.8%), subtotal gastrectomy in 16 (20.8%), and explorative laparotomy in 15 (19.4%). Laparoscopic total gastrectomy was performed in 2 patients (2.6%) and laparoscopic subtotal gastrectomy in 2 (2.6%). In 9patients (11.68%) , additional organ resection was performed. Morbidity was seen in 9 patients (11.6%) and mortality in 3(3.9%). The most frequent pathologic stages were pT3 and pT4 (18.2% and 55.8%, respectively). Majority of the patients were in stage 3 (61%). Conclusion: The patients who were operated on because of gastric cancer were usually in an advanced stage of cancer during diagnosis, and they had extensive gastric resections and lymph node dissections. To be able to perform less invasive surgical or endoscopic procedures, it is necessary to detect cases of cancer at an earlier stage using screening programs.
