            TY  - JOUR
T1  - Bilgisayarlı Tomografik Kolonoskopinin  Kolon Tümörünü Saptama ve Evrelemesindeki Rolü
TT  - The Role of Computed Tomographic Colonoscopy on the Detection and Staging of Colorectal Cancer
AU  - Uysal Ramadan, Selma
AU  - Gökharman, Dilek
AU  - Özer, Hilal
AU  - Kacar, Mahmut
AU  - Koşar, Pınar
PY  - 2018
DA  - May
JF  - Akademik Araştırma Tıp Dergisi
JO  - AATD
PB  - Keçiören Eğitim ve Araştırma Hastanesi
WT  - DergiPark
SN  - 2528-9152
SP  - 22
EP  - 27
VL  - 2
IS  - 1
LA  - tr
AB  - Amaç: Bilgisayarlı tomografi (BT) kolonoskopi ile kolonun duvaryapısı, serozal yüzey, perikolik yağ dokusu, lenf nodları veuzak organ metastazın değerlendirilebilmesi nedeniyle diğerkolon değerlendirme tekniklerine üstündür. Bu çalışmada BTkolonoskopinin kolon kitlelerini saptama ve evrelenmesindekirolü araştırıldı.Gereç ve Yöntem: Optik kolonoskopide saptanan distal tıkayıcıkolon kanseri nedeniyle proksimal kolonun değerlendirilemediği11 olgu (2 kadın, 9 erkek, yaşları 45-71 yıl) çalışmayadahil edildi. Bağırsak temizliğini takiben BT ile olgulara, pronve supin pozisyonda BT kolonoskopi çekimi yapıldı. Bu kitleler“Modifiye Dukes” sınıflaması ile evrelendi. BT kolonoskopidensonra 1-3 gün içinde ameliyat ile çıkartılan kitlelere patolojikolarak Dukes sınıflaması yapıldı. BT kolonoskopik ve patolojikDukes sınıflaması arasındaki uyum araştırıldı.Bulgular: On bir kolon kitlesinin tamamı BT kolonoskopi ilegösterilebildi. Kitleler en sık (%36) sigmoid kolon yerleşimliolup, bunu transvers kolon (%18) takip etmekteydi. Olgularınhepsinde kitlelerin bulunduğu düzeylerden proksimale havageçişi sağlanarak, bu segmentlerin de değerlendirilebilmesisağlandı. On bir olgunun 7’sinde (%63,6) kitle proksimal veyadistalinde 5mm’nin üstünde bir veya bir kaç adet polip izlendi.Bunlardan birinde toplamda 10’dan fazla 1 cm’den büyük polipmevcut olup, bu olguya ameliyatta total kolektomi yapıldı.Diğer 10 olguda ise kitle segmental kolektomi ile çıkarıldı. BTkolonoskopi ile 8 olguda (%72,7) doğru, 1 olguda (%9,1) dahadüşük, 2 olguda (%18,2) ise daha yüksek evreleme yapıldığıgözlendi. Kolon kanser evrelemesinde BT kolonoskopi ve patolojibulguları arasında anlamlı ilişki saptandı (p&amp;lt;0.05).Sonuç: BT kolonoskopinin kolon tümörlerinde yüksek doğruluktaevrelemesi, proksimal ve distal kolon segmentlerini dedeğerlendirmeye imkan vermesi kolonun diğer görüntülemetekniklerine olan üstünlüğüdür.
KW  - BT kolonoskopi
KW  - kolorektal kanser
KW  - optik   kolonoskopi
N2  - Purpose: Computed tomography (CT) colonoscopy overcomesthe other colon evaluation techniques due to the ability ofthe colon wall, serosal surface, pericolic fat tissue, lymph nodesand distant organ metastases to be evaluated. In this study, therole of CT colonoscopy in the detection and staging of colonmasses was investigated.Material and Methods: Eleven cases (2 females, 9 males, 45-71 years) whose proximal colon could not be evaluated due todistal obstructive colon cancer detected on optical colonoscopywere included in the study. Following bowel cleansing,CT colonography was performed in the prone and supinepositions. These masses were staged with the “Modified Dukes”classification. Patients who underwent surgical excisionwithin 1-3 days after CT colonoscopy were pathologically classifiedas Dukes. The agreement between CT colonoscopy andpathology classifications was investigated by Cohen’s kappa.Results: All of the eleven colon masses was demonstrated byCT colonoscopy. The masses were the most common (36%)sigmoid colon, followed by transverse colon (18%). In all cases,it was ensured that these segments could be assessed by providingair passage to the proximal from the levels where masseswere present. Seven (63.6%) of the eleven cases had one ormore polyps on the proximal or distal 5mm above the mass.There was a total of more than 10 polyps (&amp;gt;1cm) on one of thepatient, total colectomy was done during the operation. In theother 10 cases mass was removed by segmental colectomy. CTcolonoscopy revealed that 8 cases (72.7%) had a lower gradein 1 case (9.1%) and 2 cases (18.2%) had a higher grade. Therewas a significant correlation between CT colonoscopy and pathologyfindings in colon cancer stage (p &amp;lt;0.05).Conclusion: It is the superiority of CT colonoscopy to otherimaging techniques of the colon, allowing high-precision stagingof colon tumors, and evaluation of proximal and distalcolon segments.
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UR  - https://dergipark.org.tr/en/pub/aatd/article/448958
L1  - https://dergipark.org.tr/en/download/article-file/515672
ER  -