Research Article
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Does emergency surgery have impact on lymph node harvest in colorectal cancer surgery?

Year 2022, Volume: 7 Issue: 2, 24 - 28, 01.08.2022
https://doi.org/10.25000/acem.1071023

Abstract

Aim: Adequate oncologic surgery for colorectal cancer implies proper resection margin of the resected specimen and complete mesocolic excision in order to achieve objective postoperative pathologic staging. Current recommendations require a minimum of 12 lymph nodes retrieval. In emergency colon cancer surgery, questions are raised about its impact on the lymph node number harvest. Aim of this study is to determine the impact of emergency colorectal cancer surgery on the lymph node number retrieval.
Methods: Retrospective analysis of 102 patients operated for colorectal cancer in the period of 1 year was conducted. Two groups (emergency and elective) were formed. Six surgeons performed all of the operations (three high-volume and three low-volume surgeons).
Results: Twenty patients presented as surgical emergencies and the rest 66 were elective cases. Sixteen patients with stage IV were excluded. Mean number of lymph nodes retrieved in the emergency group was 11.1 [5 - 20], and 14.7 [4 – 34] in the elective one, respectively (p = 0.004). Sufficient number of lymph nodes (≥ 12) extraction was achieved in 7 patients in the emergency group and in 48 patients in the elective one (p = 0.003).
Conclusions: Emergency colon cancer surgery did have impact on the lymph node number harvest. Adequate colorectal training is expected to improve the surgical technique in order to achieve reliable TNM staging.

References

  • Teixeira F, Akaishi EH, Ushinohama AZ, et al. Can we respect the principles of oncologic resection in an emergency surgery to treat colon cancer?. World J Emerg Surg. 2015;10:5.
  • Acar N, Acar T, Kamer E, Cengiz F, Atahan K, Kar H, Hacıyanlı M. Should we still doubt the success of emergency oncologic colorectal surgery?: A retrospective study. Ulus Travma Acil Cerrahi Derg. 2020 Jan;26(1):55-62. English.
  • Tsai HL, Huang CW, Yeh YS, Ma CJ, Chen CW, Lu CY, Huang MY, Yang IP, Wang JY. Factors affecting number of lymph nodes harvested and the impact of examining a minimum of 12 lymph nodes in stage I-III colorectal cancer patients: a retrospective single institution cohort study of 1167 consecutive patients. BMC Surg. 2016 Apr 14;16:17.

Kolorektal kanser cerrahisinde acil cerrahinin çıkarılan lenf nodu sayısına etkisi var mı?

Year 2022, Volume: 7 Issue: 2, 24 - 28, 01.08.2022
https://doi.org/10.25000/acem.1071023

Abstract

Amaç: Kolorektal kanserlerde yeterli onkolojik cerrahiyi yapabilmek için, rezeke edilen spesmenin yeterli cerrahi sağlam marjinle çıkarılması ve komplet mezokolik eksizyon yapılması gerekiyor ki posteperatif doğru patolojik evreleme yapılabilsin. Günümüzde en az 12 lenf nodu çıakrılması önerilmektedir. Acil kolorektal cerrahide çıkarılan lenf nodu sayıları üzerine sorular yükselmektedir. Bu çalışmanın amacı, acil kolorektal kanser cerrahisinin lenf nodu sayısı alımı üzerindeki etkisini belirlemektir.
Metod: 1 yıllık periyodda kolorektal kanser tanısıyla ameliyat edilmiş olan 102 hasta retrospektif olarak incelendi. İki grup (acil ve elektif) oluşturuldu. Ameliyatlar altı cerrah (üçü yüksek volüm, üçü düşük volüm) tarafından gerçekleştirildi.
Bulgular: 20 hasta acil olarak ameliyat edilmişti ve 66 hasta elektif ameliyat edilmişti. Evre IV 16 hasta çalışma dışında tutuldu. Acil ameliyat edilen grupta çıkarılan ortalama lenf nodu sayısı 11.1 [5-20] ve elektif grupta 14.7 [4-34] dir (p = 0.004). Acil ameliyat edilen grupta 7 hastada, elektif ameliyat edilen grupta 48 hastada yeterli sayıda lenf nodu (≥12) çıkarılmıştır. (p = 0.003)
Sonuç:Acil kolon cerrahisinin çıkarılan lenf nodu sayısı üzerine etkisi vardır. Yeterli kolorektal cerrahi eğitimi cerrahi tekniği geliştirerek güvenilir TNM sınıflaması sonuçlarını etki edecektir.

References

  • Teixeira F, Akaishi EH, Ushinohama AZ, et al. Can we respect the principles of oncologic resection in an emergency surgery to treat colon cancer?. World J Emerg Surg. 2015;10:5.
  • Acar N, Acar T, Kamer E, Cengiz F, Atahan K, Kar H, Hacıyanlı M. Should we still doubt the success of emergency oncologic colorectal surgery?: A retrospective study. Ulus Travma Acil Cerrahi Derg. 2020 Jan;26(1):55-62. English.
  • Tsai HL, Huang CW, Yeh YS, Ma CJ, Chen CW, Lu CY, Huang MY, Yang IP, Wang JY. Factors affecting number of lymph nodes harvested and the impact of examining a minimum of 12 lymph nodes in stage I-III colorectal cancer patients: a retrospective single institution cohort study of 1167 consecutive patients. BMC Surg. 2016 Apr 14;16:17.
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Details

Primary Language English
Subjects Surgery
Journal Section Original Research
Authors

Andrej Nikolovski 0000-0002-5286-3532

Kristijan Dervishov This is me 0000-0003-4678-1810

Cemal Ulusoy 0000-0002-4405-6618

Publication Date August 1, 2022
Published in Issue Year 2022 Volume: 7 Issue: 2

Cite

Vancouver Nikolovski A, Dervishov K, Ulusoy C. Does emergency surgery have impact on lymph node harvest in colorectal cancer surgery?. Arch Clin Exp Med. 2022;7(2):24-8.