Operations Performed for Colon Cancer in Our Clinic and Their Outcomes

Year 1970, Volume: 23 Issue: 5, 1365 - 1380, 31.10.1970

Hilmi Akın

https://izlik.org/JA25GC37AX

Abstract

Kolon kanseri cerrahisi, 19. yüzyıl sonlarından günümüze kadar önemli ölçüde gelişmiş ve günümüzde radikal rezeksiyon ile uç-uça anastomoz en iyi 5 yıllık sağkalım oranlarını sağlamaktadır. 1959–1968 yılları arasında kliniğimizde ileoekal valvden rekto-sigmoide kadar uzanan 74 tümör vakası tedavi edildi.

Vakaların %34,4’ü sağ kolonda, %50,4’ü sol kolonda yerleşmişti. Sağ kolon tümörlerinin %46,1’inde, sol kolon tümörlerinin ise %29,7’sinde küratif rezeksiyon uygulandı. Küratif rezeksiyonun mümkün olmadığı durumlarda palyatif kolostomi ve by-pass ameliyatları tercih edildi. Erken dönemde anastomoz kaçağı, peritonit, yara yeri infeksiyonu ve dolaşım yetmezliği gibi komplikasyonlar %23 oranında görüldü; ameliyat mortalitesi %2,7 idi.

Patolojik inceleme çoğunlukla papiller veya müsinöz adenokarsinomları tanımladı. Sağ kolon küratif çıkarmalarında 5 yıllık sağkalım %33,3 iken sol kolon vakalarında %16,6 olarak bulundu. Erken tanı, hastanın yaşı ve genel durumu, lenf nodu yayılımı, tümör yeri ve özenli cerrahi planlama prognozu belirleyen başlıca faktörler olarak saptandı.

Kliniğimizde Kolon Kanseri Nedeniyle Uygulanan Ameliyatlar ve Sonuçları

https://izlik.org/JA25GC37AX

Abstract

Colon cancer surgery has evolved significantly since the early 19th century, and today radical resection with end-to-end anastomosis offers the best chance for long-term survival. Between 1959 and 1968, 74 patients with tumors located from the ileocecal valve to the rectosigmoid junction were treated at Ankara University Surgical Clinic.

Right-sided tumors accounted for 34.4% of cases and left-sided for 50.4%; radical resection was performed in 46.1% of right colon and 29.7% of left colon cancers. Palliative procedures included colostomies and bypasses when curative resection was not feasible. Early postoperative complications—anastomotic leakage, peritonitis, wound infection and circulatory failure—occurred in 23% of patients, with an overall operative mortality of 2.7%.

Histopathology revealed predominantly papillary or mucinous adenocarcinomas. Prognostic analysis showed 5-year survival of 33.3% in curatively resected right-colon cancers versus 16.6% in left-colon cases. Key factors influencing outcome were early clinical diagnosis, patient age and condition, extent of lymphatic spread, tumor location and meticulous surgical planning.

Keywords

colon cancer , colectomy , hemicolectomy , prognosis , surgical outcomes

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