YOZGAT ŞEHİR HASTANESİNDE SON 5 YILDA UYGULANAN KOLESİSTEKTOMİ SPESİMENLERİNİN MORFOLOJİK VE HİSTOPATOLOJİK ÖZELLİKLERİNİN RETROSPEKTİF DEĞERLENDİRİLMESİ Retrospective Evaluation Of Morphological And Histopathological Features Of Cholecystectomy Specimens Performed İn Yozgat City Hospital For The Past 5 Years
Abstract
ÖZET
Amaç: Kolesistektomi ikinci basamak devlet hastaneleri Genel Cerrahi servislerinde en sık uygulanan ameliyatların
başında gelmektedir. Kolesistektomi spesimenlerinin histopatolojik değerlendirilmesi literatürde
yaygın olarak ele alınmıştır. Ancak morfolojik değerlendirme oldukça kısıtlıdır. Bu çalışma ile semptomatik
benign hastalıklar nedeniyle kolesistektomi yapılan hastaların kolesistektomi spesimenlerinin mikroskobik
ve makroskopik özelliklerinin yanı sıra morfolojik özelliklerinin de değerlendirilmesi amaçlandı.
Gereç ve Yöntem: Yozgat Şehir Hastanesinde Ocak 2014 ve Mart 2019 tarihleri arasında Genel Cerrahi
Servisinde gerçekleştirilen toplam 961 kolesistektomi spesimeni geriye dönük incelendi. Çalışma hastane
elektronik verilerinden hasta bilgilerine ulaşılarak geriye dönük gerçekleştirildi. Hastaların yaş, cinsiyet, uygulanan
ameliyatın şekli, histopatolojik tanı, safra taşının olup olmadığı, kolesistektomi spesimenin uzunluğu,
genişliği ve en kalın duvar ölçüleri değerlendirmeye alındı.
Bulgular: Toplam 961 hastanın 734’ü (%76,4) kadın, 227’si (%23,6) erkeklerden oluşmaktaydı. Ameliyatların
900 tanesi laparoskopik olarak (%93,7) gerçekleştirildi. Safra kesesi genişliği açısından her iki cinsiyet
arasında anlamlı fark saptanmazken (p=0,23), safra kesesi uzunluğu (p=0,04), safra kesesi duvar kalınlığının
(p=0,001) erkeklerde fazla olduğu saptandı. Kronik kolesistit kadınlarda, subakut ve akut kolesistit erkeklerde
daha sık görüldü (p=0,001). Kolelitiazis ve kolesterol oranlarına cinsiyetin etkisi saptanmadı (p=0,63).
Spesimenlerin % 14,4’de makroskopik bulgular hakkında raporlama yoktu. Toplam üç spesimende malignite
ve üç spesimende neoplastik polip saptandı.
Sonuç: İnsidental safra kesesi karsinomu ikinci basamak hastanelerde daha sık karşılaşılmaktadır. Bu yüzden
bu tür hastanelerde rutin olarak kolesistektomi spesimenleri histopatolojik değerlendirmeye gönderilmelidir.
Gönderilen spesimenlerinde daha sağlıklı mikroskobik, makroskopik ve morfolojik özelliklerinin değerlendirilmesi
için standardize edilmiş patoloji raporlamasına ihtiyaç vardır.
Anahtar Kelimeler: Kolesistektomi; İnsidental kanser; Histopatoloji inceleme; Safra kesesi morfolojisi.
ABSTRACT
Aim: The cholecystectomy is one of the most common operations performed in the general surgery department
of secondary level hospitals. Histopathological evaluation of cholecystectomy specimens has been
widely discussed in the literature. However, morphological evaluation is very limited. The aim of this study
is to evaluate the morphological features besides the microscopic and macroscopic features of specimens
performed cholecystectomy because of symptomatic benign diseases.
Material and Methods: A total of 961 cholecystectomy specimens were examined from January 2014 and
to 2019 in the General Surgery Department at Yozgat City Hospital. The study was conducted retrospectively
by accessing patient information from the hospital electronic data. Age, sex, type of surgery, histopathological
diagnosis, presence of gallstones, length, width and thickest wall measurements of cholecystectomy
specimens were evaluated.
Results: Of the total 961 patients, 734 (76.4%) were female and 227 (23.6%) were male. 900 of them were
performed laparoscopically (93.7%). There was no significant difference between the two genders in terms
of gallbladder width (p = 0.23), but gallbladder length (p = 0.04) and gallbladder wall thickness (p = 0.001)
were higher in males. Chronic cholecystitis was more common in women and subacute and acute cholecystitis
in men (p = 0.001). There was no effect of gender on cholelithiasis and cholesterol ratio (p = 0.63).
There were no reports on macroscopic findings in 14.4% of specimens. Malignancy was detected in three
specimens and neoplastic polyp was detected in three specimens.
Conclusions: Incidental gallbladder carcinoma is more common in secondary level hospitals. Therefore,
cholecystectomy specimens should be routinely sent for histopathological evaluation, especially in such
hospitals. A standardized reporting is needed to evaluate the properly microscopic, macroscopic and morphological
characteristics of the specimens.
Key words: Cholecystectomy; Incidental cancer; Histopathology examination; Gallbladder morphology.
References
- 1- Weiss AJ (Truven Health Analytics), Elixhauser A (AHRQ). Trends in Operating Room Procedures in U.S. Hospitals, 2001—2011. HCUP Statistical Brief #171. March 2014. Agency for Healthcare Research and Quality, Rockville, MD. Available from: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb171-Operating-Room-Procedure-Trends.pdf. (Avaiable 9.10.2019). 2- Kamu Hastaneleri Genel Mü dü rlüğü , T.C Sağlık Bakanlığı. Kamu hastaneleri istatistik raporu 2017.https://www.saglik.gov.tr›kamu-hastaneleri-istatistik-raporu—2017.(Erişim 9.10.2019). 3- Sqreide K, Guest RV, Harrison EM, Kendall TJ, Garden OJ, Wigmore SJ. Systematic review of management of incidental gallbladder cancer after cholecystectomy. British Journal of Surgery 2019; 106(1): 32-45. 4- Ozgun G, Esendaglı G, Akarca FG, Balci S, Argon A, Sengiz ES, et al. Retrospective Evaluation of the Epithelial Changes/Lesions and Neoplasms of the Gallbladder in Turkey and a Review of the Existing Sampling Methods: A Multicentre Study. 2018. 5- Lundgren L, Muszynska C, Ros A, Persson G, Gimm O, Valter L, et al. Are Incidental Gallbladder Cancers Missed with a Selective Approach of Gallbladder Histology at Cholecystectomy? World J Surg. 2018; 42(4): 1092-9. 6- Chun YS, Pawlik TM, Vauthey JN. 8th edition of the AJCC Cancer Staging Manual: pancreas and hepatobiliary cancers. Ann Surg Oncol. 2018; 25: 845–847. 7- Ethun CG, Postlewait LM, Le N, Pawlik TM, Buettner S,Poultsides G et al. Association of optimal time interval to re-resection for incidental gallbladder cancer with overall survival: a multi-institution analysis from the US Extrahepatic Biliary Malignancy Consortium. JAMA Surg. 2017; 152: 143–149. 8- Koppatz H, Nordin A, Scheinin T, Sallinen V. The risk of incidental gallbladder cancer is negligible in macroscopically normal cholecystectomy specimens. HPB. 2018; 20(5): 456-61. 9- Lundgren L, Muszynska C, Ros A, Persson G, Gimm O, Valter L, et al. Are incidental gallbladder cancers missed with a selective approach of gallbladder histology at cholecystectomy?. World J Surg. 2018; 42(4): 1092-9. 10- Wrenn SM, Callas PW, Abu-Jaish W. Histopathological examination of specimen following cholecystectomy: are we accepting resect and discard?. Surg Endosc. 2017; 31(2): 586-93.
Abstract
References
- 1- Weiss AJ (Truven Health Analytics), Elixhauser A (AHRQ). Trends in Operating Room Procedures in U.S. Hospitals, 2001—2011. HCUP Statistical Brief #171. March 2014. Agency for Healthcare Research and Quality, Rockville, MD. Available from: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb171-Operating-Room-Procedure-Trends.pdf. (Avaiable 9.10.2019). 2- Kamu Hastaneleri Genel Mü dü rlüğü , T.C Sağlık Bakanlığı. Kamu hastaneleri istatistik raporu 2017.https://www.saglik.gov.tr›kamu-hastaneleri-istatistik-raporu—2017.(Erişim 9.10.2019). 3- Sqreide K, Guest RV, Harrison EM, Kendall TJ, Garden OJ, Wigmore SJ. Systematic review of management of incidental gallbladder cancer after cholecystectomy. British Journal of Surgery 2019; 106(1): 32-45. 4- Ozgun G, Esendaglı G, Akarca FG, Balci S, Argon A, Sengiz ES, et al. Retrospective Evaluation of the Epithelial Changes/Lesions and Neoplasms of the Gallbladder in Turkey and a Review of the Existing Sampling Methods: A Multicentre Study. 2018. 5- Lundgren L, Muszynska C, Ros A, Persson G, Gimm O, Valter L, et al. Are Incidental Gallbladder Cancers Missed with a Selective Approach of Gallbladder Histology at Cholecystectomy? World J Surg. 2018; 42(4): 1092-9. 6- Chun YS, Pawlik TM, Vauthey JN. 8th edition of the AJCC Cancer Staging Manual: pancreas and hepatobiliary cancers. Ann Surg Oncol. 2018; 25: 845–847. 7- Ethun CG, Postlewait LM, Le N, Pawlik TM, Buettner S,Poultsides G et al. Association of optimal time interval to re-resection for incidental gallbladder cancer with overall survival: a multi-institution analysis from the US Extrahepatic Biliary Malignancy Consortium. JAMA Surg. 2017; 152: 143–149. 8- Koppatz H, Nordin A, Scheinin T, Sallinen V. The risk of incidental gallbladder cancer is negligible in macroscopically normal cholecystectomy specimens. HPB. 2018; 20(5): 456-61. 9- Lundgren L, Muszynska C, Ros A, Persson G, Gimm O, Valter L, et al. Are incidental gallbladder cancers missed with a selective approach of gallbladder histology at cholecystectomy?. World J Surg. 2018; 42(4): 1092-9. 10- Wrenn SM, Callas PW, Abu-Jaish W. Histopathological examination of specimen following cholecystectomy: are we accepting resect and discard?. Surg Endosc. 2017; 31(2): 586-93.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research |
| Authors | |
| Publication Date | March 25, 2020 |
| Published in Issue | Year 2020 Volume: 10 Issue: 1 |