The Evaluation of Patients Operated Due to Colorectal Cancer Kolorektal Kanserler / Colorectal Cancers

Year 2015, Volume: 16 Issue: 2, 102 - 109, 04.07.2015

İbrahim Aydın İbrahim Şehitoğlu Ender Özer Ahmet Fikret Yücel Ahmet Pergel Recep Bedir Hasan Güçer Dursun Ali Şahin

https://doi.org/10.18229/ktd.73484

Cited By: 2

Abstract

Objective: The presention of Recep Tayyip Erdoğan University
Medical Faculty Department Of General Surgery Clinic’s cases
that were operated for colorectal cancer and to discuss them in
accompany with the current literature.
Material and Methods: In Recep Tayyip Erdoğan University
Medical Faculty Department Of General Surgery Clinic,
between 2008 and 2013, the records of 138 patients operated
for colorectal cancer were investigated retrospectively. Patients’
age, gender, tumor localization, ASA values, complications,and
histopathological examination of tumor and its stage were
recorded.
Results:
85 (61.6%) of the patients were men and 53 (38.4%) were
women.When the cases were assessed according to tumor
localization, they were in the rectosigmoid region 20 (14.5%),
sigmoid colon 39 (28.2%), descending colon 16 (11.6%),
transverse colon 3 (2.2%), ascending colon 9 (6.5%) and
cecum 20 (14.5%). Low anterior resection to 45 (32.6%), left
hemicolectomy to 43 (31.1%), right hemicolectomy to 29
(21%), Hartmann procedure to 9 (6.5%), abdominoperineal
resection to 6 (4.3%), transverse colectomy to 3 (2.2%) and
total proctocolectomy to 3 (2.2%) of those patients were
performed. In 4 (2.9%) patients, complications developed
intraoperatively, and in 40 (29%) postoperatively. While no
intraoperative mortality was observed, 4 (2.9%) patients were
recorded in the postoperative period. Tumor stage is important
factor during diagnosis of colorectal cancer. As a result of
staging postoperative specimens, 5 (3.6%) patient in stage I, 22
patient (15.9%) in stage II, 79 patient (57.2%) in stage III, and
32 patient (23.3%) in stage IV were determined.
Conclusion: While the most important prognostic factor in
colorectal cancer is tumor stage, patients in our country are
generally diagnosed in advanced stages. This also causes
increase in morbidity and mortality. We think determining
thecolorectal cancers in early phases can be performed by
country-wide generalization of routine scanning programmes
and raising of consciousness in the community together with
places giving primary care health service.

Keywords

Colorectal cancer, age, surgical treatment, tumor stage, complication, scanning program

Kolorektal Kanser Nedeniyle Opere Ettiğimiz Hastaların Değerlendirilmesi

Abstract

Amaç: Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniği’nde kolorektal kanser (KRK) nedeni ile ameliyat edilen olguları sunmak ve güncel literatür eşliğinde tartışmak.

Gereç ve Yöntem: Recep Tayyip Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniği’nde 2008-2013 tarihleri arasında KRK nedeniyle ameliyat edilen 138 hastanın kayıtları geriye dönük olarak incelendi. Hastaların yaş, cinsiyet, tümörün lokalizasyonu, ASA (American Society of Anesthesiologists) değerleri, komplikasyonlar, tümörün histopatolojik incelemesi ve evresi kaydedildi.

Bulgular: Yüzotuz sekiz hastanın 85 (%61.6)’i erkek, 53 (%38.4)’ü kadındı. Vakalar tümör yerleşim yerine göre değerlendirildiğinde; rektum 31 (%22.5), rektosigmoid bölge 20 (%14.5), sigmoid kolon 39 (%28.2), inen kolon 16 (%11.6), transvers kolon 3 (%2.2), çıkan kolon 9 (%6.5) ve çekum 20 (%14.5) şeklinde dağılım göstermekte idi. Bu hastaların 45’ine (%32.6) low anterior rezeksiyon, 43’üne (%31.1) sol hemikolektomi, 29’una (%21) sağ hemikolektomi, 9’una (%6.5) Hartmann prosedürü, 6’sına (%4.3) abdominoperineal rezeksiyon, 3’üne (%2.2) transvers kolektomi ve 3’üne (%2.2) total proktokolektomi yapıldı. Bu ameliyatların9’u (%6.5) laparoskopik olarak gerçekleştirildi. İntraoperatif olarak 4 (%2.9) hastada komplikasyon gelişti. Postoperatif olarak 40 (%29) hastada komplikasyon gelişti. İntraoperatif mortalite gözlenmezken, postoperatif 4 (%2.9) hasta kaybedildi. KRK’de tanı anında tümör evresi önemli bir prognostik faktör olup bizim hastalarımızda postoperatif patolojik spesmenlerin evrelenmesinde 5 (% 3.6) hasta evre I, 22 hasta (% 15.9) evre II, 79 hasta (% 57.2) evre III, 32 hasta (% 23.3) evre IV olarak saptandı.

Sonuç: KRK’de en önemli prognostik faktör tanı anındaki tümör evresi olup, ülkemizde genellikle hastalar ileri evrelerde teşhis edilmektedirler. Bu da morbidite ve mortalitenin artmasına neden olmaktadır. KRK’lerin erken evrede saptanabilmesi için, birinci basamak sağlık hizmeti veren yerler ile beraber toplumun da bilinçlendirilmesi ve rutin tarama programlarının ülkemiz genelinde yaygınlaştırılması ile gerçekleşeceğini düşünmekteyiz.

 

 

Keywords

Kolorektal kanser, yaş, cerrahi tedavi, Keywords: Colorectal cancer, age, surgical treatment, tumor tümör evresi, komplikasyon, tarama programı

References

• Eddy DM. Screening for colorectal cancer. Ann Intern Med 1990;113(5):373-84.
• Parkin DM, Pisani P, Ferlay J. Global cancer statistics. CA Cancer J Clin 1999;49(1):33-64.
• Değertekin H, Sarı Y, Arslan A, Akgül Y, Büyükbay- ram H. Age and sex distribution of colorectal carci- noma in the southeast of Turkey. The Turkish Journal of Gastroenterology 1999;10(2):153-6.
• Winawer SJ, Sherlock P. Best practice and research clinical gastroenterology. Colorectal cancer screening.Best Pract Res Clin Gastroenterol2007;21(6):1031.
• Ashktorab H, Nouraie M, Hosseinkhah F. A 50-year review of colorectal cancer in African Americans: implications for prevention and treatment. Dig Dis Sci 2009;54(9):1985-90.
• Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA CancerJ Clin2005;55(2):74-108.
• Popkin BM. The nutrition transition inlow- income countries: an emerging crisis. Nutr Rev1994;52(9):285-98.
• Tözün N, Şimşek H, Özkan H, Şimşek İ, Gören A(Editörler).Klinik gastoenteroloji ve hepatoloji. Kolorektal polipler ve polipozis sendromları. Medikal ve Nobel Yayıncılık, 2007:963-70.
• Dolar E(Editör). Kolorektal tümörler. Nobel ve Güneş Yayınları, 2005:400-8.
• Boulton-Jones JR, Gamble S. Robinson MH, Keighley MRB, Williams NS(Editors.) Surgery of the anus,rectum&colon. 2nd Edition, London: WB Goddard WP, Long RG, Teahon K. The impact epidemiology, aetiology, pathology, staging, of the two-week wait scheme for suspected gastrointestinal cancer. Clin Med 2003;3(5):483-4.
• Flasman K, O’leary DP, Senapati A, Thompson Elsevier, 2008:1348-432.
• MR. The department of health’s two week standart and rectum.18th Edition,Philadelphia: Saunders for bowel cancer: is it working? Gut 2004;53(3):387
• Beauchamp RD, Evers BM, Mattox KL. (Editors). Colon Sabiston textbook of surgery. In: Townsend CM, Compton CC. Colorectal carcinoma: diagnostic, prognostic, and molecular features. Mod Pathol 2003;16(4):376-88.
• Kemeny N, Niedzwiecki D, Shurgot MS, Oderman N, Peveretos P. Site distribution of carsinoma of the large intestine: a retrospective study of 600 cases. Dis Colon Rectum 1989;32(1):14-6.
• RN. Prognostic variables patients with hepatic metastases from colorectal cancer. Importance of medical assessment of liver involvement. Cancer 1989;63(4):742-7.
• Kemppainen M, Raiha I, Rajala T,Sourander L. Delay in diagnosis of colorectal cancerin elderly patients. Age and Ageing 1993;22(4):260-5.
• WhitefordM. Early complications in colorectal surgery ASCRS core subject, Annual Scientific Meeting 2009.
• Karanjia ND, Corder AP, Beam P, Heald RJ. does colorectal cancer present? symptoms, duration, and clues to location. Am J Gastroenterol 1999;94(10):3039-45.
• Leakage from stapled low anastomosis after total mesorectal excision for carcinoma of the rectum. Br J Surg 1994;81(8):1224-6.
• Hawley PR, Ritchie JK. Complications of ileostomy and colostomy following excisional surgery. Clin Gastroenterol 1979;8(2):403-15.
• Menteş BB, Ege B, Üner A, Ünsal D, Yüksel O, Bostancı H, Oğuz M. Kolorektal kanserlerin tedavi sonuçları: tek merkezli, 200 vakalık seri. Gazi Tıp Dergisi 2007;18(3):97-103.
• Siegel R, Naishadham D, Jemal A. Cancer Statistics, 2012. CA Cancer J Clin 2012;62(1):10-29.
• Sağlık Bakanlığı Kanserle Savaş Dairesi Başkanlığı 2006-2008 yılları Türkiye kanser insidansı. www. kanser.gov.tr. Erişim: (28.12.2013)
• Gürsu RU, Kesmezacar Ö, Karaçetin D, Mermut Ö, B. Ökten, Güner Şİ. İstanbul Eğitim ve Araştırma Hastanesi Onkoloji Birimi: yeni kurulan bir ünitenin 18 aylık sonuçları. Istanbul Med J 2012;13(1):13-8. Saunders Company, 1999:998-1061.
• Gordon PH. Malignant neoplasms of the colon. In: Gordon PH, Nivatvongs S (Editors.) Principles and practice of surgery fort he colon, rectum and anus. 3rd Edition,Informa Healthcare USA Inc, 2007:489- 6
• Wei EK, Giovannucci E, Wu K. Comparison of risk factors for colon and rectal cancer. Int J Cancer 2004;108(3):433.
• Burt RW, DiSario JA, Cannon-Albright L. Genetics of colon cancer: impact of inheritance on colon cancer risk. Annu Rev Med 1995;46(1):371-9 108