The effect of the surgical method on the number of disected lymph nodes in colorectal cancer surgery

Year 2018, Volume: 10 Issue: 4, 423 - 426, 01.12.2018

Serden Ay

https://doi.org/10.21601/ortadogutipdergisi.424332

Abstract

Aim: By the
dissemination of laparoscopic colorectal surgery there are many studies
comparing the laparoscopic and open surgery. One of the parameters that are
compared is the dissected lymph node number. The guidelines offer that there
should be a minimum number of 12 lymph nodes for the staging of colorectal
cancer. It is reported that only 48% of the resections achieve this number. In
this study aims to compare the number of lymph nodes resected in laparoscopic
and open colorectal cancer surgery.

Material and Method: The
files of the patients who had colorectal surgery in our clinic in between
January 2011 and January 2013 were retrospectively evaluated. The patients were
divided into two groups as laparoscopic and open surgery groups. Patients’ age,
gender, preoperative diagnosis, tumor stage, surgical method, resected lymph
node number and positivity of lymphatic metastasis were recorded. The groups
were compared according to lymph node features.

Results: There were 55
patients with colorectal surgery [17(31%) laparoscopic and 38(69%) open surgery].
The mean age of the patients was 63.9±12.9, the groups were similar in terms of
age, gender and the tumor stage. The mean dissected lymph node number was
17.2±4.8 for laparoscopy group and 18.7±5.2 for open surgery group. This
difference was not statistically significant (p>0.05).  There is no difference in between the groups
in terms of metastatic lymph node numbers.

Conclusion: Laparoscopic
surgery is as effective as open surgery in term of harvested lymph nodes. For
the reliable tumor staging the surgeon and the pathologist should work
together. 

Keywords

Laparoscopic surgery, lymph node, colorectal surgery

Cerrahi yöntemin kolorektal kanser cerrahisinde diseke edilen lenf nodu özellikleri üzerine etkisi

Abstract

Amaç: Laparoskopik kolorektal cerrahinin
artmasıyla birlikte laparoskopik ve açık cerrahiyi karşılaştıran bir çok
çalışma yapılmaya başlanmıştır. Karşılaştırma parametrelerinden bir taneside
yeterli sayıda lenf nodunun çıkartılıp çıkartılmadığıdır. Yerinde bir
kolorektal kanser evrelemesi için kılavuzların tavsiyesi 12’den aşağı lenf nodu
çıkartılmaması gerektiği yönündedir. Literatürde kolorektal rezeksiyonların
yalnızca %48’inde bu sayıya ulaşıldığı bildirilmiştir. Biz çalışmamızda
laparoskopik kolorektal cerrahi ile açık cerrahinin lenf nodu diseksiyonu
sayısı ve özellikleri üzerine etkisini değerlendirmeyi amaçladık.

Gereç ve Yöntem: Hastanemiz genel cerrahi kliniğinde Ocak 2011-Ocak
2013 tarihleri arasında kolorektal kanser cerrahisi uygulanan hastalara ait
dosyalar retrospektif olarak tarandı. Hastalar açık cerrahi ve laparoskopik
cerrahi uygulananlar olarak iki gruba ayrıldı. Hastaların yaş, cins, ameliyat
öncesi tanıları, tümör evreleri, yapılan ameliyatın şekli, çıkarılan lenf nodu
sayısı ve lenf nodlarında metastazın olup olmadığı kaydedildi. Gruplar lenf
nodu özellikleri açısından karşılaştırıldı.

Bulgular: Toplamda 55 hastaya
kolorektal kanser cerrahisi uygulanmıştı. Bunların 17 (%31)’sine laparoskopik,
38 (%69)’ ine açık kolon cerrahisi uygulanmıştı. Hastaların yaş ortalaması
63,9±12,9 idi. Gruplar yaş, cinsiyet ve tümör evresi yönünden benzerdi.
Laparoskopik cerrahide çıkartılan lenf nodu sayısı ortalama 17,2±4,8 iken açık
cerrahide bu oran 18,7±5,2 idi. Bu fark istatistiksel olarak benzerdi
(p>0,05). Metastatik lenf nodları değerlendirildiğinde ise iki grup arasında
fark yoktu.

Sonuç:  Çıkartılan
lenf nodları bakımından laparoskopik cerrahi açık cerrahi kadar etkindir. Yerinde cerrahi
evreleme yapılabilmesi için cerrah ve patologun beraber çalışması
gerekmektedir.

Keywords

Laparoskopik cerrahi, lenf nodu, kolorektal cerrahi

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