Kanser nedeni ile yapılan sağ hemikolektomi sonrası anastomoz kaçağına etki eden faktörler: Tek merkez deneyimi

Abstract

Amaç: Sağ hemikolektomi sonrasında anastomoz kaçağı diğer gastrointestinal sistem anastomozlarına oranla göreceli olarak daha az olsa da hayatı tehdit edici önemli bir komplikasyondur. Bu çalışmanın amacı sağ hemikolektomi sonrasında anastomoz kaçağına ve mortaliteye etki eden faktörleri araştırmaktır. Gereç ve Yöntemler: 1-1-2016 / 31-12-2020 tarihleri arasında sağ kolon tümörü ön tanısı ile ameliyat edilen 18 yaş üzerindeki tüm hastalar çalışmaya dahil edildi. Hastaların demografik verileri, eşlik eden hastalıkları, ameliyat öncesi laboratuar tetkikleri, perioperatif transfüzyon durumu, ameliyatı yapan sorumlu cerrah, ameliyat zamanlaması, anastomoz tekniği ve tümör evresi değişkenleri retrospektif olarak değerlendirildi. Bulgular: Toplam 141 hasta çalışmaya dahil edildi. Ortanca yaş 62 ( min 30—max 92) idi. Anastomoz kaçağı oranı % 9.2 ( n= 13) , mortalite oranı % 5 ( n=7) idi. Anastomoz kaçağına etki eden başlıca faktörün ameliyat zamanlaması olduğu ve acil şartlarda ameliyat edilen hastalarda anastomoz kaçağı riskinin anlamlı şekilde arttığı tespit edildi. İleri yaş ve düşük albümin düzeyi anastomoz kaçağı ve mortalite üzerine etki eden diğer risk faktörleri olarak tespit edildi. Sonuç: Bu çalışma sonucunda ameliyat zamanlaması, hasta yaşı ve düşük albümin düzeyi sağ hemikolektomi sonrasında anastomoz kaçağına etki eden faktörler olarak tespit edilmiştir. Acil ameliyat gerektiren ileri yaştaki, beslenme bozukluğu olan hastalarda sağ hemikolektomi sonrası anastomoz yapılması yerine diversiyonun tercih edilmesi uygun bir yaklaşım olacaktır.

Keywords

• Anastomoz kaçağı
• Kolon kanseri
• Sağ hemikolektomi

Factors affecting anastomotic leakage after right hemicolectomy for cancer: a single center experience

Abstract

Aim Although anastomotic leakage after right hemicolectomy is relatively low, it is the most important life thereathening complication. Aim of this study is to investigate the factors affecting anastomotic leakage and mortality after right hemicolectomy. Material and Methods: All patients > = 18 years of age, undergoing right hemicolectomy for a diagnosis of adenocarcinoma in the right colon between 2016 and 2020 included to study. Patient demographics, comorbidities, preoperative labaoratory tests, perioperative transfusion status , performing surgeon, anastomotic technique, tumor stage, and timing of surgery (elective v.s emergent) are the variables investigated retrospectively. Results: Total 141 patient included to study. Mean age was 62 ( min 30—max 92). Total anastomotic leakage rate was % 9.2 (n = 13) and overall mortality rate was % 5 (n = 7).Timing of the surgery found to be the major determinant of anastomotic leakage and emergent surgery significantly increased the leakage risk. Advanced age and low albumin levels were the other factors which affect on anastomotic leakage and mortality rate. Conclusion: Age of the patient, low albumin levels and timing of the operation are found to be the risk factors affecting anastomotic leakage after right hemicolectomy. Diversion can be a feasible option after right hemicolectomy for the elderly patients’ with malnutrition who neccesitates emergent operation.

Keywords

• Anastomotic leakage
• colon cancer
• right hemicolectomy

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