EVALUATION OF COLORECTAL CANCER SURGERIES PERFORMED IN THREE YEARS

Yıl 2023, , 38 - 41, 30.04.2023

Dursun Burak Özdemir , Ahmet Karayiğit , Hayrettin Dizen , Ümit Özdemir , İhsan Karakaya , Barış Türker , Cüneyt Akyüz , Murat Ulaş , İlter Ozer , Bülent Ünal

https://doi.org/10.20492/aeahtd.1125852

Öz

Aim: This study aimed to present clinicopathological features, surgical characteristics, and short-term outcomes of patients with colorectal cancer who underwent laparoscopic or open surgery.
Material and Method: The data of colorectal cancer cases operated in the General Surgery Department of XXX between January 2017 and December 2020 were reviewed retrospectively. Tumor localization, pathological diagnoses, operation types, tumor, tumor invasion, lymph node properties, additional treatments, hemogram tests, length of hospital stay, follow-up time, postoperative complications, recurrence and mortality were analyzed.
Results: Patients’ age ranged from 36 to 87 years with a median of 66. Open surgery was performed in 79.55% and laparoscopic surgery was performed in 20.45%. The median length of hospital stay was 6 days (IQR: 5–8). Mean follow-up time was 20.52 ± 10.49 months. Postoperative infection was observed in 16.67% and postoperative leakage was observed in 6.82% of the cases. Six patients (5.61%) experienced recurrence. Mortality rate was 17.41%, and early mortality (≤30 days) rate was 3.03%.
Conclusion: More publications are needed concerning laparoscopic and open colorectal surgery. We believe that it is important for clinics to share their results and experiences in colorectal surgery, and that our results will not only contribute to the literature, but also contribute to the establishment of general surgery clinics which becoming more common in our country.

Anahtar Kelimeler

Cerrahi onkoloji, Gastrointestinal sistem, Kolorektal kanser, Mortalite

ÜÇ YILDA YAPILAN KOLOREKTAL KANSER AMELİYATLARININ DEĞERLENDİRİLMESİ

Öz

Amaç: Bu çalışma, laparoskopik veya açık cerrahi uygulanan kolorektal kanserli hastaların klinikopatolojik özelliklerini, cerrahi özelliklerini ve kısa dönem sonuçlarını sunmayı amaçlamıştır.
Gereç Ve Yöntem: Ocak 2017 ile Aralık 2020 tarihleri arasında XXX Genel Cerrahi Anabilim Dalı'nda ameliyat edilen kolorektal kanser olgularının verileri retrospektif olarak incelendi. Tümör lokalizasyonu, patolojik tanılar, operasyon tipleri, tümör, tümör invazyonu, lenf nodu özellikleri, ek tedaviler, hemogram testleri, hastanede kalış süresi, takip süresi, postoperatif komplikasyonlar, nüks ve mortalite analiz edildi.
Bulgular: Hastaların yaşları ortanca 66 olmak üzere 36 ile 87 arasındaydı. Olguların %79,55'inde açık cerrahi, %20,45'inde laparoskopik cerrahi uygulandı. Ortalama hastanede kalış süresi 6 gündü (IQR: 5-8). Ortalama takip süresi 20.52 ± 10.49 aydı. Olguların %16.67'sinde ameliyat sonrası enfeksiyon, %6.82'sinde ameliyat sonrası kaçak gözlendi. Altı hastada (%5.61) nüks görüldü. Mortalite oranı %17,41, erken mortalite (≤30 gün) oranı ise %3,03 idi.
Sonuç: Laparoskopik ve açık kolorektal cerrahi ile ilgili daha fazla yayına ihtiyaç vardır. Kliniklerin kolorektal cerrahide elde ettikleri sonuçları ve deneyimlerini paylaşmalarının önemli olduğunu, sonuçlarımızın literatüre katkı sağlayacağının yanı sıra ülkemizde giderek yaygınlaşan genel cerrahi kliniklerinin kurulmasına da katkı sağlayacağına inanıyoruz.

Anahtar Kelimeler

Surgical oncology, Gastraintestinal tract, Colorectal cancer, Mortality

Kaynakça

• 1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. doi: 10.3322/caac.21492.
• 2. Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors. Prz Gastroenterol. 2019;14(2):89-103. doi: 10.5114/pg.2018.81072.
• 3. Pak H, Maghsoudi LH, Soltanian A, Gholami F. Surgical complications in colorectal cancer patients. Ann Med Surg (Lond). 2020;55:13-18. doi: 10.1016/j.amsu.2020.04.024.
• 4. Kitano S, Inomata M, Mizusawa J, et al. Survival outcomes following laparoscopic versus open D3 dissection for stage II or III colon cancer (JCOG0404): a phase 3, randomised controlled trial. Lancet Gastroenterol Hepatol. 2017;2(4):261-268. doi: 10.1016/s2468-1253(16)30207-2.
• 5. Lacy AM, García-Valdecasas JC, Delgado S, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet. 2002;359(9325):2224-2229. doi: 10.1016/s0140-6736(02)09290-5.
• 6. Veldkamp R, Kuhry E, Hop WC, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6(7):477-484. doi: 10.1016/s1470-2045(05)70221-7.
• 7. Zhang X, Gao Y, Dai X, et al. Short- and long-term outcomes of transanal versus laparoscopic total mesorectal excision for mid-to-low rectal cancer: a meta-analysis. Surg Endosc. 2019;33(3):972-985. doi: 10.1007/s00464-018-6527-z.
• 8. White A, Ironmonger L, Steele RJC, Ormiston-Smith N, Crawford C, Seims A. A review of sex-related differences in colorectal cancer incidence, screening uptake, routes to diagnosis, cancer stage and survival in the UK. BMC Cancer. 2018;18(1):906. doi: 10.1186/s12885-018-4786-7.
• 9. Mastalier B, Tihon C, Ghiţă B, et al. Surgical treatment of colon cancer: Colentina surgical clinic experience. J Med Life. 2012;5(3):348-353.
• 10. Golfam F, Golfam P, Neghabi Z. Frequency of all types of colorectal tumors in the patients referred to selected hospitals in tehran. Iran Red Crescent Med J. 2013;15(6):473-476. doi: 10.5812/ircmj.4026.
• 11. Bedirli A, Salman B, Yuksel O. Laparoscopic versus Open Surgery for Colorectal Cancer: A Retrospective Analysis of 163 Patients in a Single Institution. Minim Invasive Surg. 2014;2014:530314. doi: 10.1155/2014/530314.
• 12. Hsieh C, Cologne KG. Laparoscopic Approach to Rectal Cancer—The New Standard? Front Oncol. 2020;10. doi: 10.3389/fonc.2020.01239.
• 13. Gehrman J, Angenete E, Björholt I, Lesén E, Haglind E. Cost-effectiveness analysis of laparoscopic and open surgery in routine Swedish care for colorectal cancer. Surg Endosc. 2020;34(10):4403-4412. doi: 10.1007/s00464-019-07214-x.
• 14. Zhou S, Wang X, Zhao C, et al. Laparoscopic vs open colorectal cancer surgery in elderly patients: short- and long-term outcomes and predictors for overall and disease-free survival. BMC Surg. 2019;19(1):137. doi: 10.1186/s12893-019-0596-3.
• 15. Van Der Pas MH, Haglind E, Cuesta MA, et al. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 2013;14(3):210-218. doi: 10.1016/s1470-2045(13)70016-0.
• 16. Bonjer HJ, Deijen CL, Abis GA, et al. A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med. 2015;372(14):1324-1332. doi: 10.1056/NEJMoa1414882.
• 17. Jeong SY, Park JW, Nam BH, et al. Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): survival outcomes of an open-label, non-inferiority, randomised controlled trial. Lancet Oncol. 2014;15(7):767-774. doi: 10.1016/s1470-2045(14)70205-0.
• 18. Braga M, Vignali A, Zuliani W, Frasson M, Di Serio C, Di Carlo V. Laparoscopic versus open colorectal surgery: cost-benefit analysis in a single-center randomized trial. Ann Surg. 2005;242(6):890-895, discussion 895-896. doi: 10.1097/01.sla.0000189573.23744.59.
• 19. Bonjer HJ, Hop WC, Nelson H, et al. Laparoscopically assisted vs open colectomy for colon cancer: a meta-analysis. Arch Surg. 2007;142(3):298-303. doi: 10.1001/archsurg.142.3.298.
• 20. Skancke M, Arnott SM, Amdur RL, Siegel RS, Obias VJ, Umapathi BA. Lymphovascular Invasion and Perineural Invasion Negatively Impact Overall Survival for Stage II Adenocarcinoma of the Colon. Dis Colon Rectum. 2019;62(2):181-188. doi: 10.1097/dcr.0000000000001258.
• 21. Mckay GD, Morgan MJ, Wong SK, et al. Improved short-term outcomes of laparoscopic versus open resection for colon and rectal cancer in an area health service: a multicenter study. Dis Colon Rectum. 2012;55(1):42-50. doi: 10.1097/DCR.0b013e318239341f.
• 22. Panis Y, Maggiori L, Caranhac G, Bretagnol F, Vicaut E. Mortality after colorectal cancer surgery: a French survey of more than 84,000 patients. Ann Surg. 2011;254(5):738-743; discussion 743-734. doi: 10.1097/SLA.0b013e31823604ac.