Mide Kanseri Nedeniyle Cerrahi Uygulanan ve Postoperatif Dönemde Plevral Efüzyon Gelişip Göğüs Tüpü ile Tedavi Edilen Hastaların Klinik Özelliklerinin Değerlendirilmesi
Yıl 2023,
Cilt: 1 Sayı: 2, 53 - 56, 22.06.2023
Serhat Binici
,
Tuba Bilen
,
Enis Oğuz
,
Emrah Dağtekin
,
Duygu Mergan İliklerden
,
Ümit Haluk İliklerden
,
Çetin Kotan
Öz
Amaç: Çalışmamızda üst gastrointestinal sistem cerrahilerinin spesifik bir türü olan mide kanseri cerrahilerinde plevral efüzyon (PE) gelişen ve tüp torakostomi uygulanarak tedavi edilen hastaların klinikopatolojik özellikleri incelenmiştir.
Gereç ve Yöntem: Etik kurul onayı sonrasında, bir üniversite hastanesinde 01.01.2017-01.01.2022 tarihleri arasında mide kanseri nedeniyle opere edilen hastaların verileri toplandı (528 hasta). Bu hastalardan postoperatif dönemde PE gelişen hastalar filtrelendi (118 hasta). Bu hastalardan PE nedeniyle su altı drenaj sistemi (tüp torakostomi) ile tedavi edilen hastaların dosyaları retrospektif olarak çalışmaya dahil edildi. Hastaların preoperatif, peroperatif ve postoperatif verileri toplandı.
Bulgular: Çalışma kriterlerine uyan 24 hastanın ortalama yaşı 62,95 yıldı. 14 (%58,3) hastaya neoadjuvan tedavi sonrasında ve 19 (%79,2) hastaya elektif koşullarda cerrahi uygulandı. En sık tümör lokalizasyonu midenin kardiya bölgesi olup (n=19), en sık uygulanan cerrahi total gastrektomiydi (n=16). Postoperatif dönemde en sık PE lokalizasyonu sol plevral aralık idi (n=14). En sık patolojik tanı adenokarsinom, en sık saptanan evreler T3 ve T4 olup, çalışmanın mortalite oranı %12,5 idi.
Sonuç: Postoperatif PE’ler mide kanseri cerrahisi sonrasında da görülebilen hızlı tedavi ve yakın takip gerektiren bir komplikasyonlardır. Öncelikli olarak etiyoloji ortaya konulmalı ve tedavi, etiyolojiye göre düzeltilmelidir. Uygun olgularda ise su altı drenaj sistemleri ile tedavi sağlanmalıdır.
Kaynakça
- Garrido VV, Sancho JF, Blasco H, et al. Diagnosis and treatment of pleural effusion. Arch Bronconeumol. 2006;42(7):349-72. DOI: 10.1016/s1579-2129(06)60545-4
- Light RW. Pleural effusions. Med Clin North Am. 2011;95(6):1055-70. DOI: 10.1016/j. mcna.2011.08.005
- Tian P, Qiu R, Wang M, et al. Prevalence, causes, and health care burden of pleural effusions among hospitalized adults in China. JAMA Netw Open. 2021;4(8):e2120306-e. DOI: 10.1001/ jamanetworkopen.2021.20306
- Nielsen PH, Jepsen SB, Olsen AD. Postoperative pleural effusion following upper abdominal surgery. Chest. 1989;96(5):1133-5. DOI: 10.1378/chest.96.5.1133
- Conde MV, Adams SG, Hines R. Overview of the management of postoperative pulmonary complications. UpToDate Waltham, MA: UpToDate. 2014.
- Light RW. Pleural effusions after coronary artery bypass graft surgery. Curr Opin Pulm Med. 2002;8(4):308-11. DOI: 10.1097/00063198-200207000-00011
- Bevelaqua F, Garritan S, Haas F, Salazar-Schicchi J, Axen K, Reggiani J-L. Complications after cardiac operations in patients with severe pulmonary impairment. Ann Thorac Surg. 1990;50(4):602-6. DOI: 10.1016/0003-4975(90)90197-e
- Ti TK, Yong NK. Postoperative pulmoner complications: A prospective study, in the trophics. Br J Surg. 1974;61:49-52. DOI: 10.1002/bjs.1800610112
- Wightman J. A prospective survey of the incidence of postoperative pulmonary complications. Br J Surg. 1968;55(2):85-91. DOI: 10.1002/bjs.1800550202
- Light RW, George RB. Incidence and significance of pleural effusion after abdominal surgery. Chest. 1976;69(5):621-5. DOI: 10.1378/chest.69.5.621
- Er M, Kotan MÇ. Üst Karın Ameliyatları Sonrası Plevral Effüzyonlar. Van Tıp Dergisi. 1997;4(4):215-7.
- DeCamp Jr MM, Mentzer SJ, Swanson SJ, Sugarbaker DJ. Malignant effusive disease of the pleura and pericardium. Chest. 1997;112(4):291-5. DOI: 10.1378/chest.112.4_supplement.291s
- Hartz RS, Bomalaski J, LoCicero III J, Murphy RL. Pleural ascites without abdominal fluid: surgical considerations. J Thorac Cardiovasc Surg. 1984;87(1):141-3.
- Djoussé L, Rothman KJ, Cupples LA, Levy D, Ellison RC. Serum albumin and risk of myocardial infarction and all-cause mortality in the Framingham Offspring Study. Circulation. 2002;106(23):2919-24. DOI: 10.1161/01.cir.0000042673.07632.76
- Porcel JM, Vives M. Etiology and pleural fluid characteristics of large and massive effusions. Chest. 2003;124(3):978-83. DOI: 10.1378/chest.124.3.978
- Koşar F. Malign plevral efüzyona yaklaşım. Güncel Göğüs Hastalıkları Serisi. 2013;1(3):108-14.
- Çobanoğlu U, Kızıltan R, Kemik Ö. Malign plevral efüzyonlar: tanı ve tedavi. Van Tıp Dergisi. 2017;24(4):397-403.
- Moon SW, Kim JJ, Cho DG, Park JK. Early detection of complications: anastomotic leakage. J Thorac Dis. 2019;11(Suppl 5):805-11. DOI: 10.21037/jtd.2018.11.55
- Karkhanis VS, Joshi JM. Pleural effusion: diagnosis, treatment, and management. Open Access Emerg Med. 2012;4:31-52. DOI: 10.2147/OAEM.S29942
Evaluation of The Clinical Features of Patients Who Underwent Gastric Cancer Surgery Developed Pleural Effusion in The Postoperative Period and Was Treated by Tube Thoracostomy
Yıl 2023,
Cilt: 1 Sayı: 2, 53 - 56, 22.06.2023
Serhat Binici
,
Tuba Bilen
,
Enis Oğuz
,
Emrah Dağtekin
,
Duygu Mergan İliklerden
,
Ümit Haluk İliklerden
,
Çetin Kotan
Öz
Aim: In our study, clinicopathological features of patients who developed pleural effusion (PE) in gastric cancer surgeries, which is a specific type of upper gastrointestinal system surgery, and were treated by tube thoracostomy were investigated.
Materials and Methods: After ethics committee approval, data of the patients who were operated on for gastric cancer in a university hospital between 01.01.2017 and 01.01.2022 were gathered (528 patients). Among these patients, patients who developed PE in the postoperative period were filtered (118 patients). Among these patients, the files of the patients who were treated with an underwater drainage system (tube thoracostomy) due to PE were included in the study retrospectively. Preoperative, perioperative, and postoperative data of the patients were collected.
Results: The mean age of 24 patients who met the study criteria was 62.95 years. Surgery was performed in 14 (58.3%) patients after neoadjuvant therapy and 19 (79.2%) under elective conditions. The most common tumor localization was the cardia region of the stomach (n=19), and the most common surgery was total gastrectomy (n=16). The most common localization of PE in the postoperative period was the left pleural space (n=14). The most common pathological diagnosis was adenocarcinoma, the most common stages were T3 and T4, and the mortality rate of the study was 12.5%.
Conclusion: Postoperative PEs are complications that can be seen after gastric cancer surgery and require rapid treatment and close follow-up. First, the etiology should be revealed, and the treatment should be adjusted according to the etiology. In appropriate cases, treatment should be provided with underwater drainage systems.
Kaynakça
- Garrido VV, Sancho JF, Blasco H, et al. Diagnosis and treatment of pleural effusion. Arch Bronconeumol. 2006;42(7):349-72. DOI: 10.1016/s1579-2129(06)60545-4
- Light RW. Pleural effusions. Med Clin North Am. 2011;95(6):1055-70. DOI: 10.1016/j. mcna.2011.08.005
- Tian P, Qiu R, Wang M, et al. Prevalence, causes, and health care burden of pleural effusions among hospitalized adults in China. JAMA Netw Open. 2021;4(8):e2120306-e. DOI: 10.1001/ jamanetworkopen.2021.20306
- Nielsen PH, Jepsen SB, Olsen AD. Postoperative pleural effusion following upper abdominal surgery. Chest. 1989;96(5):1133-5. DOI: 10.1378/chest.96.5.1133
- Conde MV, Adams SG, Hines R. Overview of the management of postoperative pulmonary complications. UpToDate Waltham, MA: UpToDate. 2014.
- Light RW. Pleural effusions after coronary artery bypass graft surgery. Curr Opin Pulm Med. 2002;8(4):308-11. DOI: 10.1097/00063198-200207000-00011
- Bevelaqua F, Garritan S, Haas F, Salazar-Schicchi J, Axen K, Reggiani J-L. Complications after cardiac operations in patients with severe pulmonary impairment. Ann Thorac Surg. 1990;50(4):602-6. DOI: 10.1016/0003-4975(90)90197-e
- Ti TK, Yong NK. Postoperative pulmoner complications: A prospective study, in the trophics. Br J Surg. 1974;61:49-52. DOI: 10.1002/bjs.1800610112
- Wightman J. A prospective survey of the incidence of postoperative pulmonary complications. Br J Surg. 1968;55(2):85-91. DOI: 10.1002/bjs.1800550202
- Light RW, George RB. Incidence and significance of pleural effusion after abdominal surgery. Chest. 1976;69(5):621-5. DOI: 10.1378/chest.69.5.621
- Er M, Kotan MÇ. Üst Karın Ameliyatları Sonrası Plevral Effüzyonlar. Van Tıp Dergisi. 1997;4(4):215-7.
- DeCamp Jr MM, Mentzer SJ, Swanson SJ, Sugarbaker DJ. Malignant effusive disease of the pleura and pericardium. Chest. 1997;112(4):291-5. DOI: 10.1378/chest.112.4_supplement.291s
- Hartz RS, Bomalaski J, LoCicero III J, Murphy RL. Pleural ascites without abdominal fluid: surgical considerations. J Thorac Cardiovasc Surg. 1984;87(1):141-3.
- Djoussé L, Rothman KJ, Cupples LA, Levy D, Ellison RC. Serum albumin and risk of myocardial infarction and all-cause mortality in the Framingham Offspring Study. Circulation. 2002;106(23):2919-24. DOI: 10.1161/01.cir.0000042673.07632.76
- Porcel JM, Vives M. Etiology and pleural fluid characteristics of large and massive effusions. Chest. 2003;124(3):978-83. DOI: 10.1378/chest.124.3.978
- Koşar F. Malign plevral efüzyona yaklaşım. Güncel Göğüs Hastalıkları Serisi. 2013;1(3):108-14.
- Çobanoğlu U, Kızıltan R, Kemik Ö. Malign plevral efüzyonlar: tanı ve tedavi. Van Tıp Dergisi. 2017;24(4):397-403.
- Moon SW, Kim JJ, Cho DG, Park JK. Early detection of complications: anastomotic leakage. J Thorac Dis. 2019;11(Suppl 5):805-11. DOI: 10.21037/jtd.2018.11.55
- Karkhanis VS, Joshi JM. Pleural effusion: diagnosis, treatment, and management. Open Access Emerg Med. 2012;4:31-52. DOI: 10.2147/OAEM.S29942