Mide kanser cerrahisi sonrası dren sıvısındaki yüksek amilaz değerinin etkisi: Bu bir komplikasyon mu yoksa sadece şüpheli biyokimyasal bir ölçüm mü?

Yıl 2019, Cilt: 44 Sayı: 2, 594 - 601, 30.06.2019

Mustafa Hasbahçeci , Merve Büşra Cengiz Adem Akçakaya , Fatma Ümit Malya , Enver Kunduz , Hüseyin Kazım Bektaşoğlu

https://doi.org/10.17826/cumj.450246

Cited By: 1

Öz

Amaç: Pankreatik fistülün, olası bir postoperatif
komplikasyon olarak, değişkenlik gösteren tanım, görülme sıklığı ve risk
faktörleri vardır. Bu çalışmada, mide cerrahisi sonrası pankreatik
fistülün etkisini değerlendirmeyi amaçladık.
Gereç ve Yöntem: Mide adenokarsinomu için tedavi edici amaçlı lenfadenektomi ile açık
gastrektomi uygulanan toplam 28 ardışık hasta retrospektif olarak
incelendi. Hastaların demografik, peri-operatif ve patolojik verileri
toplandı. Uluslararası Pankreatik Fistül Sistemi çalışma grubuna göre
teşhis ve derecelendirilen pankreas fistülü ana değişken olarak tanımlandı.

Bulgular: Hastaların yaş ortalaması 58,8 ± 10,1yıl idi ve kadın / erkek oranı 9
/ 19'du. Altı hastada (% 21.4) grade A pankreatik fistül
saptandı. Grade B ve C pankreatik fistül yoktu. Dren amilaz düzeyi
pankreas fistülü olan hastalarda anlamlı olarak daha yüksekti (p =
0,0001). Fistüllü ve fistülsüz hastalarda drenaj miktarı, hastanede kalış
süresi ve dren süreleri açısından anlamlı fark yoktu. Fistül gelişimi ile hastaların demografik özellikleri, peri-operatif ve
patolojik veriler arasında anlamlı ilişki bulunmadı.

Sonuç: Mide cerrahisi sonrası grade A pankreatik fistül gelişimi klinik
sonuçları olan majör bir komplikasyon olarak görünmemektedir. Dren
sıvısındaki yüksek amilaz seviyesi, sadece biyokimyasal bir ölçü olarak
düşünülebilir.

Anahtar Kelimeler

Gastrektomi, gastrik kanser, amilaz seviyesi, dren sıvısı, pankreas fistülü

Impact of high amylase level in drainage fluid after gastric cancer surgery: Is it a complication or suspicious biochemical measurement?

Öz

Purpose: Pancreatic fistula is a
potential postoperative complication with variable definitions, incidences and
risk factors. We intended to evaluate its impact after gastric surgery.

Materials and Methods: A total of 28 consecutive patients
who underwent curative open gastrectomy with lymphadenectomy for gastric
adenocarcinoma were retrospectively analyzed. Patients’ demographics,
peri-operative and pathological data were collected. Pancreatic fistula that
was diagnosed and graded according to International Study Group of Pancreatic
Fistula’s system was identified as main variable.

Results: Mean age of
patients was 58.8±10.1 years with a female to male ratio of 9/19. Grade
A pancreatic fistula was diagnosed in six patients (21.4%). There was no grade B and C pancreatic
fistula. Drain amylase level was significantly higher in patients with
pancreatic fistula (p=0.0001). There was no significant difference with regard
to amount of drainage, length of hospital stay and duration of drains in
patients with and without fistula. No significant association was shown between
development of fistula and patients’ demographics, peri-operative and
pathological data.

Conclusion: The development of grade A
pancreatic fistula after gastric surgery does not appear to be a major
complication with clinical consequences. High amylase level in the drainage
fluid can be considered as a biochemical measure only.  

Anahtar Kelimeler

Gastrectomy, gastric cancer, amylase level, drainage fluid, pancreatic fistula.

Kaynakça

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