Araştırma Makalesi
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Kolorektal kanser tanı ve tedavisinde önemli bir problem: Obstrüksiyon

Yıl 2020, Cilt: 28 Sayı: 2, 52 - 55, 30.08.2020
https://doi.org/10.17940/endoskopi.796036

Öz

Giriş ve Amaç: Kolorektal kanserler günümüzde hala en sık ölüm nedenleri arasındadır. Kolorektal kanserlerde mortalite ve morbidite başlangıç kolonoskopisi ve tespit edilen lezyonlar ile doğrudan ilişkilidir. Obstrükte kolorektal kanserlerde başlangıçta yeterli inceleme her zaman önemli bir sorun olmuştur. Biz obstrüksiyon tespit edilen kolorektal kanser oranını ve bu hastalara olan yaklaşımı ele almaya çalıştık. Gereç ve Yöntem: Ocak 2015- Aralık 2019 tarihleri arasında İstanbul S.B.Ü. Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesinde yapılan 10326 kolonoskopi işlemi hasta dosyalarından ve elektronik data üzerinden kolon kanseri yönünden retrospektif olarak analiz edildi. Çalışmada hastaların yaş, cinsiyet ve kolonoskopi sonuçları barsak temizliği, obstrüksiyon varlığı, tümör lokalizasyonu, patolojik tanıları yönünden analiz edilerek kayıt edildi. Bulgular: 10326 hasta dosyası taranarak 145 (%62.2) erkek ve 88 (%37.8) kadın olmak üzere 233 kolon kanseri tanısı konan hasta çalışmaya dâhil edildi. Çalışmamızda kolorektal kanser görülme sıklığı %0.02 olarak tespit edildi. Tanı alan hastalarda en sık endikasyon %28.8 (n=67) ile rektal kanama iken en sık lokalizasyon bölgesi %44.6 (n=104) ile rektum olarak tespit edilmiştir. Obstrüksiyona göre tümör lokalizasyonları incelendiğinde %69.9 (n=51) ile en yüksek obstrüksiyon tespit edilen bölge rektosigmoid bölge olmuştur. Sonuç: Kolon kanseri en sık lokalizasyon olarak rektosigmoid bölgeyi tutmakta ve bu bölgede belirgin oranda obstrüksiyona neden olmaktadır. Obstrüksiyon nedeni ile tanı anında kolonoskopik inceleme yeterli derecede yapılamamakta, bu da senkron lezyonların tespitini azaltmaktadır. Biz bu tür hastalarda preoperatif bilgisayarlı tomografik kolonografinin uygun olabileceğini hatırlatmaktayız.
Anahtar kelimeler: , ,

Kaynakça

  • 1.Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin 2015;65:87-108.
  • 2. Sulz MC, Kröger A, Prakash M, et al. Meta-analysis of the effect of bowel preparation on adenoma detection: early adenomas affected stronger than advanced adenomas. PLoS One 2016;11:e0154149.
  • 3. Baxter NN, Warren JL, Barrett MJ, Stukel TA, Doria-Rose VP. Association between colonoscopy and colorectal cancer mortality in a US cohort according to site of cancer and colonoscopist specialty. J Clin Oncol 2012;3021:2664-9.
  • 4. Clark BT, Rustagi T, Laine L. What level of bowel prep quality requires early repeat colonoscopy: systematic review and meta-analysis of the impact of preparation quality on adenoma detection rate. Am J Gastroenterol 2014;109:1714-23.
  • 5. Corley DA, Jensen CD, Marks AR, et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med 2014;370:1298-306.
  • 6. Mulder SA, Kranse R, Damhuis RA, et al. The incidence and risk factors of metachronous colorectal cancer: an indication for follow-up. Dis Colon Rectum 2012;55:522-31.
  • 7. Kahi CJ, Anderson JC, Rex DK. Screening and surveillance for colorectal cancer: state of the art. Gastrointest Endosc 2013;77:335-50.
  • 8. Liu L, Lemmens VE, De Hingh IH, et al. Second primary cancers in subsites of colon and rectum in patients with previous colorectal cancer. Dis Colon Rectum 2013;56:158-68.
  • 9. Mulder SA, Kranse R, Damhuis RA, et al. Prevalence and prognosis of synchronous colorectal cancer: a Dutch population-based study. Cancer Epidemiol 2011;35:442-7.
  • 10. Bouvier AM, Latournerie M, Jooste V, et al. The lifelong risk of metachronous colorectal cancer justifies long-term colonoscopic followup. Eur J Cancer 2008;44:522-7.
  • 11. Marques-Antunes J, Libanio D, Goncalves P, et al. Incidence and predictors of adenoma after surgery for colorectal cancer. Eur J Gastroenterol Hepatol 2017;29:932-8.
  • 12. Gaiani F, Patrizi F, Sobhani I, de’Angelis GL. Principles of colonoscopy for colorectal cancer emergency. In: de'Angelis N, Di Saverio S, Brunetti F. (eds). Emergency Surgical Management of Colorectal Cancer. Hot Topics in Acute Care Surgery and Trauma. Springer, Cham; 2019:69-80.
  • 13. Atsushi I, Mitsuyoshi O, Kazuya Y, et al. Long-term outcomes and prognostic factors of patients with obstructive colorectal cancer: A multicenter retrospective cohort study. World J Gastroenterol 2016;22:5237-45.
  • 14. Kabaçam G, Bektaş M, Sarıoğlu M, et al. Colorectal cancer detection rate in the last two decades at an endoscopy center. Endoscopy Gastrointertinal 2009;17:28-31.
  • 15. Kahi CJ, Boland CR, Dominitz JA, et al. Colonoscopy Surveillance after Colorectal Cancer Resection: Recommendations of the US Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol 2016;111:337-46.
  • 16. Hassan C, Wysocki PT, Fuccio L. Endoscopic surveillance after surgical or endoscopic resection for colorectal cancer: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Digestive Oncology (ESDO) Guideline. Endoscopy 2019;51:C1.
  • 17. Milsom JW, Shukla P. Should intraoperative colonos-copy play a role in the surveillance for colorectal cancer? Dis Colon Rectum 2011;54:504-6.
  • 18. Levin B, Lieberman DA, McFarland B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin 2008;58:130-60.
  • 19. Park SH, Lee JH, Lee SS, et al. CT colonography for detection and characterisation of synchronous proximal colonic lesions in patients with stenosing colorectal cancer. Gut 2012;61:1716-22.
  • 20. Kahi CJ, Boland CR, Dominitz JA, et al. Colonoscopy Surveillance After Colorectal Cancer Resection: Recommendations of the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology 2016;150:758-68.
  • 21. Spada C, Stoker J, Alarcon O, et al. Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline. Endoscopy 2014;46:897-915.
  • 22. Suttie SA, Shaikh I, Mullen R, et al. Outcome of right- and left-sided colonic and rectal cancer following surgical resection. Colorectal Dis 2011;13:884-9.

A predominant problem in the diagnosis and treatment of colorectal cancer: Obstruction

Yıl 2020, Cilt: 28 Sayı: 2, 52 - 55, 30.08.2020
https://doi.org/10.17940/endoskopi.796036

Öz

Background and Aims: Colorectal cancers remain among the most common causes of death today. The mortality and morbidity rates of colorectal cancers are directly related to initial colonoscopy and lesion detection. Insufficient colonoscopic examination has always been an important problem in colorectal cancers diagnosed with obstruction. We examine the rates of obstruction and how to approach to these patients. Materials and Method: A total of 10326 colonoscopy procedures performed in İstanbul S.B.U. Kanuni Sultan Suleyman Training and Research Hospital between January 2015 and December 2019 were retrospectively analyzed in terms of colon cancer from patient files and electronic data. In this study, the age, sex, and colonoscopy results of the patients were analyzed in terms of bowel cleansing, presence of obstruction, tumor localization, and pathological diagnoses. Results: A total of 10326 files were scanned, and 233 patients with colorectal cancer, 145 (62.2%) males and 88 (37.8%) females, were included in the study. The incidence of colorectal cancer was 0.02%. The most common indication was rectal bleeding (28.8%, n=67), and the most common localization region was the rectum (44.6%, n=104). When the tumor localizations were examined according to obstruction, the region with the highest obstruction was the rectosigmoid region, with a frequency of 69.9% (n=51). Conclusion: Colorectal cancer most commonly involves localization in the rectosigmoid region and is a significant cause of obstruction in this area. Colonoscopic examinations cannot be performed adequately at the time of diagnosis because of obstruction, which reduces the detection rate of synchronous lesions. Therefore, we considered that preoperative computed tomography colonography may be appropriate in such patients.

Kaynakça

  • 1.Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin 2015;65:87-108.
  • 2. Sulz MC, Kröger A, Prakash M, et al. Meta-analysis of the effect of bowel preparation on adenoma detection: early adenomas affected stronger than advanced adenomas. PLoS One 2016;11:e0154149.
  • 3. Baxter NN, Warren JL, Barrett MJ, Stukel TA, Doria-Rose VP. Association between colonoscopy and colorectal cancer mortality in a US cohort according to site of cancer and colonoscopist specialty. J Clin Oncol 2012;3021:2664-9.
  • 4. Clark BT, Rustagi T, Laine L. What level of bowel prep quality requires early repeat colonoscopy: systematic review and meta-analysis of the impact of preparation quality on adenoma detection rate. Am J Gastroenterol 2014;109:1714-23.
  • 5. Corley DA, Jensen CD, Marks AR, et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med 2014;370:1298-306.
  • 6. Mulder SA, Kranse R, Damhuis RA, et al. The incidence and risk factors of metachronous colorectal cancer: an indication for follow-up. Dis Colon Rectum 2012;55:522-31.
  • 7. Kahi CJ, Anderson JC, Rex DK. Screening and surveillance for colorectal cancer: state of the art. Gastrointest Endosc 2013;77:335-50.
  • 8. Liu L, Lemmens VE, De Hingh IH, et al. Second primary cancers in subsites of colon and rectum in patients with previous colorectal cancer. Dis Colon Rectum 2013;56:158-68.
  • 9. Mulder SA, Kranse R, Damhuis RA, et al. Prevalence and prognosis of synchronous colorectal cancer: a Dutch population-based study. Cancer Epidemiol 2011;35:442-7.
  • 10. Bouvier AM, Latournerie M, Jooste V, et al. The lifelong risk of metachronous colorectal cancer justifies long-term colonoscopic followup. Eur J Cancer 2008;44:522-7.
  • 11. Marques-Antunes J, Libanio D, Goncalves P, et al. Incidence and predictors of adenoma after surgery for colorectal cancer. Eur J Gastroenterol Hepatol 2017;29:932-8.
  • 12. Gaiani F, Patrizi F, Sobhani I, de’Angelis GL. Principles of colonoscopy for colorectal cancer emergency. In: de'Angelis N, Di Saverio S, Brunetti F. (eds). Emergency Surgical Management of Colorectal Cancer. Hot Topics in Acute Care Surgery and Trauma. Springer, Cham; 2019:69-80.
  • 13. Atsushi I, Mitsuyoshi O, Kazuya Y, et al. Long-term outcomes and prognostic factors of patients with obstructive colorectal cancer: A multicenter retrospective cohort study. World J Gastroenterol 2016;22:5237-45.
  • 14. Kabaçam G, Bektaş M, Sarıoğlu M, et al. Colorectal cancer detection rate in the last two decades at an endoscopy center. Endoscopy Gastrointertinal 2009;17:28-31.
  • 15. Kahi CJ, Boland CR, Dominitz JA, et al. Colonoscopy Surveillance after Colorectal Cancer Resection: Recommendations of the US Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol 2016;111:337-46.
  • 16. Hassan C, Wysocki PT, Fuccio L. Endoscopic surveillance after surgical or endoscopic resection for colorectal cancer: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Digestive Oncology (ESDO) Guideline. Endoscopy 2019;51:C1.
  • 17. Milsom JW, Shukla P. Should intraoperative colonos-copy play a role in the surveillance for colorectal cancer? Dis Colon Rectum 2011;54:504-6.
  • 18. Levin B, Lieberman DA, McFarland B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin 2008;58:130-60.
  • 19. Park SH, Lee JH, Lee SS, et al. CT colonography for detection and characterisation of synchronous proximal colonic lesions in patients with stenosing colorectal cancer. Gut 2012;61:1716-22.
  • 20. Kahi CJ, Boland CR, Dominitz JA, et al. Colonoscopy Surveillance After Colorectal Cancer Resection: Recommendations of the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology 2016;150:758-68.
  • 21. Spada C, Stoker J, Alarcon O, et al. Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline. Endoscopy 2014;46:897-915.
  • 22. Suttie SA, Shaikh I, Mullen R, et al. Outcome of right- and left-sided colonic and rectal cancer following surgical resection. Colorectal Dis 2011;13:884-9.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Sami Çifti Bu kişi benim 0000-0003-0226-6825

Nergiz Ekmen Bu kişi benim 0000-0002-7921-3169

Yayımlanma Tarihi 30 Ağustos 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 28 Sayı: 2

Kaynak Göster

APA Çifti, S., & Ekmen, N. (2020). Kolorektal kanser tanı ve tedavisinde önemli bir problem: Obstrüksiyon. Endoskopi Gastrointestinal, 28(2), 52-55. https://doi.org/10.17940/endoskopi.796036
AMA Çifti S, Ekmen N. Kolorektal kanser tanı ve tedavisinde önemli bir problem: Obstrüksiyon. Endoskopi Gastrointestinal. Ağustos 2020;28(2):52-55. doi:10.17940/endoskopi.796036
Chicago Çifti, Sami, ve Nergiz Ekmen. “Kolorektal Kanser Tanı Ve Tedavisinde önemli Bir Problem: Obstrüksiyon”. Endoskopi Gastrointestinal 28, sy. 2 (Ağustos 2020): 52-55. https://doi.org/10.17940/endoskopi.796036.
EndNote Çifti S, Ekmen N (01 Ağustos 2020) Kolorektal kanser tanı ve tedavisinde önemli bir problem: Obstrüksiyon. Endoskopi Gastrointestinal 28 2 52–55.
IEEE S. Çifti ve N. Ekmen, “Kolorektal kanser tanı ve tedavisinde önemli bir problem: Obstrüksiyon”, Endoskopi Gastrointestinal, c. 28, sy. 2, ss. 52–55, 2020, doi: 10.17940/endoskopi.796036.
ISNAD Çifti, Sami - Ekmen, Nergiz. “Kolorektal Kanser Tanı Ve Tedavisinde önemli Bir Problem: Obstrüksiyon”. Endoskopi Gastrointestinal 28/2 (Ağustos 2020), 52-55. https://doi.org/10.17940/endoskopi.796036.
JAMA Çifti S, Ekmen N. Kolorektal kanser tanı ve tedavisinde önemli bir problem: Obstrüksiyon. Endoskopi Gastrointestinal. 2020;28:52–55.
MLA Çifti, Sami ve Nergiz Ekmen. “Kolorektal Kanser Tanı Ve Tedavisinde önemli Bir Problem: Obstrüksiyon”. Endoskopi Gastrointestinal, c. 28, sy. 2, 2020, ss. 52-55, doi:10.17940/endoskopi.796036.
Vancouver Çifti S, Ekmen N. Kolorektal kanser tanı ve tedavisinde önemli bir problem: Obstrüksiyon. Endoskopi Gastrointestinal. 2020;28(2):52-5.