Abstract

Özet: Objektif: Kolon kanseri kadın ve erkeklerde sık görülen kanserler arasındadır. Rezeksiyon sonrası anastomoz ayrılması istenmeyen bir durumdur. Anastomoz kaçağı gelişmesine etkili çeşitli risk faktörleri vardır.
Metod: Elliüç kolon anastomoz kaçağı olgusu retrospektif olarak çalışmada yer almıştır. Bu hastalarda demografik özellikler ve yandaş hastalıklar retrospektif olarak değerlendirilmiş ve risk faktörleri literatür ile karşılaştırılmıştır.
Sonuçlar: Elliüç olgudan otuz vakada ek hastalık tespit edilmiştir. En çok tespit edilen yandaş hastalık diabetes mellitus(DM) ve hipertansiyon(HT) olup daha az sıklıkta ise kronik obstruktif akciğer hastalığı( KOAH) vb kronik hastalıklar tespit edilmiştir. Fistül gelişen hastalarda mortalite oranı %11 olup mortal olgularda genellikle DM ve HT birliktelik göstermektedir.
Tartışma: KOAH'lı hastalarda yetersiz alveoler ventilasyon ve bunun sonucunda hipoksi ve hiperkapni, doku onarım süreçlerinde olumsuz etkiye sahiptir. Mikro sirkülasyondaki değişiklikler ve hastanın diyabetes mellitus (DM) ile ilişkili enfeksiyona daha fazla duyarlılığı postoperatif fistül gelişiminde risk faktörüdür. DM ile birlikte obezite de mevcut ise anastomoz kaçak riski daha da yüksek olabiliyor. Preoperativ diastolik yüksek basınç , anastomoz kaçak riskini arttıran diğer bir faktördür. Sonuç olarak hipertansiyon, obezite, diabet, KOAH , kolorektal cerrahi sonrası anastomoz kaçaklarında etkili risk faktörleridir. Bu risk faktörleri morbidite ve mortalite artışında etkili olmaktadır. 

Retrospective Analysis of 53 Cases who Developed Colon Fistula

Abstract

Objective: Colon cancer is among the most common cancers in men and women. Separation of anastomosis after resection is undesirable. There are various risk factors affecting the development of anastomotic leakage.

Methods: Fifty-three cases of colon anastomotic leakage were included in the study retrospectively. Demographic characteristics and co-morbidities in these patients were evaluated retrospectively and risk factors were compared with the literature.

Results: Additional disease was detected in thirty of fifty-three cases. The most common co-morbidities are diabetes mellitus (DM) and hypertension (HT), while less frequent chronic diseases such as chronic obstructive pulmonary disease (COPD) have been detected. Mortality rate is 11% in patients who develop fistula, and DM and HT usually coexist in mortal cases.

Conclusion: Inadequate alveolar ventilation and consequently hypoxia and hypercapnia have negative effects on tissue repair processes in patients with COPD. Changes in the microcirculation and the patient's greater susceptibility to diabetes mellitus (DM)-related infection are risk factors for the development of postoperative fistula. If obesity is present together with DM, the risk of anastomotic leakage may be even higher. Preoperative diastolic pressure is another factor that increases the risk of anastomotic leakage. In conclusion, hypertension, obesity, diabetes, COPD are effective risk factors for anastomotic leakage after colorectal surgery. These risk factors are effective in increased morbidity and mortality. Keywords: colon, cancer, anastomosis, leakage, fistula 

Keywords

• colon
• cancer
• anastomosis
• leakage
• fistula

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