KOLON KANSERİNDE ROBOTİK VE AÇIK SAĞ KOLEKTOMİNİN POSTOPERATİF VE ONKOLOJİK SONUÇLARININ KARŞILAŞTIRILMASI

Öz

Amaç: Bu çalışma, sağ kolon kanseri için robotik sağ hemikolektominin kısa vadeli sonuçlarını konvansiyonel sağ hemikolektomiyle karşılaştırmayı amaçlamaktadır. Gereç ve Yöntem: 2020-2022 yılları arasında sağ taraf yerleşimli kolorektal kanser nedeniyle cerrahi tedavi uygulanan hastalar çalışmaya dahil edildi. Hastalar konvansiyonel cerrahi geçirenler Grup 1, robotik cerrahi uygulananlar Grup 2 olmak üzere 2 gruba ayrıldı. Bu gruplarda hastalara ait klinik veriler ve peroperatif sonuçlar karşılaştırıldı. Bulgular: Çalışmamıza 51 hasta katıldı. Grup 1 39 hastadan, Grup 2 12 hastadan oluşuyordu. Yaş ortalaması (60,7 ve 62,3 p=0,773) idi. Hiçbir dönüşüm veya intraoperatif komplikasyon oluşmadı. Genişletilmiş sağ hemikolektomi (%23,1 ve %8,36 p=0,083) oranında uygulandı. Operasyon süresi Grup 2'de uzundu (2,84 ve 3,04 p=0,023). Grup 1’de bir hasta postoperatif dönemde ileus nedeniyle tekrar ameliyat edildi. En sık T3 evre tümörler (%48,7 ve %50, p=0,794) ve N0 (%38,5 ve %41,7, p=0,827) saptanmıştı. Lenf nodu diseksiyonu sayıları total lenf nodları 37,2 ve 41,9 (p=0,179) ve malign nodlar 2,54 ve 6,42 (p=0,881) idi. En sık görülen Clavien-Dindo skoru her iki grupta da 1 idi (%79,5 ve %83,3, p=0,339). Yatış süresi gruplarda benzerdi (6,38 ve 5,92, p=0,156). Grup 1'de 6 hastada hastaneye tekrar başvuru görüldü. Başvuru sebepleri anastomoz kaçağı, ileus ve genel durum bozukluğu idi. Sonuç: Deneyimlerimiz sağ kolon kanserinin tedavisi için robotik cerrahinin fizibilitesini ve güvenliğini doğrulamaktadır. Bu yöntem tatmin edici kısa vadeli sonuçlar sağlamıştır.

Anahtar Kelimeler

• Kolorektal kanser
• robotik cerrahi
• sağ kolektomi
• postoperatif komplikasyon
• onkolojik sonuçlar

COMPARISON OF POSTOPERATIVE AND ONCOLOGICAL OUTCOMES IN ROBOTIC AND OPEN RIGHT COLECTOMY FOR COLON CANCER

Öz

Objective:This study aims to compare the short-term outcomes of robotic right hemicolectomy for right sided colon cancer to those of conventional open right hemicolectomy. Material and Method:Patients who underwent surgical treatment for right sided colorectal cancer between 2020 and 2022 were included in the study. Patients had been divided into 2 groups: Group1, who underwent conventional surgery, and Group2, who underwent robotic surgery.Clinical data and peropative findings of patients were compared between the groups. Result:A total of 51 patients participated in our study. Group1 consisted of 39 patients and Group2 consisted of 12 patients. The mean age was 60.7 vs. 62.3 (p=0.773). No conversions or intraoperative complications occurred. Extended right hemicolectomy was performed in 23.1% vs. 8.36% (p=0.083). The operation time was longer in Group2 (2.84 vs. 3.04,p=0.023). One patient in Group 1 underwent reoperation for ileus during the postoperative period. T3 stage tumors (48.7% vs. 50%,p=0.794) and N0 lymph node metastasis (38.5% vs. 41.7%,p=0.827) were detected most frequently. The total number of lymph nodes dissected was 37.2 vs. 41.9 (p=0.179). The number of malignant lymph nodes was 2.54 vs. 6.42 (p=0.881). The most common Clavien-Dindo score was 1 in both groups (79.5% vs. 83.3%,p=0.339). The length of stay was similar between the groups (6.38 vs. 5.92, p=0.156). Readmission occurred in 6 patients in Group1, with reasons being anastomotic leakage, ileus, and general condition disorder. Conclusion:Our experience shows the feasibility and safety of robotic surgery for the treatment of right sided colonic cancer. This method has provided satisfactory short-term outcomes.

Anahtar Kelimeler

• Colorectal cancer
• Robotic surgery
• Right colectomy
• Postoperative complications
• Oncologic outcomes

Kaynakça

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