ÜST EKSTREMİTE KAYNAKLI MALİGN DERİ TÜMÖRLERİNE YÖNELİK YAPILAN AKSİLLER DİSEKSİYON SONRASI GELİŞEN LENFÖDEM İLE ÇIKARILAN LENF NODU SAYISI ARASINDAKİ İLİŞKİ

Öz

Amaç: Deri kanserleri en sık görülen malign kanserlerdendir. Cilt kanserinin cerrahi tedavisi için aksiller diseksiyon yapılması gereken durumlar mevcuttur ve aksiller diseksiyon sonrası sekonder lenfödem nadir değildir. Çalışmada, lenfödem gelişimini öngörebilecek faktörleri değerlendirmek için diseksiyon materyallerinde çıkarılan lenf nodu sayısı incelenmiştir. Gereç ve Yöntem: Çalışmamıza 2019-2022 yılları arasında üst ekstremite kaynaklı malign deri tümörü nedeniyle aksiller lenf nodu diseksiyonu yapılan hastalar dahil edildi. Yaş, cinsiyet, primer malignite tipi, lezyonun lokalizasyonu, diseksiyon materyalinde çıkarılan toplam lenf nodu sayısı, diseksiyon materyalinde saptanan metastatik lenf nodu sayısı, SLNB öyküsü, opere edilen ve edilmeyen ekstremite arasındaki ölçüm farkı preoperatif ve postoperatif birinci yılda kaydedildi. Bulgular: Çalışmamızda, çıkarılan toplam lenf nodu sayısı ile diseke edilen ve edilmeyen kol arasındaki çap farkı arasında istatistiksel olarak anlamlı pozitif korelasyon bulunurken, metastatik lenf nodu sayısı ile diseke edilen uzuv ile diğer uzvun metakarpofalangeal eklemleri arasındaki çap farkı arasında istatistiksel olarak anlamlı pozitif korelasyon bulunmuştur. Sonuç: Lenfödem, tedavisi zor olan ve erken teşhis edildiğinde prognozu hafifletilebilen bir komplikasyondur. Diseksiyon materyallerinde eksize edilen lenf nodu sayısı ve metastatik lenf nodu sayısı değerlendirilerek lenfödem gelişebilecek hastalarda erken önlem almak, hastaları eğitmek, bireysel tedavi odaliteleri geliştirmek ve istenmeyen komplikasyonlardan kaçınmak mümkün olabilir

Anahtar Kelimeler

• Aksiller lenf nodu diseksiyonu
• melanom
• sekonder lenfödem
• melanom dışı cilt kanseri

THE RELATIONSHIP BETWEEN LYMPHEDEMA AFTER AXILLARY DISSECTION FOR MALIGNANT SKIN TUMORS OF UPPER EXTREMITY AND NUMBER OF LYMPH NODES REMOVED

Öz

Objective: Skin cancers are the most common malignant cancers. For the surgical treatment of skin cancer, there are cases where axillary dissection should be performed, and secondary lymphedema after axillary dissection is not uncommon. The study examined the number of lymph nodes removed in the dissection materials to evaluate the factors that may predict the development of lymphedema. Material and Method: Our study included patients who underwent axillary lymph node dissection for malignant skin tumors originating from the upper extremities between 2019 and 2022. Age, gender, type of primary malignancy, localization of the lesion, total number of lymph nodes removed in the dissection material, number of metastatic lymph nodes detected in the dissection material, history of SLNB, and the difference in measurements between the operated and non-operated extremity were recorded preoperatively and at the first year postoperatively. Result: In our study, there was a statistically significant positive correlation between the total number of lymph nodes removed and the diameter difference between the dissected and non-dissected arms. At the same time, there was a statistically significant positive correlation between the number of metastatic lymph nodes and the diameter difference between the dissected limb and the metacarpophalangeal joints of the other limb. Conclusion: Lymphedema is a complication that is difficult to treat and whose prognosis can be alleviated if detected early. By evaluating the number of excised and metastatic lymph nodesin the dissection materials, it may be possible to take early precautions, educate patients, develop individual treatment modalities, and avoid unwanted complications in patients who may develop lymphedema.

Anahtar Kelimeler

• Axillary lymph node dissection
• melanoma
• secondary lymphedema
• non-melanoma skin cancer

Kaynakça

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