LAPAROSKOPİK ve AÇIK YÖNTEM İLE KOLOREKTAL CERRAHİ YAPILAN HASTALARIN KARŞILAŞTIRILMASI

Yıl 2022, Cilt: 29 Sayı: 4, 567 - 574, 27.12.2022

Selim Tamam , Zafer Ergül , Serhat Tokgöz , İsmail Oskay Kaya

https://doi.org/10.17343/sdutfd.1108081

Öz

Amaç
Laparoskopik kolorektal cerrahi günümüzde birçok
merkezde yaygın olarak kullanılan bir yöntem halini
almıştır. Çalışmamızda laparoskopik ve açık kolorektal
cerrahi uygulanan olgularda postoperatif klinik ve
onkolojik sonuçların karşılaştırılması ve literatür ile kıyaslanması
amaçlanmıştır.
Gereç ve Yöntem
Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi
genel cerrahi kliniğinde Ocak 2012 ile Aralık
2018 tarihleri arasında kolorektal cerrahi uygulanan
hastaların verileri retrospektif olarak incelenmiştir.
Bulgular
Çalışmamıza 438’i (%80,5) açık, 73’ü (%13,4) laparoskopik,
33’ü (%6,1) konversiyon ile rezeksiyon
uygulanan toplam 544 hasta dahil edildi. Seride acil
opere edilen vaka sayısı 158 (%29,0), elektif vaka sayısı
386’dır (%71,0). Toplam 156 (%28,7) postoperatif
komplikasyon saptanmış olup, gruplara göre değerlendirildiğinde;
laparoskopik cerrahi grubunda postoperatif
komplikasyon 20 (%27,4), açık cerrahi grubunda
126 (%28,8), konversiyon grubunda 10 (%30,3)
postoperatif komplikasyon saptanmıştır. Rektum
kanserlerinde ortalama çıkarılan lenf nodu sayıları
açık prosedürde 19,0±9,7, laparoskopik prosedürde
22,3±11,6’ dir (p:0,198). Laparoskopik ve açık cerrahi
grubundaki rektum kanseri olgularında sırasıyla 1
(%2,3) ve 8 (%5,9) hastada pozitif çevresel cerrahi
sınır saptanmıştır (p:0,456). Ortalama distal cerrahi
sınır açık grupta 45,1±39,8, laparoskopik grupta
41,1±37,7 ’dir (p:0,608).
Sonuç
Laparoskopik kolorektal kanser cerrahisi klinik ve onkolojik
sonuçlar yönünden açık prosedür ile karşılaştırılabilir
sonuçlara sahiptir. Minimal invaziv cerrahinin
bilinen birçok avantajı göz önüne alındığında laparoskopik
cerrahi muhtemelen kolon kanseri için standart
tedavi haline gelecektir.

Anahtar Kelimeler

Laparoskopi, Laparoskopik Kolorektal Cerrahi, Kolorektal Cerrahi, Kolon Kanseri, Rektum Kanseri

COMPARISON OF PATIENTS TREATED WITH LAPAROSCOPIC AND OPEN COLORECTAL SURGERY

Öz

Objective
Laparoscopic colorectal surgery has become a widely
used method in many centers today. In our study,
it was aimed to compare the postoperative clinical
and oncological results in patients who underwent
laparoscopic and open colorectal surgery and to
compare them with the literature.
Material and Method
The data of patients who underwent colorectal
surgery between January 2012 and December 2018
at the Dışkapı Yıldırım Beyazıt Training and Research
Hospital General Surgery clinic were analyzed
retrospectively.
Results
A total of 544 patients were included in our study,
of which 438 (80.5%) underwent open resection, 73
(13.4%) laparoscopic, 33 (6.1%) underwent resection
with conversion. In the series, the number of cases
that were operated urgently was 158 (29.0%), and the
number of elective cases was 386 (71.0%). A total
of 156 (28.7%) postoperative complications were
detected. When evaluated according to the groups;
There were 20 (27.4%) postoperative complications
in the laparoscopic surgery group, 126 (28.8%) in the
open surgery group, and 10 (30.3%) in the conversion
group. The mean number of lymph nodes removed in
rectal cancers is 19.0±9.7 in the open procedure and
22.3±11.6 in the laparoscopic procedure (p: 0.198). A
positive circumferential surgical margin was found in 1
(2.3%) and 8 (5.9%) patients with rectal cancer in the
laparoscopic and open surgery groups, respectively
(p: 0.456). The mean distal surgical margin was
45.1±39.8 mm in the open group and 41.1±37.7 mm
in the laparoscopic group (p: 0.608).
Conclusion
Laparoscopic colorectal cancer surgery has
comparable clinical and oncological outcomes to the
open procedure. Given the many known advantages
of minimally invasive surgery, laparoscopic surgery
will likely become the standard treatment for colon
cancer.

Anahtar Kelimeler

Laparoscopy, Laparoscopic Colorectal Surgery, Colorectal Surgery, Colon Cancer, Rectal Cancer

Kaynakça

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