Öz
Giriş: Serviks kanseri, kadın genital organlarının malign tümörleri
arasında sık rastlanmaktadır. Primer radikal histerektomi sonrası
radyoterapi ve kemoradyoterapi uygulanmasının hastanın yaşam süresi
ve rekkürrens üzerine olumlu etkileri vardır. Primer radikal histerektomi
ve kemoradyoterapi başarısız olduğu durumlarda, özellikle
santral rekürrenslerde, pelvik ekzantrasyon yapılabilir ancak pelvik
ekzantrasyon küratif bir seçenek değildir. Serviks CA lokal invaziv ve
komplike tiplerinin tedavisinde kombine ameliyatlar (ekzentrasyonlar)
hastalara komforlu yaşam sağlar.
Materyal ve Sonuçlar: 2006-2012 yıllarında Azerbaycan Ulusal
Onkoloji Merkezinde lokal invaziv serviks karsinomalı 15 hastada
pelvik ekzantrasyon gerçekleştirilmiştir. Lokal invaziv karsinomlu 8
(%53.3) hastaya anterior ekzentrasyon, 5 (%33.3) hastaya posterior ekzentrasyon
ve 2 (%13.3) hastaya total ekzentrasyon gerçekleitirilmiitir.
Postoperatif dönemde %20 hastaya tekrar operasyon gerçekleştirilmiştir.
15 hastanın 2(%13.3) ‘de tümörün lokal invaziv oluiuna bağ-
lı olarak vagina ile rektum arasında fistül görüldü.
Sonuç: Preoperatif tanı yöntemlerindeki gelişmeler, gelişimiş cerrahi
teknikler ve ileri postoperatif yoğun bakım olanakları, hastaya
pelvik eksenteratif cerrahi ile ikinci bir sağkalım iansı tanımaktadır.
Bu yaklaiım ultraradikal cerrahi konusunda deneyimli ve iyi eğitilmii
bir cerrahi ekip ve erken postoperatif dönemde dikkatli bir yoğun
bakım ekibini gerektirir.
Anahtar Kelimeler
Kaynakça
- 1. DiSaia Creasman. Klinik Jinekolojik Onkoloji. Gunefl Kitabevi Ltd.fiti., Ankara 2003, s:97.
- 2. Marnitz S, Köhler C, Müller M, Behrens K, Hasenbein K, Schneider A. Indications for primary and secondary exenterations in patients with cervical cancer. Gynecol Oncol. 2006 Dec;103(3):1023-30.
- 3. Landoni F, Maneo A, Colombo A, Placa F, Milani R, Perego P, et al. Randomized study of radical surgery versus radiotherapy for stage IB-IIA cervical cancer. Lancet 1997;350:535-40.
- 4. Lai CH, Hong JH, Hsueh S, Ng KK, Chang TC, Tseng CJ, et al. Preoperative prognostic variables and the impact of postoperative adjuvant therapy on the outcomes of stage IB or II cervical carcinoma patients with or without pelvic lymph node metastases. Cancer 1999;85:1537-46.
- 5. Lai CH. Management of recurrent cervical cancer. Chang Gung Med J. 2004 Oct;27(10):711-7.
- 6. Peiretti M, Zapardiel I, Zanagnolo V, Landoni F, Morrow CP, Maggioni A. Management of recurrent cervical cancer: a review of the literature. Surg Oncol. 2012 Jun;21(2):e59-66. doi: 10.1016/j.suronc.2011.12.008.
- 7. Hacker NF. Cervical cancer. In: Berek JS and Hacker NF, eds. Practical Gynecologic Oncology, 3rd ed. Pliladelphia: Lippincott Williams & Wilkins, 2000:345-405.
- 8. Ramirez PT, Modesitt SC, Morris M, Edwards CL, Bevers MW, Wharton JT, et al. Funtional outcomes and complications of continent urinary diversions in patients with gynecologic malignancies. Gynecol Oncol 2002;85:285-91
Öz
Introduction: Cervical cancer is common among malignant
tumors of the female genital organs. Primary radiotherapy and
chemoradiation after radical hysterectomy has a positive impact on
the implementation of the patient's life expectancy and recurrence. In
cases where the primary radical hysterectomy and chemoradiation
fail, especially central recurrence, pelvic exenteration can be curative,
but is not an option. Combined surgery in the treatment of locally
invasive and complicated types of cervical carcinoma patients provides
comfortable living.
Materials and Results: In 2006-2012 Azerbaijan National
Oncology Center, a local pelvic exenteration was carried out in 15
patients with invasive cervical carcinoma. Locally invasive carcinoma
of the 8 (53.3%) patients with anterior exenteration, 5 (33.3%) patients,
posterior exenteration and 2 (13.3%) patients were total exenteration.
The postoperative period, the patient re-operation was 20%. 15
patients, 2 (13.3%), depending on whether the tumor is locally invasive
fistula between the vagina and the rectum was observed.
Conclusion: Preoperative diagnostic tests, improved surgical
techniques, postoperative intensive care and advanced facilities,
patients with pelvic exentrative surgery gives a second chance of survival.
This approach is experienced and well-trained surgical team
ultra-radical surgery and intensive care team in the early postoperative
period requires careful.
Anahtar Kelimeler
Kaynakça
- 1. DiSaia Creasman. Klinik Jinekolojik Onkoloji. Gunefl Kitabevi Ltd.fiti., Ankara 2003, s:97.
- 2. Marnitz S, Köhler C, Müller M, Behrens K, Hasenbein K, Schneider A. Indications for primary and secondary exenterations in patients with cervical cancer. Gynecol Oncol. 2006 Dec;103(3):1023-30.
- 3. Landoni F, Maneo A, Colombo A, Placa F, Milani R, Perego P, et al. Randomized study of radical surgery versus radiotherapy for stage IB-IIA cervical cancer. Lancet 1997;350:535-40.
- 4. Lai CH, Hong JH, Hsueh S, Ng KK, Chang TC, Tseng CJ, et al. Preoperative prognostic variables and the impact of postoperative adjuvant therapy on the outcomes of stage IB or II cervical carcinoma patients with or without pelvic lymph node metastases. Cancer 1999;85:1537-46.
- 5. Lai CH. Management of recurrent cervical cancer. Chang Gung Med J. 2004 Oct;27(10):711-7.
- 6. Peiretti M, Zapardiel I, Zanagnolo V, Landoni F, Morrow CP, Maggioni A. Management of recurrent cervical cancer: a review of the literature. Surg Oncol. 2012 Jun;21(2):e59-66. doi: 10.1016/j.suronc.2011.12.008.
- 7. Hacker NF. Cervical cancer. In: Berek JS and Hacker NF, eds. Practical Gynecologic Oncology, 3rd ed. Pliladelphia: Lippincott Williams & Wilkins, 2000:345-405.
- 8. Ramirez PT, Modesitt SC, Morris M, Edwards CL, Bevers MW, Wharton JT, et al. Funtional outcomes and complications of continent urinary diversions in patients with gynecologic malignancies. Gynecol Oncol 2002;85:285-91
Ayrıntılar
| Diğer ID | JA65VG36MF |
|---|---|
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Ekim 2013 |
| Gönderilme Tarihi | 1 Ekim 2013 |
| Yayımlandığı Sayı | Yıl 2013 Cilt: 16 Sayı: 4 |