Jinekolojik onkolojide kolon cerrahisi
Küçük Resim Yok
Tarih
2010
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Jinekolojik onkolojide özellikle de sitoredüktif over kanser cerrahisinde kolon rezeksiyonunun yararları, endikasyonları, morbibite ve mortalite üzerine etkilerinin olgu serisi eşliğinde tartışılması Yöntem: Ege Üniversitesi Jinekolojik Onkoloji bölümünde 2008-2009 yılları arasında yapılan 120 jinekolojik onkoloji operasyonundan 14‘ünde kolon cerrahisi (%11,6) gerçekleştirilmiştir. Kolon cerrahisi geçiren hastalarda ortalama yaş 58.2 (37-77) bulunmuştur. Bu hastalardan bir tanesi endometrium adenokarsinomu tanısıyla opere olurken, bir tanesi tuba karsinomu ön tanısıyla cerrahi girişime alınmıştır. Tüm diğer hastalar (n=12) over karsinomu ön tanısıyla opere olmuşlardır. Bulgular: Kolon cerrahisi uygulanan olgularda bir hastaya rektosigmoid tümör ekstirpasyonu ve primer anastomoz, bir hastaya kolostomi, üç hastaya appendektomi, beş hastaya rektosigmoid mezosundan tümör ekstirpasyonu uygulanırken; birer hastada transvers kolon mezosundan tümör ekstirpasyonu, rektovajinal kitle ekstirpasyonu gerçekleştirildi. Üç hastada ise kolona herhangi bir zarar verilmeden adezyolizis yapılarak tümöral dokuya ulaşılarak optimal sitoredüksiyon sağlandı. Antikoagulan alan bir olguda cerrahi sonrası dördüncü günde ciddi kanama ortaya çıkmıştır. Sonuç: Literatürde optimal sitoredüktif cerrahinin daha uzun sağkalım sağladığı belirtilmesine rağmen, hastaların genel durumları (yaş, sistemik hastalık, kemoterapi öyküsü) cerrahi morbidite ve mortaliteye olan etkileri yönünden önemlidir.
Objective: To discuss the benefits, morbidity and mortality and the endications for colon resection in gynecologic oncology especially in cytoreductive ovarian cancer operations and to present a case series. Methods: We reviewed 120 patients who underwent gynecologic oncology operations between 2008-2009 in Ege University Hospital. Colon surgery was performed 14 of them.(%11.6) The mean age of patients who had colon surgery were 58.2(37-77). Two patients underwent surgery besides ovarian carcinoma; one of them with the diagnosis of endometrium adenocarcinoma and the other with primary tubal adenocarcinoma. All the others were (n=12) operated with the diagnosis of ovarian carcinoma. Results: Rectosigmoid tumor extirpation and primer anastomosis (n=1), colostomy (n=1), appendectomy (n=3), tumor extirpation from sigmoid mesentery (n=5), tumor extirpation from transvers colon mesentery (n=1) and rectovaginal tumor extirpation (n=1) was performed. In three of the patients the dissection of adhesions was performed without any damage to colon with the aim of optimal cytoreduction. Serious hemorrage occured in one patient due to use of anticoagulation drugs at the fourth postoperative day. Conclusion; Although studies demonstrated that optimal cytoreductive surgery provides longer survival in ovarian cancer patients, patient’s medical and physical conditions like age, systemic illness, chemotherapy history are also important for morbidity and mortality.
Objective: To discuss the benefits, morbidity and mortality and the endications for colon resection in gynecologic oncology especially in cytoreductive ovarian cancer operations and to present a case series. Methods: We reviewed 120 patients who underwent gynecologic oncology operations between 2008-2009 in Ege University Hospital. Colon surgery was performed 14 of them.(%11.6) The mean age of patients who had colon surgery were 58.2(37-77). Two patients underwent surgery besides ovarian carcinoma; one of them with the diagnosis of endometrium adenocarcinoma and the other with primary tubal adenocarcinoma. All the others were (n=12) operated with the diagnosis of ovarian carcinoma. Results: Rectosigmoid tumor extirpation and primer anastomosis (n=1), colostomy (n=1), appendectomy (n=3), tumor extirpation from sigmoid mesentery (n=5), tumor extirpation from transvers colon mesentery (n=1) and rectovaginal tumor extirpation (n=1) was performed. In three of the patients the dissection of adhesions was performed without any damage to colon with the aim of optimal cytoreduction. Serious hemorrage occured in one patient due to use of anticoagulation drugs at the fourth postoperative day. Conclusion; Although studies demonstrated that optimal cytoreductive surgery provides longer survival in ovarian cancer patients, patient’s medical and physical conditions like age, systemic illness, chemotherapy history are also important for morbidity and mortality.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Türk Jinekoloji ve Obstetrik Derneği Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
7
Sayı
2
