Meme kanserine bağlı aksiller girişim yapılan hastalarda lenfödem ve kol morbiditesinin prospektif incelenmesi
Yükleniyor...
Dosyalar
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Meme kanseri cerrahisi sonrasında gelişebilen ve ciddi morbidite yaratabilen lenfödemin, aksiller cerrahi prosedür (aksiller diseksiyon, sentinel lenf nodu biyopsisi), kemoterapi, kemoterapinin zamanlaması (adjuvan-neoadjuvan), radyoterapi, kilo değişimi, kola uygulanan invaziv girişimler gibi faktörlerle ilişkisini incelemek amaçlandı.
GEREÇ VE YÖNTEM: Ekim 2019-Nisan 2021 arasında Ege Üniversitesi Tıp fakültesi Genel Cerrahi Anabilim Dalı’nda meme kanseri nedeniyle meme ve aksilla cerrahisi geçirmiş olan hastalar kol morbiditesi açısından prospektif olarak incelendi. Dahil edilme kriterlerine uyan ardışık 119 hastanın verilerine, hastanemizin veritabanından ve olgu rapor formundan ulaşıldı. Hastalar lenfödem varlığı ve lenfödem gelişimine etki edebilecek risk faktörleri açısından değerlendirildi. BULGULAR: Toplam 119 hasta içinde 18 (%15) hastada lenfödem olduğu görüldü. Bu hastalarda lenfödem gelişimi için risk faktörleri değerlendirmesi açısından aksiller diseksiyon uygulamak, neoadjuvan kemoterapi almak, adjuvan aksiller radyoterapi almak, cerrahi alan enfeksiyonu geçirmek, tümör çapının büyük olması, çıkarılan lenf nodları ve metastatik lenf nodları sayısı değerlendirildi. Aksiller diseksiyon uygulamak, cerrahi alan enfeksiyonu geçirmek, tümör çapının büyük olması, metastatik lenf nodunun fazla olması, aksiller radyoterapi uygulanmasının lenfödem gelişimini artırdığı görüldü. (p<0.05) Adjuvan veya neoadjuvan kemoterapinin, VKİ’nin, tümörün yerinin ve memeye uygulanan cerrahi prosedürün ise lenfödem gelişimine anlamlı etkisi olmadığı görüldü. Bunun yanında kolda şişlik, ağırlık hissi tarifleyen hastalarda lenfödemin daha sık görüldüğü ve bu durumun uyarıcı olması gerektiği tespit edildi. (p<0.05) SONUÇ: Çalışmanın sonucunda aksiller bölgeye yapılan cerrahinin büyümesi ve aksiller bölgeye uygulanan radyoterapi ile lenfödemin arttığı görüldü. Hastalarda aksiller diseksiyondan kaçınmak, uygun hastalarda metastatik lenf nodu sayısını düşürmek ve SLNB’ye uygun hale getirmek için neoadjuvan kemoterapinin iyi bir alternatif olabileceği görüldü.
AIM: It was aimed to examine the relationship of lymphedema, which can develop after breast cancer surgery and cause serious morbidity, with factors such as axillary surgical procedure (axillary dissection, sentinel lymph node biopsy), chemotherapy, timing of chemotherapy (adjuvant-neoadjuvant), radiotherapy, weight change, invasive interventions applied to the arm. MATERIALS AND METHODS: Patients who had undergone breast and axilla surgery for breast cancer in Ege University Faculty of Medicine, Department of General Surgery between October 2019 and April 2021 were prospectively analyzed. The data of 119 patients who met the inclusion criteria were obtained from the database of our hospital and the case report form. The patients were evaluated in terms of presence of lymphedema and risk factors that may affect the development of lymphedema. RESULTS: Lymphedema was observed in 18 (15%) patients out of a total of 119 patients. Axillary dissection, adjuvant axillary radiotherapy, surgical site infection, large tumor diameter, removed lymph nodes and metastatic lymph nodes were evaluated in terms of risk factors for lymphedema development in these patients. It was observed that performing axillary dissection, surgical site infection, large tumor diameter, large metastatic lymph nodes, and axillary radiotherapy increased the development of lymphedema. (p<0.05) Adjuvant or neoadjuvant chemotherapy, BMI, tumor location and surgical procedure applied to the breast did not have a significant effect on the development of lymphedema. In addition, in the detection of lymphedema, it was determined that lymphedema was more common in the case of swelling in the arm and a feeling of heaviness. (p<0.05) CONCLUSIONS: As a result of the study, it was observed that lymphedema increased with the enlargement of surgery to the axillary region and radiotherapy applied to the axillary region. It was seen that neoadjuvant chemotherapy can be a good alternative to avoid axillary dissection in patients, to reduce the number of metastatic lymph nodes in suitable patients, and to make them suitable for SLNB.
AIM: It was aimed to examine the relationship of lymphedema, which can develop after breast cancer surgery and cause serious morbidity, with factors such as axillary surgical procedure (axillary dissection, sentinel lymph node biopsy), chemotherapy, timing of chemotherapy (adjuvant-neoadjuvant), radiotherapy, weight change, invasive interventions applied to the arm. MATERIALS AND METHODS: Patients who had undergone breast and axilla surgery for breast cancer in Ege University Faculty of Medicine, Department of General Surgery between October 2019 and April 2021 were prospectively analyzed. The data of 119 patients who met the inclusion criteria were obtained from the database of our hospital and the case report form. The patients were evaluated in terms of presence of lymphedema and risk factors that may affect the development of lymphedema. RESULTS: Lymphedema was observed in 18 (15%) patients out of a total of 119 patients. Axillary dissection, adjuvant axillary radiotherapy, surgical site infection, large tumor diameter, removed lymph nodes and metastatic lymph nodes were evaluated in terms of risk factors for lymphedema development in these patients. It was observed that performing axillary dissection, surgical site infection, large tumor diameter, large metastatic lymph nodes, and axillary radiotherapy increased the development of lymphedema. (p<0.05) Adjuvant or neoadjuvant chemotherapy, BMI, tumor location and surgical procedure applied to the breast did not have a significant effect on the development of lymphedema. In addition, in the detection of lymphedema, it was determined that lymphedema was more common in the case of swelling in the arm and a feeling of heaviness. (p<0.05) CONCLUSIONS: As a result of the study, it was observed that lymphedema increased with the enlargement of surgery to the axillary region and radiotherapy applied to the axillary region. It was seen that neoadjuvant chemotherapy can be a good alternative to avoid axillary dissection in patients, to reduce the number of metastatic lymph nodes in suitable patients, and to make them suitable for SLNB.
Açıklama
Anahtar Kelimeler
Meme Kanseri, Lenfödem, Lenfödem Risk Faktörleri, Aksiller Diseksiyon, Sentinel Lenf Nodu Biyopsisi, Breast Cancer, Lymphedema, Lymphedema Risk Factors, Axillary Dissection, Sentinel Lymph Node Biopsy
