Ramazan GÜNDOĞDU, Hakan YABANOĞLU, Serkan ERKAN, Murat KUŞ

Familyal Adenomatöz Polipozis Koli’li hastalarda Klinik ve Cerrahi Tedavi Sonuçlarımız

Amaç: Familyal adenomatöz polipozis koli (FAP) kolorektal bölgede çok sayıda adenomatöz polip ile karakterizedir. FAP hastalarında kolorektal kanser riski kaçınılmaz olduğundan cerrahi tedavi en belirleyici unsurdur. Bu çalışmada FAP tanısı ile cerrahi tedavi uygulanan hastaların sonuçlarının ve kliniğimizin deneyimlerinin literatüre sunulması amaçlanmıştır.Araçlar ve Yöntem: Merkezimizde 2011-2020 tarihleri arasında FAP nedeniyle cerrahi uygulanan hastaların dosyaları geriye dönük olarak incelendi. Çoklu veri eksikliği olan hastalar çalışma dışı bırakıldı. 30 hasta çalışmaya alındı. Hastaların bulguları kaydedildi.Bulgular: Hastaların 13’ü (%43) erkek, 17’si (%57) kadındı. Hastaların 17’sine (%57) total proktokolektomi (TPK), 13’üne (%43) TK yapıldı. Hastaların kolonoskopilerinin 15’i malignite şüphesi içeriyordu. Bu hastaların kolonoskopik biyopsilerin 8’i adenokanserdi. Hastaların 20’sinde (%67) spesmen patolojisi adenokanserdi. Hastaların 10’unda (%33) komplikasyon ve 1’inde mortalite görüldü. Komplikasyonlar TPK (%60) yapılan hastalarda daha çoktu.Sonuç: FAP daha çok kolonu ilgilendirse de üst gastrointestinal sistemi de tutabilmektedir. Cerrahi, halen tedavinin en önemli basamağını oluştursa da komplikasyon oranları azımsanmayacak düzeylerdedir. Yapılacak cerrahinin türüne hastanın yaşı, polip yaygınlığı ve takiplere olan uyum durumuna göre karar verilmelidir.

Anahtar Kelimeler:

Familyal Adenomatöz Polipozis, kanser, kolektomi

Our Clinical and Surgical Treatment Results in Familial Adenomatous Polyposis Coli Patients

Purpose: Familial adenomatous polyposis coli (FAP) is characterized by multiple adenomatous polyps in the colorectal region. Surgical treatment is the most decisive factor in FAP patients, as the risk of colorectal cancer is inevitable. In this study, it was aimed to present the results of patients who underwent surgical treatment with the diagnosis of FAP and the experiences of our clinic to theliterature.Materials and Methods: The files of patients who underwent surgery for FAP between 2011 and 2020 in our center were retrospectively reviewed. Patients with multiple data deficiencies were excluded. 30 patients were included in the study. The findings of the patients were recorded.Results: 13 (43%) of the patients were male, 17 (57%) were female. Total proctocolectomy (TPK) was performed in 17 (57%) of the patients, and TK was performed in 13 (43%) of them. 15 of the patients' colonoscopies included suspicion of malignancy. Eight of the colonoscopic biopsies of these patients were adenocarcinoma. Specimen pathology was adenocarcinoma in 20 (67%) of the patients.Complications were seen in 10 (33%) of the patients and mortality was seen in 1. Complications were more common in patients with TPK (60%).Conclusion: Although FAP mostly involves the colon, it may involve the upper gastro intestinal system. Although surgery is still the most important step of the treatment, the complication rates are substantial. The type of surgery to be performed should be decided according to the age of the patient, the prevalence of polyp and compliance with follow-up.

Keywords:

Familial Adenomatous Polyposis, Cancer, Colectomy,

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