Osman AYDIN, Volkan ÖTER, Muhammed Kadri ÇOLAKOĞLU, Yiğit Mehmet ÖZGÜN, Erol PİŞKİN, Erdal Birol BOSTANCI

İntrahepatik kolanjiokarsinomların lenf nodu diseksiyon sonuçları, cerrahi tedavi yöntemleri ve onkolojik sonuçları, tek merkez deneyimi

Giriş ve Amaç: İntrahepatik kolanjiokarsinom, bir safra yolu kanseridir. İntrahepatik kolanjiokarsinom için mevcut tek küratif tedavi karaciğer rezeksiyonudur. Bu çalışmanın amacı, merkezimizde yapılan intrahepatik kolanjiokarsinomların lenf nodu diseksiyonu, cerrahi yönetimi ve nüks oranlarının sonuçlarını vermektir. Gereç ve Yöntem: Ocak 2019 – Ocak 2023 tarihleri arasında kliniğimizde intrahepatik kolanjiokarsinom tedavisi gören hastaların tıbbi kayıtları retrospektif olarak değerlendirildi. Bulgular: Kliniğimizde 24 hasta ameliyat edildi. Hastaların 12'si kadın, 12'si erkekti ve yaş ortalaması 52.75 ± 10.20 idi. Ortanca tümör boyutu 8.50 cm idi. Ameliyatta 12 hastaya sağ hepatektomi, 6 hastaya sol hepatektomi, 2 hastaya genişletilmiş sol hepatektomi, 2 hastaya santral hepatektomi ve 2 hastaya segment 4 artı 5 rezeksiyon uygulandı. Ortalama çıkarılan lenf nodu sayısı 9.95 ± 3.56 idi. 5 hastada malign lenf nodu görüldü. Postoperatif ortanca hastanede kalış süresi 13.50 gündü. Postoperatif ilk 3 ayda sadece 2 hastada mortalite gözlendi. Hastaların medyan genel sağkalımı 318.50 gündü. Sonuç: Çalışmamızın sonucunda preoperatif doğru evreleme ile seçilecek intrahepatik kolanjiokarsinom hastalarında, rezeke edilebilir tümörü olan hastaların komorbiditeleri ve durumları değerlendirilerek agresif cerrahi, cerrahi sırasında hepatoduodenal lenf nodlarının çıkarılması ve hastalarda karaciğer hacim genişletme işlemleri Remnant karaciğer hacim yetmezliği gelişebilecek hastalarda, küratif tek şans olan hastaların rezeksiyona zorlanmasının gerekli olduğu gösterilmiştir.

Anahtar Kelimeler:

İntrahepatik kolanjiokarsinoma, cerrahi, lenf nodu diseksiyonu

Lymph node dissection results, surgical management modalities and oncologic results of intrahepatic cholangiocarcinomas, single center experience

Background and Aims: Intrahepatic cholangiocarcinoma is a cancer of the biliary tract. The only current curative treatment for intrahepatic cholangiocarcinoma is liver resection. The aim of this study is given the result of the lymph node dissection, surgical management and recurrens ratio of intrahepatic cholangiocarcinomas in our center. Material and Methods: The medical record of patients who were treated for intrahepatic cholangiocarcinoma in our clinic were retrospectively evaluated between January 2019 to January 2023. Results: Twenty four patients were operated in our clinic. Of the patients, 12 were female, 12 were male, and the mean age was 52.75 ± 10.20 years. The median tumor size was 8.50 cm. Twelve patients had right hepatectomy, 6 patients had left hepatectomy, 2 patients had extended left hepatectomy, 2 patients had central hepatectomy and 2 patients had segment 4 plus 5 resection in the operation. The mean number of lymph node removed was 9.95 ± 3.56. Malignant lymph node was seen in 5 patients. Postoperative median hospital stay was 13.50 days. Mortality was observed in only 2 patient in the first 3 months postoperatively. The median overall survival of the patients was 318.50 days. Conclusions: As a result of our study, in patients with intrahepatic cholangiocarcinoma, patients who will be selected with preoperative correct staging, aggressive surgery by evaluating the comorbidities and conditions of patients with resectable tumors, removal of hepatoduodenal lymph nodes during surgery, and liver volume expansion procedures in patients who may develop remnant liver volume failure, to force to resection, which is the only curative chance of patients is demonstrated that it is necessary.

Keywords:

Intrahepatic cholangiocarcinoma, surgery, lymph node dissection,

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