Hacı Murat ÇAYCI, Umut Eren ERDOĞDU, Hasan ÇANTAY, Süleyman ORMAN, Mustafa AKAR, HAKAN DEMİRCİ

Mide kanseri deneyimlerimiz: Tanı ve tedavide geç mi kalıyoruz?

Giriş ve Amaç: Mide kanserinin erken tanınması tedavide daha sınırlı rezeksiyonların yapılmasına ve sağ kalımın iyileşmesine olanak sağlar. Amacımız mide kanserli hastalarımızın semptomları, endoskopik bulguları ve ameliyat piyeslerini değerlendirerek hangi evrelerde başvurduklarını saptamaktır. Gereç ve Yöntem: Mide kanseri nedeniyle elektif opere edilen 77 hastanın verileri retrospektif olarak değerlendirildi. Hastaların demografik verileri, ko-morbiditeleri, tümör lokalizasyonları, pasaj geçişinin olup olmadığı, semptomlar ve süreleri, endoskopik patoloji sonuçları, Amerikan Anesteziyoloji Derneği sınıflaması, uygulanan rezeksiyon tipleri, patolojik evreler, tümör büyüklüğü, çıkarılan ortalama lenf nodu ve metastatik lenf nodu sayısı ve evreleri değerlendirildi. Bulgular: Çalışmamızda, olguların 55’i (%71,4) erkek, 22’si (%28,6) kadın idi. Olguların 46’sına (%59,8) total gastrektomi,16’sına (%20.8) subtotal gastrektomi ve 15’ine de (%19,4) eksploratif laparotomi uygulandı. Laparoskopik yaklaşımla 2 (%2,6) olguya total gastrektomi, 2 (%2,6) olguya subtotal gastrektomi yapıldı. Olguların 9’unda (%11,68) ek organ rezeksiyonu yapıldı. Morbidite 9 (%11,6) olguda görüldü. Mortalite 3 (%3,9) olguda görüldü. En sık saptanan T patolojik evresi pT3 ve pT4 idi (sırasıyla %18,2 ve %55,8). Olgularımızın büyük çoğunluğunun Evre 3 (%61) oldukları görüldü. Sonuç: Mide kanseri nedeniyle ile ameliyat edilen hastalarımız tanı sırasında genellikle ileri evrede olup, bu hastalara geniş çaplı mide rezeksiyonları ve lenf nodu diseksiyonları yapılmaktadır. Minimal cerrahi girişimlerin veya endoskopik girişimlerin uygulanabilmesi için tarama programları ile olguların erken evrede saptanması gereklidir.

Anahtar Kelimeler:

Mide kanseri, cerrahi, evre, endoskopik tarama

Our stomach cancer experiences: is there any retardation in diagnosis or treatment?

Background and Aims: Early diagnosis of gastric cancer allows for limited resection and improved survival. Our aim is to evaluate the symptoms, endoscopic findings and surgical procedures of our patients with stomach cancer and to determine at which stage they are applying. Materials and Methods: The data of 77 patients who were operated for gastric cancer were evaluated retrospectively. Patients’ demographic data, co-morbidities, tumor localization, presence or absence of passage, symptoms, and duration, endoscopic pathology results, American Society of Anesthesiologist, type and method of resection applied, pathologic stage, tumor size, the number of lymph nodes removed, the number of metastatic lymph nodes and stages were evaluated. Results: In our study, 55 (71.4%) male and 22 (28.6%) women were included. Total gastrectomy was performed in 46 patients (59.8%), subtotal gastrectomy in 16 patients (20.8%) and explorative laparotomy in 15 patients (19.4%). Two patients (2.6%) underwent total gastrectomy with the laparoscopic approach and subtotal gastrectomy in two patients (2.6%). In nine (11.68%) cases, additional organ resection was performed. Morbidity was seen in nine patients (11.6%) and mortality was seen in 3 cases(3.9%). The most frequent pathologic stages were pT3 and pT4 (18.2% and 55.8%, respectively). It was seen that the majority of our cases were in Stage 3 (61%). Conclusion: Our patients who are operated due to gastric cancer are usually in an advanced stage during diagnosis and they have extensive gastric resections and lymph node dissections. In order to be able to perform less invasive surgical procedures or endoscopic procedures, it is necessary to detect the cases at an earlier stage with screening programs.

Keywords:

Gastric cancer surgery, stage, endoscopy, screening,

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