Mide kanser cerrahisi sonrası dren sıvısındaki yüksek amilaz değerinin etkisi: Bu bir komplikasyon mu yoksa sadece şüpheli biyokimyasal bir ölçüm mü?

Amaç: Pankreatik fistülün, olası bir postoperatif komplikasyon olarak, değişkenlik gösteren tanım, görülme sıklığı ve risk faktörleri vardır. Bu çalışmada, mide cerrahisi sonrası pankreatik fistülün etkisini değerlendirmeyi amaçladık.Gereç ve Yöntem: Mide adenokarsinomu için tedavi edici amaçlı lenfadenektomi ile açık gastrektomi uygulanan toplam 28 ardışık hasta retrospektif olarak incelendi. Hastaların demografik, peri-operatif ve patolojik verileri toplandı. Uluslararası Pankreatik Fistül Sistemi çalışma grubuna göre teşhis ve derecelendirilen pankreas fistülü ana değişken olarak tanımlandı. Bulgular: Hastaların yaş ortalaması 58,8 ± 10,1yıl idi ve kadın / erkek oranı 9 / 19'du. Altı hastada (% 21.4) grade A pankreatik fistül saptandı. Grade B ve C pankreatik fistül yoktu. Dren amilaz düzeyi pankreas fistülü olan hastalarda anlamlı olarak daha yüksekti (p = 0,0001). Fistüllü ve fistülsüz hastalarda drenaj miktarı, hastanede kalış süresi ve dren süreleri açısından anlamlı fark yoktu. Fistül gelişimi ile hastaların demografik özellikleri, peri-operatif ve patolojik veriler arasında anlamlı ilişki bulunmadı. Sonuç: Mide cerrahisi sonrası grade A pankreatik fistül gelişimi klinik sonuçları olan majör bir komplikasyon olarak görünmemektedir. Dren sıvısındaki yüksek amilaz seviyesi, sadece biyokimyasal bir ölçü olarak düşünülebilir.

Impact of high amylase level in drainage fluid after gastric cancer surgery: Is it a complication or suspicious biochemical measurement?

Purpose: Pancreatic fistula is a potential postoperative complication with variable definitions, incidences and risk factors. We intended to evaluate its impact after gastric surgery. Materials and Methods: A total of 28 consecutive patients who underwent curative open gastrectomy with lymphadenectomy for gastric adenocarcinoma were retrospectively analyzed. Patients’ demographics, peri-operative and pathological data were collected. Pancreatic fistula that was diagnosed and graded according to International Study Group of Pancreatic Fistula’s system was identified as main variable.Results: Mean age of patients was 58.8±10.1 years with a female to male ratio of 9/19. Grade A pancreatic fistula was diagnosed in six patients (21.4%). There was no grade B and C pancreatic fistula. Drain amylase level was significantly higher in patients with pancreatic fistula (p=0.0001). There was no significant difference with regard to amount of drainage, length of hospital stay and duration of drains in patients with and without fistula. No significant association was shown between development of fistula and patients’ demographics, peri-operative and pathological data. Conclusion: The development of grade A pancreatic fistula after gastric surgery does not appear to be a major complication with clinical consequences. High amylase level in the drainage fluid can be considered as a biochemical measure only.  

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Cukurova Medical Journal-Cover
  • ISSN: 2602-3032
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1976
  • Yayıncı: Çukurova Üniversitesi Tıp Fakültesi
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