Kolorektal Kanser Cerrahisinde Eksize Edilen Toplam ve Metastatik Lenf Nodu Sayısına Aşırı Kilonun Etkisi

Amaç: Çalışmamızda, kolorektal kanser (KRK) tanısı ile elektif şartlarda opere ettiğimiz hastalarda eksize edilen toplam ve metastatik lenf nodu sayısına yüksek vücut kit- le indeksin (VKİ)’in etkisini araştırmak amaçlanmıştır. Yöntemler: 2014 Mart- 2016 Ocak döneminde KRK ta- nısı nedeni ile laparoskopik ve konvansiyonel kolorektal cerrahi geçiren 71 hastanın kayıtları retrospektif olarak incelendi. Hastalara ait yaş, cinsiyet, VKİ, cerrahi yöntem, tümör yerleşimi, çıkartılan toplam ve metastatik lenf nodu sayısı, tümör çapı ve postop mortalite değerlendirildi. Hastalardan VKİ 24,9 (kg/m2 ) ve altında olanlar normal (Grup 1), VKİ 25 (kg/m2 ) ve üzerinde olanlar aşırı kilolu (Grup 2) olarak iki ayrı gruba ayrıldı. Daha sonra gruplar arasındaki parametreler ve yüksek VKİ’nin etkileri değer- lendirildi. Bulgular: Hastaların ortalama yaşı 64,5 ± 14 idi. Aşırı kilolu gruptaki ortalama VKİ 27,0 (kg/m2 ) iken normal ki- losu olan grupta ise VKİ ortalaması 22,3 (kg/m2 ) idi. Tü- mör yerleşim yerine göre her iki grupta en az görülen yer transvers kolon iken en çok yerleştiği bölge grup 1 de sağ kolon, sigmoid kolon ve rektum; grup 2 de ise rektum, sağ kolon ve sigmoid kolondur. Gruplar arasında postop er- ken mortalite açısından anlamlı bir fark tespit edilmemiştir (p>0.05). Her iki gruptan çıkarılan ortalama toplam lenf nodu sayısı sırası ile 14 ve 12’idir. VKİ ile tümör çapı, ek- size edilen toplam ve metastatik lenf nodu sayısı arasında herhangi bir korelasyon tespit edilmemiştir. Sonuç: Aşırı kilo, KRK cerrahisinde eksize edilen toplam ve metastatik lenf nodu sayısı ile tümör çapını etkileme- mektedir. Dolayısıyla cerrahlar kilolu hastalarda kanser cerrahisinde yeterli sayıda lenf nodu eksize edememe kaygısına kapılmamalıdırlar

The Effect of Overweight Status on Total and Metastatic Number of Harvested Lymph Nodes During Colorectal Surgery

Objective: The aim of this study is to evaluate the rela- tionship between higher body mass index (BMI) and har- vested total or metastatic lymph node numbers in patients who underwent surgery for colorectal cancers. Methods: Between March 2014 and January 2016, totally 71patients who underwent laparoscopic or conventional surgery for colorectal cancer were evaluated retrospec- tively. The data of age, gender, BMI, surgical procedure, tumor localization , postoperative mortality status, total number of harvested and metastatic lymph node were collected. The patients having 24.9 (kg/m2 ) or lower BMI values were classified as normal (Group 1) and patients having BMI values of 25 or over were overweight (Group 2). Afterwards, the parameters between groups and the effect of higher BMI were analyzed. Results: The mean age of the patients was 64.5 ± 14 years. The average BMI value in group 1 was 22.3 (kg/ m 2 ) and 27.0 (kg/m2 ) in group 2. According to localisation of tumor, transverse colon was the rare region for both groups. The common regions for tumor localisation in group 1 were right colon, sigmoid colon and rectum. In group 2 the common localisation for tumors were rectum, right colon and sigmoid colon. There was no difference between groups about postoperative mortality rates (p > 0.05). The mean of the total number of harvested lymph nodes were 14 in group 1 and 12 in group 2. There were no relationship between BMI and tumor diameter, total or metastatic number of harvested lymph nodes. Conclusion: Higher BMI values does not effect the num- ber of excised total or metastatic lymph nodes and tumor diameters. Therefore, the surgeons should not hesitate in overweight patients cancer surgery for dissecting ad- equate number of lymph nodes.

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Dicle Tıp Dergisi-Cover
  • ISSN: 1300-2945
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1963
  • Yayıncı: Cahfer GÜLOĞLU
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