Kolorektal kanser tanı ve tedavisinde önemli bir problem: Obstrüksiyon

Giriş ve Amaç: Kolorektal kanserler günümüzde hala en sık ölüm nedenleri arasındadır. Kolorektal kanserlerde mortalite ve morbidite başlangıç kolonoskopisi ve tespit edilen lezyonlar ile doğrudan ilişkilidir. Obstrükte kolorektal kanserlerde başlangıçta yeterli inceleme her zaman önemli bir sorun olmuştur. Biz obstrüksiyon tespit edilen kolorektal kanser oranını ve bu hastalara olan yaklaşımı ele almaya çalıştık. Gereç ve Yöntem: Ocak 2015- Aralık 2019 tarihleri arasında İstanbul S.B.Ü. Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesinde yapılan 10326 kolonoskopi işlemi hasta dosyalarından ve elektronik data üzerinden kolon kanseri yönünden retrospektif olarak analiz edildi. Çalışmada hastaların yaş, cinsiyet ve kolonoskopi sonuçları barsak temizliği, obstrüksiyon varlığı, tümör lokalizasyonu, patolojik tanıları yönünden analiz edilerek kayıt edildi. Bulgular: 10326 hasta dosyası taranarak 145 (%62.2) erkek ve 88 (%37.8) kadın olmak üzere 233 kolon kanseri tanısı konan hasta çalışmaya dâhil edildi. Çalışmamızda kolorektal kanser görülme sıklığı %0.02 olarak tespit edildi. Tanı alan hastalarda en sık endikasyon %28.8 (n=67) ile rektal kanama iken en sık lokalizasyon bölgesi %44.6 (n=104) ile rektum olarak tespit edilmiştir. Obstrüksiyona göre tümör lokalizasyonları incelendiğinde %69.9 (n=51) ile en yüksek obstrüksiyon tespit edilen bölge rektosigmoid bölge olmuştur. Sonuç: Kolon kanseri en sık lokalizasyon olarak rektosigmoid bölgeyi tutmakta ve bu bölgede belirgin oranda obstrüksiyona neden olmaktadır. Obstrüksiyon nedeni ile tanı anında kolonoskopik inceleme yeterli derecede yapılamamakta, bu da senkron lezyonların tespitini azaltmaktadır. Biz bu tür hastalarda preoperatif bilgisayarlı tomografik kolonografinin uygun olabileceğini hatırlatmaktayız. Anahtar kelimeler: , ,

Anahtar Kelimeler:

Kolorektal kanser, lokalizasyon, obstrüksiyon

A predominant problem in the diagnosis and treatment of colorectal cancer: Obstruction

Background and Aims: Colorectal cancers remain among the most common causes of death today. The mortality and morbidity rates of colorectal cancers are directly related to initial colonoscopy and lesion detection. Insufficient colonoscopic examination has always been an important problem in colorectal cancers diagnosed with obstruction. We examine the rates of obstruction and how to approach to these patients. Materials and Method: A total of 10326 colonoscopy procedures performed in İstanbul S.B.U. Kanuni Sultan Suleyman Training and Research Hospital between January 2015 and December 2019 were retrospectively analyzed in terms of colon cancer from patient files and electronic data. In this study, the age, sex, and colonoscopy results of the patients were analyzed in terms of bowel cleansing, presence of obstruction, tumor localization, and pathological diagnoses. Results: A total of 10326 files were scanned, and 233 patients with colorectal cancer, 145 (62.2%) males and 88 (37.8%) females, were included in the study. The incidence of colorectal cancer was 0.02%. The most common indication was rectal bleeding (28.8%, n=67), and the most common localization region was the rectum (44.6%, n=104). When the tumor localizations were examined according to obstruction, the region with the highest obstruction was the rectosigmoid region, with a frequency of 69.9% (n=51). Conclusion: Colorectal cancer most commonly involves localization in the rectosigmoid region and is a significant cause of obstruction in this area. Colonoscopic examinations cannot be performed adequately at the time of diagnosis because of obstruction, which reduces the detection rate of synchronous lesions. Therefore, we considered that preoperative computed tomography colonography may be appropriate in such patients.

Keywords:

Colorectal cancer, localization, obstruction,

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