İLHAN ECE, Fahrettin ACAR, HÜSEYİN YILMAZ, BAYRAM ÇOLAK, SERDAR YORMAZ, MUSTAFA ŞAHİN

Mide Kanseri Tedavisinde Açık ve Laparoskopik Distal Subtotal Gastrektominin Kısa Dönem Onkolojik Sonuçları

Amaç: Bu çalışmada lokal ileri evre mide kanseri için uygulanan laparoskopik ve açık distal subtotal gastrektomi olgularında kısa dönem onkolojik sonuçların karşılaştırılması amaçlandı. Gereç ve Yöntem: Lokal ileri evre mide kanseri tanısı ile Eylül 2014- Eylül 2015 tarihleri arasında distal subtotal gastrektomi uygulanan toplam 22 hasta çalışmaya dahil edildi. Tüm hastalarda bilgisayarlı tomografi ile uzak metastaz taraması yapıldı ve ameliyat öncesi dönemde patolojik olarak mide kanseri tanısı doğrulandı. Açık teknikle distal subtotal gastrektomi (DSG) ve D2 lenfadenektomi yapılan hastalar laparoskopik distal subtotal gastrektomi (LDSG) ve D2 lenfadenektomi yapılan hastalar ile yaş, cinsiyet, tümör boyutu, çıkarılan lenf nodu sayısı ve cerrahinin erken dönem sonuçları açısından karşılaştırıldı. Bulgular: Hastaların yaş ortalaması 53,8±10.2 yıl, vücut kitle indeksi 26.1±3.9 kg/m2 idi. Her iki grupta hasta özellikleri açısından fark yoktu. Ame-liyat süresi LDSG grubunda anlamlı oranda yüksek olmasına rağmen kanama miktarı daha azdı. Cerrahi olarak çıkarılan tümörlerin boyutları ve diseke edilen lenf nodu sayısında fark yoktu. Ayrıca erken postoperatif komplikasyon oranı her iki grupta benzerdi. Sonuç: LDSG açık teknik ile benzer komplikasyon oranına sahip, eşit sayıda lenf nodu diseksiyonu sağlayan güvenli bir yöntemdir. Ayrıca LDSG daha az kanamaya neden olarak onkolojik sonuçlarda iyileşme sağlayabilir.

Short-Term Oncologic Outcomes in the Treatment of Open and Laparoscopic Distal Subtotal Gastrectomy for Gastric Cancer.

Objective: The aim of this study was to compare the short-term oncologic outcomes of laparoscopic and open distal subtotal gastrectomy for locally advanced gastric cancer. Material and Method: Twentytwo patients who diagnosed as locally advanced gastric cancer were treated with distal subtotal gastrectomy from September 2014 to September 2015 were included the study. All patients underwent computed tomography scan for distant metastasis, and the diag-nosis of gastric cancer was confirmed by pathologic evaluation. Patients that were treated open distal subtotal gastrectomy with D2 lymphadenectomy and laparoscopic distal subtotal gastrectomy (LDSG) with D2 lymphadenectomy were compared in terms of age, gender, size of tumor, number of removed lymph nodes, and early results of surgery. Results: The mean age of patients was 53.8 ± 10.2 years and body mass index was 26.1 ± 3.9 kg/m2. There was no difference in terms of patient characteristics in both groups. Operative time was significantly long in LDSG group but the level of blood loss was less. There was no difference in the number of dissected lymph notes and the size of the removed tumor. Early postoperative complication rate was also similar in both groups. Conclusion: LDSG is a safe method that provides an equal number of lymph node dissection with similar complication rates. LDSG can also provide improvements in oncologic results with less blood loss.

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