Halil İbrahim TAŞCI, Ahmet TEKİN, Ebubekir GÜNDEŞ, MURAT ÇAKIR, Hacı Hasan ESEN

İnce barsak gastrointestinal stromal tümörlerinde acil cerrahi

Amaç: Gastrointestinal stromal tümörler (GİST) gastrointestinal traktın en yaygın mezenkimal tümörleridir. En sık görülen lokalizasyonlar mide ve ince barsak dır. Bu çalışmada ince barsak lokalizasyonlu acil GİST vakalarında kliniğimizin cerrahi yaklaşımını, tümörlerin özelliklerini ve klinik prezentasyonlarını ortaya koymayı amaçladık. Gereç yöntem: Ocak 2006- Aralık 2011 yılları arasında Necmettin Erbakan Üniversitesi Meram Tıp Fakültesinde acil şartlarda opere edilen 8 ince barsak GIST vakası retrospektif olarak incelendi. Bulgular: Kliniğimizde tanısı konmuş 84 GİST vakası mevcuttu. Bunlardan 21'inde ince barsak GİST'İ saptandı. Bu vakalarında 8'i acil olarak başvuran ve opere edilen hastalardı. Bu hastaların 4'ü (%50) kadın, 4'ü erkek (%50) olup, ortalama yaşları 65 idi. Tüm hastalar acil başvurmuş ve tüm olgulara acil cerrahi uygulanmıştır. Postoperatif erken dönemde 1 (%14) hastada mortalite görüldü. Ortalama 30 aylık takiplerinde rekürrens görülmedi. Sonuç: Deneyimimiz gösterdi ki GIST'lere acil cerrahi müdahale gerekebilmektedir. Tümör boyutu ile tümörün semptomatik olması arasında ilişki olabileceği düşünülmüştür. Nadiren lenf nodlarına metastaz yaptıkları ve negatif cerrahi sınır elde etmek zor olmadığından laparoskopik rezeksiyon genelde mümkündür. Uygun vakalarda laparoskopik yöntemler tercih edilmelidir

Gastrointestinal stromal tumors of the small ıntestine ın emergency surgery

Aim: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. The most frequent localizations are the stomach (50-60%) and the small intestine (20-30%). In this study, our aim is to present the surgical approach of our clinic to emergency GIST cases with small intestinal localization, the features of the tumors and their clinical presentations. Material and Method: The cases of 8 patients with GISTs of the small intestine, who had emergency surgery between January 2006 and December 2011 at Necmettin Erbakan University, Meram Medical School, were evaluated retrospectively. Results: There were 84 diagnosed GIST cases at our clinic. 21 of these had GIST of the small intestine. 8 out of these 21 cases had presented in emergency and had been operated on. 4 of these patients were female (50%), while 4 were male (50%) and the average age of the patients was 65 . All patients presented in emergency and emergency surgery was performed on all the cases. Mortality was seen in 1 (14%) patient during the early post-op period. No recurrences were seen during the 30 months of average follow-up. Conclusion: Our experience revealed that emergency surgical intervention might be needed for GISTs. It was considered that there might be a relationship between the tumor size and the fact that the tumor was symptomatic. Laparoscopic resection is generally possible since they are rarely metastatic to the lymph nodes and it is not difficult to obtain negative surgical borders. Laparoscopic methods should be preferred in appropriate cases

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