Cevdet KAYA, Orhan KOCA, Muzaffer Oğuz KELEŞ, Gülhan YILMAZ, Metin ÖZTÜRK, Hüseyin KANBEROĞLU, M. İhsan KARAMAN

6 yıllık radikal sistektomi deneyimimiz

Giriş: Mesane kanseri üriner sistemin en sık görülen ikinci kanseridir. Radikal sistektomi ve üriner diversiyon, invaziv mesane tümörlerinin tedavisinde altın standarttır. Kliniğimizde radikal sistektomi operasyonu uygulanan hastalar retrospektif olarak değerlendirildi. Yöntem: Ocak 2003 ve 2008 tarihleri arasında kliniğimizde mesane tümörü nedeni ile radikal sistektomi operasyonu uygulanmış 71 hasta retrospektif olarak demografik özellikler, preoperatif ve postoperatif patolojileri ile uygulanan üriner diversiyon yöntemleri açısından değerlendirildi. Ayrıca, operasyon sırasında ve hastaların takibinde görülen komplikasyonlar da incelendi. Bulgular: Operasyon sonrası ortalama takip süresi 28,8 ay idi. Patolojik evreleme 13 hastada (%18) noninvaziv rapor edilirken, 20 hastada (%28) T2, 25 hastada (%35) T3, 14 hastada (%19.7) ise evre T4 tümör rapor edildi. Hastalardan 7'sinde squamoz hücreli karsinom bildirilirken, 24 hastada lenf nodu metastazı tespit edildi. Postoperatif erken dönemde 12 hastada yara yeri enfeksiyonu, 6 hastada yara evantrasyonu, 3 hastada ileus, 2 hastada üreteroileal anastomozdan idrar kaçağı vardı. Postoperatif geç dönemde ise birer olguda loop stenozu ve ürostomi materyaline karşı alerjik reaksiyon gözlemlendi. İki hastada exitus gelişmişti. Sonuç: Radikal sistektomi operasyonu literatür ile uyumlu morbidite ve mortalite oranları ile yapılabilmektedir.

Our 6-year experience in radical cystectomy

Objective: Bladder cancer is the second most common cancer of the urinary tract. Radical cystectomy and urinary diversion is the gold standard treatment model of invasive bladder cancer. Patient and Methods: We evaluated 71 patients who underwent radical cystectomy, retrospectively according to their demographic properties, pre-operative and post-operative pathologies and method of urinary diversion and the complications between January 2003 and 2008. Results: Mean follow-up was 28.8 months after the operation. The pathologic stage was superficial at 13 patients (18%), T2 at 20 patients (28%), T3 at 25 patients (35%) and T4 at 14 patients (19%). Squamous cell carcinoma was reported in 7 and lymph node metastasis was in 24 patients. Postoperative short-term complications were wound infection in 12, wound eventration at 6, ileus in 3 and urinary leakage form ureteroileal anastomosis in 2 patients. Additionally, loop stenosis in 1 patient and allergic reaction due to urostomy material in 1 patient were noted. 2 patients died at the same time day after the operation. Conclusion: Radical cystectomy is found to be effective treatment modality with low complication rates parallel to the data in the literature.

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