6 YILLIK RADİKAL SİSTEKTOMİ DENEYİMİMİZ
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.
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