İki Farklı Zaman Aralığı ve İki Ayrı Merkezdeki Kolorektal Cerrahide Anastomoz Kaçaklarımızın Literatür Eşliğinde Değerlendirilmesi

Kolorektal cerrahide en önemli ve korkulan komplikasyonlardan biri anastomoz kaçakları ve buna bağlı pelviperitoneal sepsistir. Kolorektal cerrahide mortalitenin %30-50’sinden anastomoz kaçakları sorumludur. Mortalite oranını, kaçağın erken tanınması ve yandaş hastalıklar belirler. İzmir Atatürk Eğitim ve Araştırma Hastanesi 3.Genel Cerrahi Kliniği’nde (İAEAH) 2000-2008 yılları arasında opere edilen kolon ve rektum kanseri olgularının yayınlanmamış olan verileri ile halen çalışmakta olduğum Muğla Sıtkı Koçman Üniversitesi Eğitim ve Araştırma Hastanesi Genel Cerrahi Kliniği’nde (MSKÜEAH) 2012-2021 yılları arasında cerrahi tedavi gören kolon ve rektum olgularının verileri retrospektif olarak incelenmiştir. Belirtilen dönemler içerisinde, İAEAH çalışmasında 216, MSKÜEAH’de ise 251 cerrahi tedavi uygulanan kolorektal kanser olgusu saptanmıştır. Bu retrospektif çalışmada uygulanmış olan kolorektal cerrahi sonrası gelişen anastomoz kaçakları değerlendirilmiştir. Anastomoz kaçaklarının, reoperasyon olasılıkları, cerrahi morbidite ve mortalitenin, hastanede yatış süresinin ve hastaneye tekrar gelişin, lökorejyonel nüks riskinin artışı, beş yıllık genel sağ kalımın azalması ve hastaların yaşam kalitesinin düşmesi ve maliyet gibi olumsuz sonuçlarının daima hatırlanarak, kaçak önleyici tedbirlerin artırılması ve bunun için de yeni klinik çalışmaların yapılması gerekmektedir. Bu çalışmanın amacı cerrahi teknik, radyoloji, yoğun bakım gibi önemli alanlarda ilerlemelerin, iki ayrı merkezde farklı çalışma dönemlerinde kolorektal cerrahi uygulanan olgularda anastomoz kaçaklarına olan etkilerini araştırmaktır.

Anahtar Kelimeler:

Kolorektal Karsinom, Anastomoz Kaçağı, Risk Faktörleri, Cerrahi Morbidite, Mortalite

The Evaluation of Our Anastomosic Leakages Developed on Colorectal Surgery in Two Different Times and in Two Separate Centers Across the Literature

One of the most important and feared complications in colorectal surgery is anastomotic leakage and associated pelviperitoneal sepsis. Anastomotic leaks are responsible for 30-50% of the mortality in colorectal surgery. Early detection of leakage and co-morbidities determine the mortality rate. With the unpublished data of colon and rectum cancer cases operated between 2000 and 2008 in the 3rd General Surgery Clinic of İzmir Atatürk Training and Research Hospital (İAEAH); The data of the colon and rectum cases who underwent surgical treatment between 2012-2021 in Muğla Sıtkı Koçman University Training and Research Hospital (MSKÜEAH) General Surgery Clinic, where I am still working, were analyzed retrospectively. Within the specified periods, 216 cases of colorectal cancer in the IAEAH study and 251 surgically treated colorectal cancer cases in MSKUEAH were detected. In this retrospective study, anastomotic leaks developed after colorectal surgery were evaluated. By always remembering the negative consequences of anastomotic leaks such as reoperation possibilities, surgical morbidity and mortality, length of hospital stay and hospital readmission, increased risk of leucoregional recurrence, reduced five-year overall survival, decreased quality of life and cost of patients, leak prevention measures should be increased and for this, further clinical studies need to be done. The aim of this study is to investigate the effects of advances in surgical technique, important fields such as radiology and intensive care on anastomotic leaks in patients who underwent colorectal surgery at different study periods in two different centers.

Keywords:

Colorectal Carcinoma, Anastomotic Leak, Risk Factors, Surgical Morbidity, Mortality,

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