Seyfi EMİR, Selim SÖZEN, Burhan KANAT, Zeynep ÖZKAN, Fatih YAZAR, Burak KAVLAKOĞLU, Mehmet BOZAN, Fatih EROL

Mekanik Bağırsak Tıkanıklığına Neden Olan Kolorektal Kanserlerde Morbidite ve Mortaliteye Etki Eden Faktörler

ÖZET Amaç: Bu çalışmanın amacı obstrüksiyon yapmış kolorektal kanserler nedeniyle kliniğimizde acil şartlarda opere edilen hastalardaki morbidite ve mortalite oranlarını ve bunlara etki eden faktörleri sunmaktır. Materyal – Metod: Ocak 2008 - Temmuz 2012 yılları arasında mekanik barsak tıkanıklığına neden olmuş kolorektal kanser nedeniyle ameliyat edilen 10 erkek ve 8 kadın olmak üzere 18 hasta retrospektif olarak değerlendirildi. Hastalar yaş, cinsiyet, komplikasyon, yapılan ameliyat, morbidite, mortalite açısından incelendi. Yaşın, cinsiyetin ve tümör yerleşiminin morbidite üzerine olan etkileri incelendi. Bulgular: Hastaların yaş ortalaması 66 ± 8.6 idi. Yetmiş yaş üzerinde 10 (%56.6) vardı. Hastaların 16’sında komplet bir obstruksiyon izlendi (%88.8). Bir hastada obstrüksiyonla beraber perforasyon mevcuttu (%5.6). On iki hastaya Hartman prosedürü (%66.7) uygulanırken, 2 hastaya loop kolostomi (%11.2), 2 hastaya sağ hemikolektomi (%11.2), 1 hastaya total kolektomi ileorektal anastomoz (%5.6), 1 hastaya sağ hemikolektomi uç ileostomi (%5.6) uygulandı. Beş hastada morbidite izlendi (%27.8). İki hastada mortalite izlendi (%11.2). Morbidite görülen tüm hastalar 70 yaş üzerindeydi (p=0.21). cinsiyete göre ve tümörün yerleşim yerine göre ise morbidite oranları açısından anlamlı fark yoktu. Sonuç: Obstruktif kolorektal kanser nedeniyle acil operasyona alınan hastalarda mortalite ve morbidite izlenme olasılığı artmaktadır. Bunun nedenlerinden birisi hastaların daha çok ileri yaşlarda olmalarıdır. Ayrıca hastalarda perforasyon gibi eşlik eden bir komplikasyon varlığı mortalite ve morbiditeyi ciddi ölçüde arttırmaktadır.

Anahtar Kelimeler:

Kolon kanseri, obstrüksiyon, morbidite, mortalite

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Aim The aim of this study is sharing the morbidity and mortality rates and risc factors efecting the morbidity and mortality rates of patients underwent emergency operation in our clinic. Materials and Methods Between January 2008 - July 2012 eighteen patients, 10 men and 8 women, who operated because of obstructive colorectal cancer, were reviewed. Patients were examined fora ge, sex, complication, operation type, morbidity and mortality. The effects of age, sex and tumor location on morbidity and mortality were examined. Results Mean age of patients was 66 ± 8,6. Ten patients were elder than 70 (% 56,6). Complet obstruction was seen in 16 patients (% 88,8). In one patient perforation was seen wtih obstrucion (% 5,6). Hartmann’s procedure was performed for 12 patients (% 66,7), loop colostomy was performed for two patients (% 11,2), right hemicolectomy was performed for two patients (% 11,2), total colectomy with ileorectal anastomosis was performed for 1 patient (% 5,6), right hemicolectomy with end ileostomy was performed for 1 patient (% 5,6). Morbidity was seen in 5 patients (% 27,8). Mortality was seen in two patients (% 11,2). Both patients with mortality were elder than 70 (p=0.21). There weren’t any significant difference for sex and tumor’s location. Conclusion Morbidity and mortality rates increases in patients whom underwent emergency surgery for obstructive colorectal cancer. Being elder patient is one of the reasons. And also accompanied complications like perforation searously increase mortality and morbidity

Keywords:

Colon cancer, obstruction, morbidity, mortality,

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