Selim TAMAM, Zafer ERGÜL, Serhat TOKGÖZ, İsmail Oskay KAYA

LAPAROSKOPİK ve AÇIK YÖNTEM İLE KOLOREKTAL CERRAHİ YAPILAN HASTALARIN KARŞILAŞTIRILMASI

Amaç Laparoskopik kolorektal cerrahi günümüzde birçok merkezde yaygın olarak kullanılan bir yöntem halini almıştır. Çalışmamızda laparoskopik ve açık kolorektal cerrahi uygulanan olgularda postoperatif klinik ve onkolojik sonuçların karşılaştırılması ve literatür ile kıyaslanması amaçlanmıştır. Gereç ve Yöntem Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi genel cerrahi kliniğinde Ocak 2012 ile Aralık 2018 tarihleri arasında kolorektal cerrahi uygulanan hastaların verileri retrospektif olarak incelenmiştir. Bulgular Çalışmamıza 438’i (%80,5) açık, 73’ü (%13,4) laparoskopik, 33’ü (%6,1) konversiyon ile rezeksiyon uygulanan toplam 544 hasta dahil edildi. Seride acil opere edilen vaka sayısı 158 (%29,0), elektif vaka sayısı 386’dır (%71,0). Toplam 156 (%28,7) postoperatif komplikasyon saptanmış olup, gruplara göre değerlendirildiğinde; laparoskopik cerrahi grubunda postoperatif komplikasyon 20 (%27,4), açık cerrahi grubunda 126 (%28,8), konversiyon grubunda 10 (%30,3) postoperatif komplikasyon saptanmıştır. Rektum kanserlerinde ortalama çıkarılan lenf nodu sayıları açık prosedürde 19,0±9,7, laparoskopik prosedürde 22,3±11,6’ dir (p:0,198). Laparoskopik ve açık cerrahi grubundaki rektum kanseri olgularında sırasıyla 1 (%2,3) ve 8 (%5,9) hastada pozitif çevresel cerrahi sınır saptanmıştır (p:0,456). Ortalama distal cerrahi sınır açık grupta 45,1±39,8, laparoskopik grupta 41,1±37,7 ’dir (p:0,608). Sonuç Laparoskopik kolorektal kanser cerrahisi klinik ve onkolojik sonuçlar yönünden açık prosedür ile karşılaştırılabilir sonuçlara sahiptir. Minimal invaziv cerrahinin bilinen birçok avantajı göz önüne alındığında laparoskopik cerrahi muhtemelen kolon kanseri için standart tedavi haline gelecektir.

Anahtar Kelimeler:

Laparoskopi, Laparoskopik Kolorektal Cerrahi, Kolorektal Cerrahi, Kolon Kanseri, Rektum Kanseri

COMPARISON OF PATIENTS TREATED WITH LAPAROSCOPIC AND OPEN COLORECTAL SURGERY

Objective Laparoscopic colorectal surgery has become a widely used method in many centers today. In our study, it was aimed to compare the postoperative clinical and oncological results in patients who underwent laparoscopic and open colorectal surgery and to compare them with the literature. Material and Method The data of patients who underwent colorectal surgery between January 2012 and December 2018 at the Dışkapı Yıldırım Beyazıt Training and Research Hospital General Surgery clinic were analyzed retrospectively. Results A total of 544 patients were included in our study, of which 438 (80.5%) underwent open resection, 73 (13.4%) laparoscopic, 33 (6.1%) underwent resection with conversion. In the series, the number of cases that were operated urgently was 158 (29.0%), and the number of elective cases was 386 (71.0%). A total of 156 (28.7%) postoperative complications were detected. When evaluated according to the groups; There were 20 (27.4%) postoperative complications in the laparoscopic surgery group, 126 (28.8%) in the open surgery group, and 10 (30.3%) in the conversion group. The mean number of lymph nodes removed in rectal cancers is 19.0±9.7 in the open procedure and 22.3±11.6 in the laparoscopic procedure (p: 0.198). A positive circumferential surgical margin was found in 1 (2.3%) and 8 (5.9%) patients with rectal cancer in the laparoscopic and open surgery groups, respectively (p: 0.456). The mean distal surgical margin was 45.1±39.8 mm in the open group and 41.1±37.7 mm in the laparoscopic group (p: 0.608). Conclusion Laparoscopic colorectal cancer surgery has comparable clinical and oncological outcomes to the open procedure. Given the many known advantages of minimally invasive surgery, laparoscopic surgery will likely become the standard treatment for colon cancer.

Keywords:

Laparoscopy, Laparoscopic Colorectal Surgery, Colorectal Surgery, Colon Cancer, Rectal Cancer,

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