Bahadır KARTAL, Mehmet Abdussamet BOZKURT, Cemal SEYHUN

KOLOREKTAL KANSER NEDENİYLE AMELİYAT GİREN HASTALARIN AMELİYAT ÖNCESİ BAĞIRSAK HAZIRLIK MODELLERİNİN KARŞILAŞTIRILMASI

Amaç Toplumda en sık görülen kanser kolorektal kanserdir (KRK). Cerrahi morbidite ve mortaliteyi azaltmayı amaçlayan çalışmalar, preoperatif barsak hazırlığının önemli bir katkısını bulmuştur. Bağırsak hazırlığı için modeller arasında mekanik temizlik, antibiyotik kullanımı ve kontrol grupları yer alıyordu. Bu çalışmada elektif kolorektal kanser için preoperatif barsak hazırlığını karşılaştırdık ve etkilerini değerlendirdik. Materyal ve metodlar Kolorektal kanserli 144 hastayı (n=144) prospektif olarak dört gruba ayırmak için preoperatif barsak hazırlama modeli kullanıldı. Birinci gruptaki hastalara (Grup I) mekanik barsak hazırlığı (MBH), ikinci gruba (Grup II) oral antibiyotik tedavisi (OAB) ve MBH, üçüncü gruba intravenöz antibiyotik tedavisi (IVAB), MBH ve OAB uygulandı. grup (Grup III) ve dördüncü grupta (Grup IV) barsak hazırlığı yapılmadı. Hastalar arasında demografik bilgiler, anastomoz kaçağı, cerrahi alan enfeksiyonu, karın içi apse, postoperatif ileus ve ölüm karşılaştırıldı. Bulgular Çalışmanın Grup I, II, III ve IV'ünde sırasıyla 35 hasta, 38 hasta, 35 hasta ve 36 hasta vardı. Gruplar yaş, cinsiyet ve ASA (American Society of Anesthesiologists) puanına göre değerlendirildiğinde dört grup arasında istatistiksel olarak anlamlı fark yoktu (p> 0,05). Cerrahi alan enfeksiyonu (CAE), intraabdominal apse ve anastomoz kaçağı arasında anlamlı fark vardı (p0.05). Mortalite ve postoperatif ileus arasında anlamlı fark yoktu (p > 0.05). Sonuç Elektif KRK nedeniyle ameliyat olmuş hastalarda mekanik kolon temizliği ve antibiyotik uygulamalarının barsak hazırlığı yaklaşımının uygun olduğunu düşünüyoruz.

Anahtar Kelimeler:

Kolorektal kanser, bağırsak hazırlığı, cerrahi

COMPARISON OF PREOPERATIVE BOWEL PREPARATION MODELS OF PATIENTS WHO UNDERWENT SURGERY FOR COLORECTAL CANCER

Background The most prevalent cancer in society is colorectal cancer (CRC). Studies aiming to lower surgical morbidity and mortality have found a significant contribution from preoperative bowel preparation. Models for bowel preparation included mechanical cleaning, the use of antibiotics, and control groups. We compared preoperative bowel preparation for elective colorectal cancer and evaluated its effects in this study. Material and Methods Preoperative bowel preparation model was used to prospectively split 144 patients (n=144) with colorectal cancer into four groups. Patients in the first group (Group I) underwent mechanical bowel preparation (MBP), followed by oral antibiotic therapy (OAB) and MBP in the second group (Group II), intravenous antibiotic therapy (IVAB), MBP, and OAB in the third group (Group III), and no bowel preparation in the fourth group (Group IV). Demographic information, anastomotic leakage, surgical site infection, intraabdominal abscess, postoperative ileus, and death were compared between patients. Results Groups I, II, III, and IV of the study each had 35 patients, 38 patients, 35 patients, and 36 patients, respectively. There was no statistically significant difference between the four groups when the groups were evaluated by age, gender, and ASA (American Society of Anesthesiologists) score (p> 0.05). There were significant differences between surgical site infection (SSI), intraabdominal abscess, and anastomosis leaking (p0.05). Mortality and postoperative ileus did not differ significantly (p > 0.05). Conclusion We consider that the bowel preparation approach of mechanical colon cleansing and antibiotic administration is appropriate for patients who have had surgery owing to elective CRC.

Keywords:

Colorectal cancer, bowel preparation, surgery,

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