Orhan KOCA, Metin ÖZTÜRK, Ali Murat GÖKÇE, Muzaffer Oğuz KELEŞ, Mustafa GÜNEŞ, M İhsan KARAMAN

Hekim deneyiminin transüretral rezeksiyon sonrası mesane kanseri nüksü üzerine etkisi

Amaç: Mesane kanseri, genitoüriner sistem kanserleri içinde prostat kanserinden sonra ikinci sıklıkta görülmektedir. Yüzeysel mesane kanserinin standart tedavisi transüretral rezeksiyondur TUR . Cerrah deneyiminin bu operasyon sonrası nüks üzerine etkisi araştırıldı.Gereç ve Yöntem: Ocak 2002-ocak 2009 tarihleri arasında yüzeysel mesane kanseri nedeni ile komplet TUR yapılan 227 hasta retrospektif olarak değerlendirildi. Tüm olgulara post-operatif intrakaviter mitomisin uygulandı. Tüm olgularda postoperatif 3’üncü ayda sistoskopi kontrolü yapıldı. Operatörler 0-3 yıllık asistan doktor grup 1 , 4-5 yıllık asistan doktor grup2 ve uzman doktor grup 3 olarak 3 gruba ayrıldı. Bulgular: Hastaların yaş ortalaması 65,7±12,6 iken, bu hastaların 127’si primer mesane kanseri, 100’ü sekonderdi. Sekonder mesane kanseri bulunan hastalara yapılan TUR sonrası nüks primer olanlarınkinden anlamlı olarak yüksekti. Cerrah deneyimi açısından bakıldığında grup 1, 2 ve 3’ten anlamlı olarak yüksek iken, grup 2 ile 3 arasındaki fark istatistiksel olarak anlamlı düzeylere ulaşmadığı gözlemlendi. Sonuç: Çalışmamızın sonuçları nüks oranlarını arttırdığı bilinen diğer parametreler ile birlikte cerrah deneyiminin de göz önünde bulundurulması gerektiğini düşündürmektedir

Anahtar Kelimeler:

Mesane kanseri, transüretral rezeksiyon, nüks

Effect of physician’s experience on the recurrence of the bladder cancer after transurethral resection

Objective: Bladder cancer is the second most common cancer of the urinary system cancers after prostate cancer. Standard treatment of superficial bladder cancer is transurethral resection TUR . Effect of surgeon’s experience on post-operative recurrence was evaluated.Materials and Methods: We carried out a retrospective evaluation of 227 patients who had undergone complete TUR because of the superficial bladder cancer between January 2002 and January 2009. All patients were applied mitomycin after the operation. All patients underwent control cystoscopy at the third month of the operation. Surgeons were divided into three groups; 0-3 year resident doctor group 1 , 4-5 year resident doctor group 2 and specialist doctor.Results: The mean age of the patients was 65,7±12,6, 127 patients were primary bladder cancer while 100 were recurrent bladder cancer. Recurrence rate was higher in the patients whom undergone TUR because of bladder cancer than the primer patients. When we compared group1 with group 2 and 3, the difference was statistically significant while there was no significant difference between group 2 and group3.Conclusion: Experience of the surgeon should be considered together with other parameters that are known to increase the rate of recurrence

Keywords:

Bladder cancer, transurethral resection, recurrence,

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