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POTANSİYEL OLARAK KÜRATİF REZEKSİYON GEÇİREN MİDE KANSERİ HASTALARINDA MİKROSKOPİK REZEKSİYON SINIRI TUTULMASININ ERKEN VE GEÇ SONUÇLARI

Journal Name:

  • Cerrahpaşa Tıp Dergisi

Publication Year:

  • 2005

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
At a curative resectional procedure in for cases of gastric cancer, a matter of great import is boundaries of the invading process extending to the oral and/or anal directions. Failure to appreciate this fact during gastrectomy leads to transection in an area invaded by the tumor. Resection-line involvement has been shown to have a causing effect on both anastomatic leakage and perioperative mortality. It also predisposes to anastomotic recurrence and long-term survival rate is impaired. Prognostic impact of resection-line involvement was investigated in patients undergoing potentially curative gastrectomy. Information collected from medical and pathological records included the age and gender of patients, location of tumor, histology type histologic grade, macroscopic type, regional lymph node metastasis and residual tumor in resectional lines. A positive margin was defined as disease present at the line of luminal transection in the mucosa, submucosa and/or serosa. Results.- Resection-line involvements were seen in 30 (16%) of the 185 evaluable patients, Resection-line involvement was associated with age (p=0.08), tumor location (p=0.007), tumor differentiation (p=0.01), macroscopic type of tumor (p=0.19), nodal staging (p=0.002) number of the metastatic nodes (p=0.003) and type of operation (p=0.08). The presence of positive margins was a significant and independent factor of outcome for the entire group (n=185) and associated with worse survival (p=0.016). The significance of a positive microscopic margin in gastric cancer was dependent on the extent of disease. This factor was not predictive of outcome in patients who had undergone complete gross resection and have pathologically proved advanced disease. However, if both groups of patients are stratified according to stage, differentiation, macroscopic type of the tumor, and lymph node metastases, resection-line involvement determined a shorter survival only in patients with stage-II, well-differentiated, ulceroinfiltrative carcinoma and no stage.
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Abstract (Original Language): 
Potansiyel olarak küratif rezeksiyon geçiren mide kanserli hastalarda rezeksiyon sınırlarına çok daha titiz değerlendirilmesi zorunludur. E-dindiğimiz bilgiler göstermiştir ki pozitif re-zeksiyon sınırlı olgularda ilerlemiş hastalığı olanlar daha agresif cerrahi girişime ihtiyaç duymaksızın yakından gözlenirken No evreli, ülseroinfiltratif karsinomlu, grade I ve grade II, stage II hastalar için rezeksiyon sınırı/sınırları-nın re-eksizyonu düşünülmelidir. Mide karsinomlu hastaların prognozu hasta-lık evresi, rezektabilite ve hastanın genel duru-mu ile bağlantılıdır. Mide karsinomu için gü-nümüzde mevcut tek küratif tedavi cerrahi re-zeksiyondur. Potansiyel olarak küratif rezeksi-yon uygulamanın esası, primer lezyonun ve başta nodüller olmak üzere tüm metastatik lez-yonların çıkarılmasıdır. Erken teşhis ne kadar erken konulabilirse, böyle bir radikal cerrahi işlem uygulayabilme ihtimali o kadar artar. Po-tansiyel olarak küratif rezeksiyon yapılmasında en önemli problemlerden biri, rezeksiyon sını-rında makroskobik veya mikroskobik rezidüel tümör kalmasıdır. Rezeksiyon sınırında rezidü-el tümör mevcudiyeti küratif rezeksiyonu pal-yatif duruma getirir.1-5 Rezeksiyon sınırında re-zidüel tümör mevcudiyeti, anastomoz kaçağı, sepsis gibi cerrahi komplikasyonların oranında artışa, peroperatif mortalitenin yükselmesine sebep olduğu gibi, 1,6 anastomoz nüksüne de zemin hazırlar.2,3,7 Bunun sonucu olarak, bazı serilerde 5 yıllık uzun dönem sağ kalım oranın-da %20’yi aşan bir azalma gösterilmiştir.8 Bu retrospektif çalışmada, rezeksiyon sını-rında tümör tutulmasının postoperatif erken ve geç dönem sonuçları ve somut verilere dayana-rak değerlendirmenin sonuçları ve faydaları üzerinde durduk.
FULL TEXT (PDF): 
PDF icon arastirmax-potansiyel-olarak-kuratif-rezeksiyon-geciren-mide-kanseri-hastalarinda-mikroskopik-rezeksiyon-siniri-tutulmasinin-erken-gec-sonuclari.pdf
  • 1
12-19
  • Turkish

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