Mide kanserinde D2 lenf nodu diseksiyonu morbidite ve mortaliteyi arttırır mı?
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Dosyalar
Tarih
2012
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Derman Medical Publishing
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada amaç D1 ve D2 lenf nodu diseksiyonu (LND) uygulanan
mide kanserli hastaların postoperatif morbidite ve mortalite açısından karşılaştırılmasıdır. Gereç ve Yöntem: Bu çalışma 1995–2006 yılları arasında mide
kanseri nedeniyle opere edilen toplam 137 olgu retrospektif olarak incelenerek yapıldı. Küratif niyetle opere edilen 111 olgu çalışmaya alındı. D1 ve D2
LND yapılan iki grup, hasta sayısı, cinsiyet, yaş, hastalığın evresi ve ASA dereceleri yönünden karşılaştırıldı. İki grup cerrahi yöntem, stapler kullanımı,
operasyon süresi, ek organ rezeksiyonları, hastanede kalış süresi, postoperatif komplikasyonlar, reoperasyon gereksinimi ve operatif mortalite yönünden analiz edildi. Bulgular: Yüz on bir olgunun 50’sine D1, 61’ine D2 LND uygulandığı saptandı. Olguların 23’ü kadın, 88’i erkek idi. Kadın/Erkek oranı 1/4
olarak saptandı. Ortalama yaş D1 LND grubunda 59, D2 LND grubunda 58,7
olarak saptandı. Gruplar arasında yaş, cinsiyet, hastalığın evresi, tümör lokalizasyonu, tümör tipi, ortalama hastanede yatış süresi ve ASA dereceleri yönünden istatistiksel olarak anlamlı bir farklılık saptanmadı (p>0.05). İki grup
arasında operasyon süresi açısından istatistiksel bir fark saptandı (p<0.01).
Gruplar arası morbidite ve mortalite açısından istatistiksel bir fark saptanmadı (Sırasıyla p=0,787, p=0,656). Her iki grupta mortalite oranı 70 yaş ve
üstü hastalarda diğer hastalara göre daha yüksek bulundu. Sonuç: Ülkemizde
ve dünyada mide kanserinde D2 LND rutin olarak uygulanmamaktadır. Ancak
bazı çalışmalarda özellikle evre II ve III olgularda morbidite ve mortalite oranlarını arttırmadan, hasta yaşam sürelerini anlamlı bir şekilde uzattığı bildirilmektedir. Bu görüşlerin tam tersi görüşler de mevcuttur. Çalışmamızda mide
kanserinde D2 LND yapılan hastalardaki morbidite ve mortalite oranları D1
lenf nodu diseksiyonu yapılan hastalarla benzer bulunmuştur.
Aim: The aim of this study is to compare the postoperative morbidity and mortality of patients with gastric cancer who had D1 and D2 lymph node dissection (LND). Material and Method: This study was carried out on total 137 patients retrospectively who were operated by for gastric carcinoma between 1995 and 2006. 111 patients who were operated with curative intent were included in the study. The two groups on whom D1 and D2 LND was applied were compared from the number of patients, sex, age, stage of disease and ASA grade. The two groups were analyzed in respect of surgical methods, the use of staplers, operative time, additional organ resections, hospital stay, postoperative complications and the need for re-operation, and operative mortality. Results: It was seen that D1 LND was applied to 50 of the 111 patients; D2 LND was applied to 61 of them. 23 of the patients were female and 88 were male. It was seen that the ratio of Female/Male as 1/4. The mean age of the D1 LND group was 59, and the D2 LND group was 58,7. There was no statistically significant difference between the groups with regard to age, gender, stage of disease, tumor location, tumor type, the average length of hospital stay and ASA grade (p>0.05). A statistical difference in operative time was seen between the two groups (p<0.01). There was no statistical difference between the groups regarding morbidity and mortality (Respectively p=0,787, p=0.656). Mortality rate in both groups was seen to be higher with patients of 70 and over 70. Discussion: D2 LND is not routinely applied in our country and in the world in gastric cancer. However, in some studies it has been reported that it prolongs survival time of patients meaningfully especially of those who have stage II and III without increasing morbidity and mortality rate. Opinions that are exactly opposite exist as well. In our study, it was seen that morbidity and mortality rates are similar with patients who had D2 LND and with those with D1 lymph node dissection.
Aim: The aim of this study is to compare the postoperative morbidity and mortality of patients with gastric cancer who had D1 and D2 lymph node dissection (LND). Material and Method: This study was carried out on total 137 patients retrospectively who were operated by for gastric carcinoma between 1995 and 2006. 111 patients who were operated with curative intent were included in the study. The two groups on whom D1 and D2 LND was applied were compared from the number of patients, sex, age, stage of disease and ASA grade. The two groups were analyzed in respect of surgical methods, the use of staplers, operative time, additional organ resections, hospital stay, postoperative complications and the need for re-operation, and operative mortality. Results: It was seen that D1 LND was applied to 50 of the 111 patients; D2 LND was applied to 61 of them. 23 of the patients were female and 88 were male. It was seen that the ratio of Female/Male as 1/4. The mean age of the D1 LND group was 59, and the D2 LND group was 58,7. There was no statistically significant difference between the groups with regard to age, gender, stage of disease, tumor location, tumor type, the average length of hospital stay and ASA grade (p>0.05). A statistical difference in operative time was seen between the two groups (p<0.01). There was no statistical difference between the groups regarding morbidity and mortality (Respectively p=0,787, p=0.656). Mortality rate in both groups was seen to be higher with patients of 70 and over 70. Discussion: D2 LND is not routinely applied in our country and in the world in gastric cancer. However, in some studies it has been reported that it prolongs survival time of patients meaningfully especially of those who have stage II and III without increasing morbidity and mortality rate. Opinions that are exactly opposite exist as well. In our study, it was seen that morbidity and mortality rates are similar with patients who had D2 LND and with those with D1 lymph node dissection.
Açıklama
Anahtar Kelimeler
Gastric Cancer, Lymphadenectomy, Mide Kanseri, Lenf Nodu Diseksiyonu
Kaynak
Journal of Clinical and Analytical Medicine
WoS Q Değeri
N/A
Scopus Q Değeri
N/A
Cilt
3
Sayı
2
