Akciğer kanserinin cerrahi tedavisinde sleeve rezeksiyonlarının yeri
Küçük Resim Yok
Tarih
2013
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Maltepe Üniversitesi
Erişim Hakkı
Attribution-NonCommercial-NoDerivs 3.0 United States
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Amaç: Bronşial sleeve rezeksiyonlar akciğerin habis ve selim patolojilerinde pnömonektomi operasyonunun alternatifi olarak geliştirilmiş tekniklerdir. Gereç ve Yöntem: Bu çalışma İstanbul Süreyyapaşa Göğüs Cerrahi merkezinde Eylül 1994- Mayıs 2009 tarihleri arasında 71 hastaya uygulanan sleeve rezeksiyonları incelemek amacıyla yapılmıştır. Bulgular: Uzun dönem takipte sleeve rezeksiyon uygulanan hastalardan 26'sı kaybedildi, ortalama takip süresi 33 ay, maksimum takip süresi 120 aydı. Standart sapması 27.7 olarak bulundu. İki yıllık sağkalım %67.2 (ort.57.3 ay±7.5) olarak saptandı.Komplikasyonların ortaya çıkmasıyla; operasyon yapılan taraf, anastomoz şekli ( tek- tek, devamlı sütür ), olguların yaşı arasındaki ilişki araştırıldı ancak istatistiksel olarak anlamlı bir sonuç bulunamadı. (Sırasıyla; p=0.09, p=0.4, p=0.3 ).Operasyon tarafının sağ ya da sol olmasının sağkalıma etkisi araştırıldığında istatistiksel olarak anlamlı bir sonuç bulunamadı (p=0.13). Sağ kalım oranlarını, komplikasyonların varlığına göre değerlendirdiğimizde istatistiksel olarak anlamlı olmamakla birlikte, anlamlıya yakın sonuç elde edildi (p= 0.08). Sağkalım oranlarının, uygulanan ek cerrahi işlemlerden etkilendiği istatistiksel olarak anlamlı bulundu (p= 0.03). N faktörü; N0, N1 ve N2 olmak üzere üç ayrı gruba ayrıldı ve sağkalıma etkisi araştırıldı ve istatistiksel olarak anlamlı bulundu ( p= 0.03). 2 yıllık sağkalım N0'da % 81.5, N1'de % 63, N2'de % 21 olarak bulundu. Tümör çaplarının sağkalıma etkisi istatistiksel olarak anlamlı bulunmadı ( p=0.6) Sonuç: Sleeve rezeksiyonlar diğer rezeksiyonlar gibi düşük mortalite ve morbidite ile yapılabilir.
Aim: Bronchial sleeve resections are developed as alternative techniques to pneumonectomy operation in malignant and benign pathologies of the lung. Patients and Methods: This study was carried out between September 1994 and May 2009 in order to examine 71 patients who underwent sleeve resection in Istanbul Sureyyapasa Chest Surgery Center. Results: Twenty-six of the patients died in long term follow-up, mean and maximum follow-up duration was 33 months and 120 months, respectively. Standard deviation was 27.7. General survival rate in two years was 67.2% (mean 57.3±7.5 months). With the development of complications; the relationships between operation side, anastomosis technique (seperate, continuous suture), patients' age were investigated, however statistically significant results were found (p=0.09, p=0.4, p=0.3, respectively). The effect on survival was investigated between right and left sided operation, no significant results were found statistically (p=0.13). When survival rates were analysed according to the presence of complications; better statistical results were found, however still with no statistical significance (p= 0.08). It was statistically significant that survival rates were affected by additional surgical procedures (p= 0.03). It was also statistically significant that N factor, which was divided into three groups: N0, N1 and N2, had an influence on survival (p=0.03). The two-year survival rate was 81.5% in N0, 63% in N1, 21% in N2. There was no statistically significant effect on survival by tumor diameters (p=0.6). Conclusion: Sleeve resections can be performed with low mortality and morbidity rates like other resections.
Aim: Bronchial sleeve resections are developed as alternative techniques to pneumonectomy operation in malignant and benign pathologies of the lung. Patients and Methods: This study was carried out between September 1994 and May 2009 in order to examine 71 patients who underwent sleeve resection in Istanbul Sureyyapasa Chest Surgery Center. Results: Twenty-six of the patients died in long term follow-up, mean and maximum follow-up duration was 33 months and 120 months, respectively. Standard deviation was 27.7. General survival rate in two years was 67.2% (mean 57.3±7.5 months). With the development of complications; the relationships between operation side, anastomosis technique (seperate, continuous suture), patients' age were investigated, however statistically significant results were found (p=0.09, p=0.4, p=0.3, respectively). The effect on survival was investigated between right and left sided operation, no significant results were found statistically (p=0.13). When survival rates were analysed according to the presence of complications; better statistical results were found, however still with no statistical significance (p= 0.08). It was statistically significant that survival rates were affected by additional surgical procedures (p= 0.03). It was also statistically significant that N factor, which was divided into three groups: N0, N1 and N2, had an influence on survival (p=0.03). The two-year survival rate was 81.5% in N0, 63% in N1, 21% in N2. There was no statistically significant effect on survival by tumor diameters (p=0.6). Conclusion: Sleeve resections can be performed with low mortality and morbidity rates like other resections.
Açıklama
Anahtar Kelimeler
sleeve, akciğer kanseri cerrahisi, sleeve, lung cancer surgery
Kaynak
Maltepe Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
5
Sayı
2
Künye
Kosif Mısırlıoğlu, A., Alpay, L., Kanbur, S., Koşar, A., Sönmez, H., Demir, M., Baysungur, V., Yalçınkaya, İ. ve Örki, T. (2013). Akciğer kanserinin cerrahi tedavisinde sleeve rezeksiyonlarının yeri / The role of sleeve resections in surgical treatment of lung cancer. Maltepe Tıp Dergisi. 5(2), s. 5-13.
