SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE
Yıl: 2020 Cilt: 53 Sayı: 3 Sayfa Aralığı: 196 - 201 Metin Dili: İngilizce DOI: 10.20492/aeahtd.805025 İndeks Tarihi: 29-11-2021
SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE
Öz: AIM: Colorectal cancer is the most common cause of large bowel obstruction in elderly. The aim of this study is to compare the clinical findings and perioperative outcomes of elder and younger colorectal cancer patients who were urgently operated for obstruction in our department. MATERIAL AND METHOD: The files of patients who underwent emergency surgery for acute mechanical bowel obstruction due to colorectal cancer between January 2015 and December 2019 at the Sakarya University School of Medicine, Department of General Surgery were retrospectively reviewed. RESULTS: A total of 187 patients who had emergency operation due to colorectal cancer-related obstruction in a 5-year period were included. 55.6% (n = 104) were over the age of 65, 46.4% (n = 83) were under the age of 65. ASA scores, tumor localization, and mean total hospital stay, duration of intensive care unit stay were statistically different between the two groups (p <0.05, p <0.022, p = 0.011). No significant difference detected in terms of mortality (p = 0.103). CONCLUSION: Obstructive colorectal cancers in geriatric patients who require emergency surgery form a more challenging group than the elective conditions. Our study shows that similar outcomes can be achieved in terms of postoperative complications, early mortality and oncological principles; with the younger cohort.
Anahtar Kelime: OBSTRUKSİYONA NEDEN OLMUŞ KOLOREKTAL KANSERLİ YAŞLI HASTALARDA ACİL CERRAHİ SONUÇLARI: TEK MERKEZ DENEYİMİ
Öz: AMAÇ: Kolorektal kanserler, yaşlılarda kalın bağırsak tıkanıklığının en yaygın nedenidir. Bu çalışmanın amacı, bölümümüzde acil olarak obstrüksiyon nedeniyle ameliyat edilen yaşlı ve genç kolorektal kanserli hastaların klinik bulgularını ve perioperatif sonuçlarını karşılaştırmaktır. GEREÇ VE YÖNTEM: Sakarya Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı’nda, Ocak 2015-Aralık 2019 tarihleri arasında, kolorektal kansere bağlı akut mekanik barsak tıkanıklığı nedeniyle acil ameliyat edilen hastaların dosyaları retrospektif olarak incelendi. BULGULAR: 5 yıllık sürede, kolorektal kansere bağlı tıkanıklık nedeniyle acil ameliyat olmuş toplam 187 hasta çalışmaya dahil edildi. Olguların %55,6 'sı (n = 104) 65 yaş üzerinde, %46,4'ü (n = 83) 65 yaşın altındaydı. ASA skorları, tümör lokalizasyonu, ortalama toplam hastanede kalış süresi ve yoğun bakımda yatış süresi iki grup arasında istatistiksel olarak farklıydı (p <0.05, p <0.022, p = 0.011). Mortalite açısından gruplar arasında anlamlı bir fark saptanmadı (p = 0.103). SONUÇ: Acil cerrahi gerektiren geriatrik hastalarda obstrüktif kolorektal kanserler, seçici koşullara göre daha zorlayıcı bir grubu oluşturmaktadır. Çalışmamız, geriatrik gruptaki hastalarda postoperatif komplikasyonlar, erken mortalite ve onkolojik prensipler açısından genç grup ile benzer sonuçların elde edilebileceğini göstermektedir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1)Douaiher J, Ravipati A, Grams B, et al. Colorectal cancer-global burden, trends, and geographical variations. J Surg Oncol. 2017; 115: 619–30.
- 2)Bayraktar B, Ozemir IA, Kefeli U, et al. Colorectal stenting for palliation and as a bridge to surgery: A 5-year follow-up study. World J Gastroenterol. 2015; Aug 21; 21: 9373-9.
- 3)Costa G, Frezza B, Fransvea P, , et al. Clinico-pathological features of colon cancer patients undergoing emergency surgery: a comparison between elderly and non-elderly patients. Open Med (Wars). 2019; Oct 2; 14: 726-34. doi: 10.1515/med-2019-0082.
- 4)Greenlee RT, Hill-Harmon MB, Murray T, et al. Cancer statistics, 2001. Ca-A Cancer Journal of Clinicians. 2001; 51: 15-36
- 5)Kluger Y, Ben-Ishay O, Sartelli M, et al. World society of emergency surgery study group initiative on Timing of Acute Care Surgery classification (TACS). World J Emerg Surg. 2013; 8: 17
- 6)Clavien P, Sanabria J, Strasberg S. Proposed classification of complication of surgery with examples of utility in cholecystectomy. Surgery. 1992; 111: 518–26.
- 7)Smothers L, Hynan L, Fleming J, et al. Emergency surgery for colon carcinoma. Diseases of the Colon and Rectum. 2003; 1: 24-30
- 8)Hermans E, van Schaik PM, Prins HA, et al. Outcome of colonic surgery in elderly patients with colon cancer. J Oncol. 2010; 2010: 865-908. Doi:10.1155/2010/865908
- 9)Siegel R, Ma J, Zou Z, et al. Cancer statistics, 2014. CA Cancer J Clin. Jan-Feb 2014; 64: 9-29. doi: 10.3322/caac.21208.
- 10)Menegozzo CAM, Teixeira Jr F, Couto Netto SD, et al. Outcomes of Elderly Patients Undergoing Emergency Surgery for Complicated Colorectal Cancer: A Retrospective Cohort Study. Clinics (Sao Paulo). 2019; 74: e1074. Published online 2019 Aug 13. doi: 10.6061/clinics/2019/e1074
- 11)Aquina CT, Becerra AZ, Xu Z, et al. Nonelective colon cancer resection: A continued public health concern. Surgery. 2017; 161: 1609-18. https://doi.org/10.1016/j.surg. 2017.01.001
- 12)Balducci L, Aapro M. Complicated and complex: helping the older patient with cancer to exit the labyrinth. J Geriatr Oncol. 2014; 5: 116-8.
- 13)Hsu T.C. Comparison of One-Stage Resection and Anastomosis of Acute Complete Obstruction of Left and Right Colon. Am J Surg. 2005; Apr; 189: 384-7. doi: 10.1016/j.amjsurg.2004.06.046.
- 14)K.K. Tan, R. Sim. Surgery for obstructed colorectal malignancy in an Asian population: predictors of morbidity and comparison between left and right-sided cancers. J Gastrointest Surg. 2010 ; 14: 295-302
- 15)Webster PJ, Aldoori J, Burke DA. Optimal management of malignant left-sided large bowel obstruction: do international guidelines agree? World J Emerg Surg. 2019; 14: 23. Published online 2019 May 22. doi: 10.1186/s13017-019-0242-5 PMCID: PMC6530001
- 16)Ghazal AH, El-Shazly WG, Bessa SS, et al. Colonic Endolumenal Stenting Devices and Elective Surgery Versus Emergency Subtotal/ Total Colectomy in the Management of Malignant Obstructed Left Colon Carcinoma. J Gastrointest Surg. 2013 Jun; 17: 1123-9. doi: 10.1007/s11605-013-2152-2. Epub 2013 Jan 29. PMID: 23358847
- 17)NCCN Clinical practice guidelines in Oncology: Colon Cancer. Available at www.nccn.org. Accessed March 10, 2013.
- 18)Bilimoria KY, Stewart AK, Palis BE, et al. Adequacy and importance of lymph node evaluation for colon cancer in the elderly. J Am Coll Surg. 2008; 206: 247–54.
- 19)Chang GJ, Rodriguez-Bigas MA, Skibber JM, et al. Lymph node evaluation and survival after curative resection of colon cancer: Systematic review. J Natl Cancer Inst. 2007; 99: 433–41.
- 20)Xu Z, Becerra AZ, Aquina CT, et al. Emergent Colectomy Is Independently Associated with Decreased Long-Term Overall Survival in Colon Cancer Patients. J Gastrointest Surg. 2017; 21: 543-53. https://doi.org/10.1007/ s11605-017-3355-8
- 21)Sjo OH, Larsen S, Lunde OC, et al. Short term outcome after emergency and elective surgery for colon cancer. Colorectal Dis. 2009; 11: 733–9.
| APA | Dikicier E, Kamburoğlu M, GONULLU E, Akdeniz Y, Ozdemir K, Mantoglu B, kocer b, Çelebi F (2020). SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE. , 196 - 201. 10.20492/aeahtd.805025 |
| Chicago | Dikicier Enis,Kamburoğlu Muhammet Burak,GONULLU Emre,Akdeniz Yesim,Ozdemir Kayhan,Mantoglu Baris,kocer belma,Çelebi Fehmi SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE. (2020): 196 - 201. 10.20492/aeahtd.805025 |
| MLA | Dikicier Enis,Kamburoğlu Muhammet Burak,GONULLU Emre,Akdeniz Yesim,Ozdemir Kayhan,Mantoglu Baris,kocer belma,Çelebi Fehmi SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE. , 2020, ss.196 - 201. 10.20492/aeahtd.805025 |
| AMA | Dikicier E,Kamburoğlu M,GONULLU E,Akdeniz Y,Ozdemir K,Mantoglu B,kocer b,Çelebi F SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE. . 2020; 196 - 201. 10.20492/aeahtd.805025 |
| Vancouver | Dikicier E,Kamburoğlu M,GONULLU E,Akdeniz Y,Ozdemir K,Mantoglu B,kocer b,Çelebi F SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE. . 2020; 196 - 201. 10.20492/aeahtd.805025 |
| IEEE | Dikicier E,Kamburoğlu M,GONULLU E,Akdeniz Y,Ozdemir K,Mantoglu B,kocer b,Çelebi F "SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE." , ss.196 - 201, 2020. 10.20492/aeahtd.805025 |
| ISNAD | Dikicier, Enis vd. "SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE". (2020), 196-201. https://doi.org/10.20492/aeahtd.805025 |
| APA | Dikicier E, Kamburoğlu M, GONULLU E, Akdeniz Y, Ozdemir K, Mantoglu B, kocer b, Çelebi F (2020). SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi, 53(3), 196 - 201. 10.20492/aeahtd.805025 |
| Chicago | Dikicier Enis,Kamburoğlu Muhammet Burak,GONULLU Emre,Akdeniz Yesim,Ozdemir Kayhan,Mantoglu Baris,kocer belma,Çelebi Fehmi SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi 53, no.3 (2020): 196 - 201. 10.20492/aeahtd.805025 |
| MLA | Dikicier Enis,Kamburoğlu Muhammet Burak,GONULLU Emre,Akdeniz Yesim,Ozdemir Kayhan,Mantoglu Baris,kocer belma,Çelebi Fehmi SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi, vol.53, no.3, 2020, ss.196 - 201. 10.20492/aeahtd.805025 |
| AMA | Dikicier E,Kamburoğlu M,GONULLU E,Akdeniz Y,Ozdemir K,Mantoglu B,kocer b,Çelebi F SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2020; 53(3): 196 - 201. 10.20492/aeahtd.805025 |
| Vancouver | Dikicier E,Kamburoğlu M,GONULLU E,Akdeniz Y,Ozdemir K,Mantoglu B,kocer b,Çelebi F SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2020; 53(3): 196 - 201. 10.20492/aeahtd.805025 |
| IEEE | Dikicier E,Kamburoğlu M,GONULLU E,Akdeniz Y,Ozdemir K,Mantoglu B,kocer b,Çelebi F "SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE." Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi, 53, ss.196 - 201, 2020. 10.20492/aeahtd.805025 |
| ISNAD | Dikicier, Enis vd. "SURGICAL OUTCOMES IN ELDERLY PATIENTS WITH OBSTRUCTED COLORECTAL CANCER: SINGLE CENTER EXPERIENCE". Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi 53/3 (2020), 196-201. https://doi.org/10.20492/aeahtd.805025 |
