A comparison of clinicopathologic features of the patients with colorectal cancer after emergency and elective surgery

Acil ve elektif şartlarda opere edilen kolorektal kanserli hastaların klinikopatolojik özelliklerinin karşılaştırılması

Authors

  • Nihan Acar İKÇÜ Atatürk RT Hospital
  • Mustafa Peşkersoy İAEAH
  • Turan Acar İKÇÜ
  • Fevzi Cengiz
  • Evren Durak İAEAH
  • Murat Kemal Atahan
  • Mehmet Hacıyanlı İKÇÜ

Keywords:

Colorectal cancer; elective; emergency; lymph node dissection

Abstract

The importance of oncologic principles in colorectal cancer has been particularly emphasized in recent years. There are several studies on the quality of the conditions of emergency surgery and comparison of stage, mortality and morbidity rates between patient who underwent emergency and elective surgery. This study aimed to investigate and compare the clinicopathologic characteristics of patients with colorectal cancer according to their surgical conditions whether urgent or elective.

Medical records of 564 patients, who underwent colorectal resection between January 2011 and March 2017 anddiagnosed with colon/rectum adenocarcinoma after pathological examination, were investigated retrospectively.

There were 104 (18.4%) patients in the emergency surgery group and 460 (81.6%) patients in the elective surgery group. Majority of the patients were male61.2%, and the mean age was 64.27. The patients who had rectal tumor were 19.7% of all cases, and the tumor was located in colonic segments in the remaining 80.3%. Low anterior resection was determined as the most common procedure with the percentage of 23.2%. Anterior resection was the most common procedure in emergency surgery group (27.9%).

There was no significant difference between the mean lymph node count in terms of the type of the operation, on the basis of surgical condition. When the factors such as age, gender, tumor location, type of the operation and stage of cancer that have effects on adequate lymph node dissection, were analyzed; the only statistically significant difference was found between emergency and elective cases of the transverse colon tumors (p<0.05). While postoperative complications had no effect on the length of hospital stay, having an ostomy and an advanced cancer found to be prolonging this duration (p<0.05).

Surgical conditions have been shown to not affect the lymph node dissection which is an important factor determining the oncological process of the patient.

ÖZET

Kolorektal kanserde onkolojik prensiplerin önemi, son yıllarda özellikle vurgulanmaktadır. Bunu sağlama konusunda acil operasyon koşullarının niteliği ve acil opere olan hastaların elektif opere olan hastalara göre evre, mortalite ve morbidite oranları hakkında çeşitli çalışmalar mevcuttur. Bu çalışmada kolorektal kanser tanılı hastaların acil ve elektif opere olma koşullarına göre klinikopatolojik özelliklerinin araştırılması ve karşılaştırılması amaçlandı.

Ocak 2011-Mart 2017 tarihleri arasında kolorektal rezeksiyon yapılmış ve patolojik inceleme sonucunda kolon/rektum adenokarsinomu tanısı almış 564 hastanın dosyaları retrospektif olarak incelendi.

Acil olarak opere edilen grupta 104 (%18.4) ve elektif opere edilen grupta 460 (%81.6) hasta mevcuttu. Hastaların çoğunluğu erkekti(%61.2) ve ortalama yaş 64.27 idi. Olguların %19.7'sinde tümör rektum yerleşimli, %80.3'ünde ise kolon yerleşimli idi. Hastaların genelinde %23.2 oranıyla aşağı anterior rezeksiyon en sık yapılan işlem olarak saptanmıştır. Acil vakalarda ise en sık uygulanan prosedür anterior rezeksiyondu (%27.9).

Ameliyat koşulu bazında, ameliyat türlerine göre diseke edilen ortalama lenf nodu sayıları arasında anlamlı fark bulunmadı. Yeterli lenf nodu diseksiyonunda etkisi olabilecek yaş, cinsiyet, tümör yerleşimi, uygulanan ameliyat türü ve hastalığın evresi gibi faktörler incelendiğinde, yalnızca transvers kolon tümörlerinde acil ve elektif vakalar arasında istatistiksel olarak anlamlı fark bulundu (p<0.05). Postoperatif komplikasyon durumunun yatış süresine etkisi bulunmazken, ostomi uygulanmasının ve ileri evre hastalığa sahip olmanın yatış süresini uzattığı görüldü (p<0.05).

Hastanın onkolojik sürecini belirleyen önemli bir faktör olan lenf nodu diseksiyonunda, operasyon koşulları arasında fark olmadığı ortaya konulmuştur.

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Published

2021-03-03

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Articles