Sürdürülebilir Kalkınma Amaçları

• 2

Yazarlar

• Akın, T.(1)
• Alici, A.(1)
• Altuntas, Yunus E.(1)
• Basturk, E.(1)
• Gezen, C.(1)
• Gezen, Cem(1)
• Gumus, Mahmut(1)
• Kement, M.(1)
• Kement, Metin(1)
• Okkabaz, N.(1)
• Okkabaz, Nuri(1)
• Oncel, M.(1)
• Oncel, Mustafa(1)
• Seker, Mesut(1)
• Vural, S.(1)
• Vural, Selahattin(1)
• Yegenoglu, A.(1)

• MakaleAçık Erişim2012Scopus SJRQ2/r/gumushane/15367
  Results after multivisceral resections of locally advanced colorectal cancers: An analysis on clinical and pathological t4 tumors

  Gezen, Cem; Kement, Metin; Altuntas, Yunus E.; Okkabaz, Nuri; Seker, Mesut; Vural, Selahattin; Gumus, Mahmut; Oncel, Mustafa

  Background: Locally advanced colorectal cancers are best treated with multivisceral resections. The aim of this study is to evaluate early and late results after multivisceral resections.Methods: All patients operated for primary colorectal cancer between 2001 and 2010 were -reviewed. These were compared within the patients underwent single organ and multivisceral resections: demographics, tumor and procedure related parameters, perioperative results, early oncological outcomes and 5-year survival.Results: A total of 354 patients (59.6 ± 13.8 years old, 210 [59.3%] males) were abstracted. Ninety (25.4%) patients underwent multivisceral resections for clinical T4 tumors and en-bloc R0 resection was achieved in 82 (91.1%). Only 31 (34.4% and 8.8% of clinical T4 and all cancers, respectively) cases had actual adjacent organ invasions (pT4). Males (20%) had lower risk for locally advanced tumors than females (33.3%) (p < 0.05). PT4 cancers were more common, if the clinical T4 tumor is located in the colon (48.8% vs 21.3%; p < 0.01). Laparoscopy was seldom initiated and the risk of conversion was higher in clinical T4 tumors (p < 0.05). The rates of sphincter-saving procedures were not different. Operation time, bleeding and transfusion requirements increased when multivisceral resections were necessitated (p < 0.05), but hospital stay, complications and 30-day mortality rates were similar. The 5-year survival rates were identical (p > 0.05).Conclusions: Clinical T4 tumors are not rare and more common in women. An actual invasion (pT4) may be observed in one third of all clinical T4 tumors, and more frequent in colon cancers. An en-bloc, R0, multivisceral resection may be achieved in most cases. Multivisceral resections do not alter the rates of sphincter-saving procedures, morbidity and 30-day mortality; do not worsen survival but increase operation time, intraoperative bleeding and perioperative transfusion requirements.

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  AtıfScopus74·WoS64·OpenAlex85

  İncele
• MakaleYalnız künye2010Scopus SJRQ1/r/gumushane/15531
  Apical lymph nodes at the root of the inferior mesenteric artery in distal colorectal cancer: An analysis of the risk of tumor involvement and the impact of high ligation on anastomotic integrity

  Alici, A.; Kement, M.; Gezen, C.; Akın, T.; Vural, S.; Okkabaz, N.; Basturk, E.; Yegenoglu, A.; Oncel, M.

  Background: What level of arterial ligation is best in left-sided colon cancer and rectal cancer remains controversial. This study aims to assess the necessity and risk of high ligation from an oncological and technical perspective. Methods: The lymph nodes at the origin of the inferior mesenteric artery (IMA) were separated as apical nodes in all patients operated for distal colorectal cancer in our department. The number and status of the nodes were prospectively assessed, and demographic and tumor-related variables were evaluated as risk factors for apical tumor invasion. Anastomotic leaks were also evaluated. Results: A hundred and three patients (52 [50.5%] males, 60.3 ± 12.9 years old) were included. The number of non-apical lymph nodes harvested was 14.5 ± 7.1 with an additional 4.4 ± 3.2 apical nodes at the high ligation site. Tumor invasion of apical nodes was observed in 6 (5.8%) patients. Two of these (1.9%) had no other positive nodes (skip metastases). Although none of the variables evaluated was found significant for predicting apical node positivity, tumor invasion was detected in 8.5 and 22.2% of patients with pT3 and pN2 cancers, respectively. Among patients, who had an anastomosis (n = 84, 81.6%), anastomotic leak was observed in 7(8.3%) and 1 (1.2%) of these patients required emergency relaparotomy. There was no mortality related to high ligation. Conclusions: High ligation of IMA may be routinely performed in patients with distal colorectal cancer, since tumor invasion of apical lymph nodes is neither rare (>5%) nor predictable, and skip metastases may also occur. This is especially true in case of an advanced disease for which apical node positivity peaks. The anastomotic leak rate is less than 10%, and mortality is low after high ligation of IMA.

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  AtıfScopus60·WoS56·OpenAlex65

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