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Árangur brottnáms á endaþarmi vegna krabbameins eða forstiga þess á Landspítala 2008-2012

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Authors
Hörður Már Kolbeinsson
Elsa Björk Valsdóttir
Páll Helgi Möller
Issue Date
2017-12-06

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Other Titles
Outcome after surgical resection for rectal cancer and its precursors in Landspitali University Hospital 2008-2012
Citation
Læknablaðið 2017,103(12):531-535
Abstract
Inngangur: Endaþarmskrabbamein eru um 2-3% allra krabbameina á Íslandi og eru aðgerðir á endaþarmi hornsteinn í meðferð þeirra. Upplýsingar um þá sem fara í brottnám á endaþarmi vegna krabbameins eða forstiga þess á Íslandi í dag eru takmarkaðar. Tilgangur rannsóknarinnar var að kanna árangur aðgerða á endaþarmi vegna krabbameins eða forstiga þess á 5 ára tímabili. Efniviður og aðferðir: Rannsóknin var afturskyggn. Gerð var leit í skráningarkerfi aðgerða á Landspítala að öllum sem fóru í brottnám eða hlutabrottnám vegna endaþarmskrabbameins eða forstiga þess á árunum 2008-2012. Gagna var aflað um aldur, kyn, aðgerðir, aðra krabbameinsmeðferð en skurðaðgerð, þörf á enduraðgerð og lifun sjúklinga. Niðurstöður: Heildarfjöldi sjúklinga sem fóru í aðgerð á tímabilinu var 144. Meðalaldur sjúklinga var 66 ár (bil: 33-89). Fjöldi sem fékk meðferð með geislum og/eða lyfjum fyrir aðgerð var 65 (45%). Flestir, eða 65%, fóru í fremra brottnám, 21% í gagngert brottnám, 11% í Hartmanns-­aðgerð og 3% fóru í annars konar aðgerðir. Meirihluti sjúklinga (88%) reyndist vera með krabbamein og 12% með forstig krabbameins. Samtenging var gerð í 67% tilfella og varanlegt stóma lagt út í 33% tilfella. Framkvæma þurfti enduraðgerð innan 30 daga í 12% tilfella. Dánarhlutfall eftir 30 daga og eitt ár var 0,7% og 6,2%. Meðaleftirfylgni var 56 mánuðir (bil: 1-98). Staðbundin endurkoma meins varð í 7,1% tilfella og 5 ára lifun var 77%. Ályktun: Tegundir aðgerða á Landspítala eru svipaðar og þekkist erlendis. Árangur skurðaðgerða á endaþarmi vegna krabbameina eða forstiga þess á Landspítala virðist sambærilegur við það sem best gerist erlendis.
Backround: Rectal cancer makes up 2-3% of all cancers in Iceland and surgery is the mainstay of its treatment. Information regarding those who undergo resection of the rectum because of rectal cancer or its precursors in Iceland today is lacking. The aim of this study was to evaluate what kind of surgical treatment rectal cancer patients receive at Landspitali University Hospital along with peri-operative and long-term outcomes. Methods: The study was retrospective. All patients undergoing total or partial resection of the rectum for rectal cancer or its precursor from 2008-2012 in Landspitali University hospital were included. Information regarding age, sex, surgery, neoadjuvant and adjuvant treatment along with reoperations and survival were gathered. Results: The total number of patients included were 144. Mean age was 66 years (33-89). Neoadjuvant treatment was used in 65 (45%) cases. Most of the patients (65%) underwent anterior resection of the rectum, 21% abdominoperineal resection, 11% Hartmann´s procedure and 3% other surgery. Majority of the patients had a cancer diagnoses (88%) but 12% had dysplastic adenomas. An anastomosis was made in 67% of cases, others (33%) got a permanent stoma. Reoperation rate within 30 days was 12%. Thirty day and 1 year mortality were 0.7% and 6.2% respectively. Average follow up time was 56 months (1-98). Local recurrence rate was 7,1%, five year survival rate was 77%. Conclusion: The surgical treatment for rectal cancer in Landspitali is up to international standard. Perioperative and long-term outcomes are similar to what other authors have reported.
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http://www.laeknabladid.is/tolublod/2017/12/nr/6565
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ae974a485f413a2113503eed53cd6c53
10.17992/lbl.2017.12.163
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Icelandic Journal Articles (Peer Reviewed)

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