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ÖZET Amaç: Kolesistektomi ikinci basamak devlet hastaneleri Genel Cerrahi servislerinde en sık uygulanan ameliyatların başında gelmektedir. Kolesistektomi spesimenlerinin histopatolojik değerlendirilmesi literatürde yaygın olarak ele alınmıştır. Ancak morfolojik değerlendirme oldukça kısıtlıdır. Bu çalışma ile semptomatik benign hastalıklar nedeniyle kolesistektomi yapılan hastaların kolesistektomi spesimenlerinin mikroskobik ve makroskopik özelliklerinin yanı sıra morfolojik özelliklerinin de değerlendirilmesi amaçlandı. Gereç ve Yöntem: Yozgat Şehir Hastanesinde Ocak 2014 ve Mart 2019 tarihleri arasında Genel Cerrahi Servisinde gerçekleştirilen toplam 961 kolesistektomi spesimeni geriye dönük incelendi. Çalışma hastane elektronik verilerinden hasta bilgilerine ulaşılarak geriye dönük gerçekleştirildi. Hastaların yaş, cinsiyet, uygulanan ameliyatın şekli, histopatolojik tanı, safra taşının olup olmadığı, kolesistektomi spesimenin uzunluğu, genişliği ve en kalın duvar ölçüleri değerlendirmeye alındı. Bulgular: Toplam 961 hastanın 734’ü (%76,4) kadın, 227’si (%23,6) erkeklerden oluşmaktaydı. Ameliyatların 900 tanesi laparoskopik olarak (%93,7) gerçekleştirildi. Safra kesesi genişliği açısından her iki cinsiyet arasında anlamlı fark saptanmazken (p=0,23), safra kesesi uzunluğu (p=0,04), safra kesesi duvar kalınlığının (p=0,001) erkeklerde fazla olduğu saptandı. Kronik kolesistit kadınlarda, subakut ve akut kolesistit erkeklerde daha sık görüldü (p=0,001). Kolelitiazis ve kolesterol oranlarına cinsiyetin etkisi saptanmadı (p=0,63). Spesimenlerin % 14,4’de makroskopik bulgular hakkında raporlama yoktu. Toplam üç spesimende malignite ve üç spesimende neoplastik polip saptandı. Sonuç: İnsidental safra kesesi karsinomu ikinci basamak hastanelerde daha sık karşılaşılmaktadır. Bu yüzden bu tür hastanelerde rutin olarak kolesistektomi spesimenleri histopatolojik değerlendirmeye gönderilmelidir. Gönderilen spesimenlerinde daha sağlıklı mikroskobik, makroskopik ve morfolojik özelliklerinin değerlendirilmesi için standardize edilmiş patoloji raporlamasına ihtiyaç vardır. Anahtar Kelimeler: Kolesistektomi İnsidental kanser Histopatoloji inceleme Safra kesesi morfolojisi. ABSTRACT Aim: The cholecystectomy is one of the most common operations performed in the general surgery department of secondary level hospitals. Histopathological evaluation of cholecystectomy specimens has been widely discussed in the literature. However, morphological evaluation is very limited. The aim of this study is to evaluate the morphological features besides the microscopic and macroscopic features of specimens performed cholecystectomy because of symptomatic benign diseases. Material and Methods: A total of 961 cholecystectomy specimens were examined from January 2014 and to 2019 in the General Surgery Department at Yozgat City Hospital. The study was conducted retrospectively by accessing patient information from the hospital electronic data. Age, sex, type of surgery, histopathological diagnosis, presence of gallstones, length, width and thickest wall measurements of cholecystectomy specimens were evaluated. Results: Of the total 961 patients, 734 (76.4%) were female and 227 (23.6%) were male. 900 of them were performed laparoscopically (93.7%). There was no significant difference between the two genders in terms of gallbladder width (p = 0.23), but gallbladder length (p = 0.04) and gallbladder wall thickness (p = 0.001) were higher in males. Chronic cholecystitis was more common in women and subacute and acute cholecystitis in men (p = 0.001). There was no effect of gender on cholelithiasis and cholesterol ratio (p = 0.63). There were no reports on macroscopic findings in 14.4% of specimens. Malignancy was detected in three specimens and neoplastic polyp was detected in three specimens. Conclusions: Incidental gallbladder carcinoma is more common in secondary level hospitals. Therefore, cholecystectomy specimens should be routinely sent for histopathological evaluation, especially in such hospitals. A standardized reporting is needed to evaluate the properly microscopic, macroscopic and morphological characteristics of the specimens. Key words: Cholecystectomy Incidental cancer Histopathology examination Gallbladder morphology.
Colesistektomy is the second stage of the public hospitals in the General Surgery Services. The histopathological assessment of cholestectomy specimens has been widely discussed in literature. Morphological assessment is very limited. This study aimed at evaluating the microscopic and macroscopic characteristics of cholecystectomy spots of patients with symptomatic benign diseases as well as the morphological characteristics. In the Yozgat City Hospital between January 2014 and March 2019, a total of 961 cholesystectomy sperms performed in the General Surgery Service were re-examined. The study was carried out backward by accessing the patient’s information from the hospital’s electronic data. The patient’s age, gender, the form of the surgery, the histopathological diagnosis, whether there is a yellow stone, the length of the cholesystectomy specimen, the width, the wall measurements of the vessel were taken to be assessed. Results: A total of 961 patients consisted of 734 (76.4%) women and 227 (23.6%) men. 900 of the operations were performed laparoscopically (93.7 percent). There was no significant difference between the two sexes (p=0.23) and the length of the yellow cut (p=0.04), while the thickness of the yellow cut (p=0,001) was found to be greater in men. Chronic cholecystitis was more common in women, subacute and acute cholecystitis in men (p=0,001). The effect of gender on cholelithiasis and cholesterol levels has not been determined (p=0.63). 14.4 percent of the specimens did not report macroscopic findings. In total, malignity was detected in three sperm and neoplastic polyps in three sperm. The result: Human-idental gallbladder carcinoma is more common in second-stage hospitals. Therefore, in these types of hospitals, cholesystectomic specimens should be submitted to histopathological assessment. Standardized pathology reporting is needed to evaluate healthier microscopic, macroscopic and morphological properties in the sent specimens. Keywords: cholesystectomy; human-idental cancer; histopathology examination; gland morphology. The cholecystectomy is one of the most common operations performed in the general surgery department of secondary level hospitals. Histopathological evaluation of cholecystectomy specimens has been widely discussed in the literature. However, morphological evaluation is very limited. The aim of this study is to evaluate the morphological features besides the microscopic and macroscopic features of specimens performed cholecystectomy because of symptomatic benign diseases. Material and Methods: A total of 961 cholecystectomy specimens were examined from January 2014 and to 2019 in the General Surgery Department at Yozgat City Hospital. The study was conducted retrospectively by accessing patient information from the hospital electronic data. Age, sex, type of surgery, histopathological diagnosis, presence of gallstones, length, width and thickest wall measurements of cholecystectomy specimens were evaluated. Results: Of the total 961 patients, 734 (76.4%) were female and 227 (23.6%) were male. 900 of them were performed laparoscopically (93.7%). There was no significant difference between the two genders in terms of gallbladder width (p = 0.23), but gallbladder length (p = 0.04) and gallbladder wall thickness (p = 0.001) were higher in males. Chronic cholecystitis was more common in women and subacute and acute cholecystitis in men (p = 0.001). There was no effect of gender on cholelithiasis and cholesterol ratio (p = 0.63). There were no reports on macroscopic findings in 14.4% of specimens. Malignancy was detected in three specimens and neoplastic polyp was detected in three specimens. Incidental gallbladder carcinoma is more common in secondary level hospitals. Therefore, cholecystectomy specimens should be routinely sent for histopathological evaluation, especially in such hospitals. A standardized reporting is needed to evaluate the properly microscopic, macroscopic and morphological characteristics of the specimens. Key words: Cholecystectomy; Incidental cancer; Histopathology examination; Gallbladder morphology.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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