\u00d6zefagus yiyecek ve i\u00e7ecekleri bo\u011fazdan mideye ta\u015f\u0131yan i\u00e7i bo\u015f t\u00fcp \u015feklinde bir organd\u0131r. \u00d6zefagus a\u011f\u0131z bo\u015flu\u011funun sonundan ba\u015flayarak g\u00f6\u011f\u00fcs kafesi i\u00e7inde soluk borusunun arkas\u0131nda devam eder ve kar\u0131nda mide ba\u015flang\u0131c\u0131nda diyafram d\u00fczeyinde sonlan\u0131r. Ki\u015fi yuttu\u011fu zaman, \u00f6zefagus kas tabakalar\u0131 kas\u0131larak yiyecekleri mide i\u00e7ine do\u011fru iter. Eri\u015fkinlerde \u00f6zefagus yakla\u015f\u0131k 25 cm kadard\u0131r. Yemek borusu kanseri y\u00f6resel beslenme al\u0131\u015fkanl\u0131klar\u0131na g\u00f6re co\u011frafi da\u011f\u0131l\u0131m fark\u0131 en y\u00fcksek olan kanserlerden birisidir. \u0130\u00e7inde \u00fclkemizin \u00f6zellikle do\u011fu ve g\u00fcneydo\u011fu Anadolu b\u00f6lgesinin de yer ald\u0131\u011f\u0131 orta do\u011fuda ve uzak do\u011fuda y\u00fcksek s\u0131kl\u0131klar bildirilmektedir. Mikroskopik incelemelerde iki de\u011fi\u015fik tipi bulunmaktad\u0131r (Skuam\u00f6z [yass\u0131 h\u00fccreli] kanser ve adenokanser ). \u00c7in, Japonya ve Afrika\u2019n\u0131n g\u00fcneyinde g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131 170\/100.000 iken Asya\u2019n\u0131n do\u011fusunda bu oran 500\/100.000\u2019lere ula\u015fmaktad\u0131r. Bu toplumlarda skuam\u00f6z h\u00fccreli kanser g\u00f6r\u00fcl\u00fcrken, geli\u015fmi\u015f \u00fclkelerde adenokanser daha fazla g\u00f6r\u00fclmektedir. ABD ve Avrupa \u00fclkelerinde oran 21\/100.000\u2019dir. \u00dclkemizde de \u00f6zefagus kanserine do\u011fu illerinde daha fazla rastlanmaktad\u0131r.<\/p>\n
<\/p>\n
\u00d6zefagus kanserlerinde genetik yatk\u0131nl\u0131ktan \u00e7ok \u00e7evresel fakt\u00f6rler ve beslenme al\u0131\u015fkanl\u0131\u011f\u0131 sorumludur. Besinlerin uygun hijyenik ortamda saklanmamas\u0131, uzun s\u00fcrede t\u00fcketilmesi, uygunsuz katk\u0131 maddeleri, t\u00fcts\u00fclenmi\u015f et, \u00e7i\u011f g\u0131dalar ve konserve besinlerdeki nitrozaminler kansere zemin haz\u0131rlar. A\u011f\u0131z sa\u011fl\u0131\u011f\u0131 bozuk olanlarda besinlerin az \u00e7i\u011fnenmesi, \u00e7ok s\u0131cak i\u00e7ecekler, mineral eksiklikleri (\u00e7inko vb.), t\u00fct\u00fcn ve sigara kullan\u0131m\u0131, radyasyona maruz kalma di\u011fer etkenlerdir.<\/p>\n
<\/p>\n
\u2022 Ya\u015f: \u00d6zefagus kanserlerine orta ya\u015f ve ileri ya\u015flarda daha s\u0131kl\u0131kla rastlan\u0131r. \u00d6zellikle 60 ya\u015f\u0131n \u00fczerindeki ki\u015filer daha fazla risk alt\u0131ndad\u0131r.<\/p>\n
\u2022 Cinsiyet: Erkeklerde kad\u0131nlardan daha fazla g\u00f6r\u00fclmektedir.<\/p>\n
\u2022 T\u00fct\u00fcn kullan\u0131m\u0131: \u00d6zefagus kanseri olu\u015fmas\u0131n\u0131n en \u00f6nemli risk fakt\u00f6rlerindendir.<\/p>\n
\u2022 Alkol kullan\u0131m\u0131: Kronik veya a\u015f\u0131r\u0131 alkol kullan\u0131m\u0131 di\u011fer \u00f6nemli bir risk fakt\u00f6r\u00fcd\u00fcr.<\/p>\n
\u2022 Barrett \u00f6zefagusu: Mide asidine uzun s\u00fcreli maruz kalan ki\u015filerde \u00f6zefagus alt u\u00e7ta birtak\u0131m kronik de\u011fi\u015fiklikler geli\u015fmektedir. Gastro\u00f6zefagial refl\u00fc denilen bu hastal\u0131kta mide asidi \u00f6zefagus i\u00e7ine gider ve \u00f6zefagus alt k\u0131s\u0131mdaki dokularda tahribata yol a\u00e7ar. \u00d6zefagusta tahri\u015f olan bu k\u0131s\u0131mdaki h\u00fccrelerin yerini mide mukoza h\u00fccreleri al\u0131r. Barrett \u00f6zefagusu olarak bilinen bu durum y\u0131llar i\u00e7inde \u00f6zefagus adenokanserlerine yol a\u00e7abilmektedir. Haz\u0131ms\u0131zl\u0131k ve refl\u00fc yak\u0131nman\u0131z varsa mutlaka sa\u011fl\u0131k kurulu\u015flar\u0131na muayeneye gidiniz.<\/p>\n
\u2022 Di\u011fer irritasyon tipleri: Skuam\u00f6z kansere zemin haz\u0131rlayan di\u011fer fakt\u00f6rler \u00f6zefagusun alt ucunda g\u00f6r\u00fclen, bir yutma bozuklu\u011fu olan ve tedavi edilmeyen akalazya hastal\u0131\u011f\u0131, insan papilloma vir\u00fcs\u00fc (HPV) enfeksiyonuna ve \u00f6zefagus darl\u0131klar\u0131d\u0131r.<\/p>\n
\u2022 Evlerde \u00f6zellikle dikkat edilmesi gereken \u00e7ama\u015f\u0131r suyu gibi kostik kimyasal maddelerin farkl\u0131 \u015fi\u015felere konulmas\u0131 sonucu \u00e7ocuklar yanl\u0131\u015fl\u0131kla yak\u0131c\u0131 s\u0131v\u0131lar\u0131 i\u00e7mektedir. Bunun sonucunda \u00f6zefagusta darl\u0131klar olu\u015fmakta ve ileride kanser geli\u015febilmektedir. Bunun yan\u0131 s\u0131ra uzun s\u00fcreli s\u0131cak i\u00e7ecek i\u00e7en ki\u015filerde risk daha fazlad\u0131r. Buna uygun olarak \u00fclkemizde \u00e7ok s\u0131cak \u00e7ay i\u00e7iminin yayg\u0131n oldu\u011fu Van ve Erzurum y\u00f6relerinde \u00f6zefagus kanseri insidans\u0131 daha y\u00fcksektir.<\/p>\n
\u2022 Kanser hikayesi: Ba\u015f boyun b\u00f6lgesinin di\u011fer kanserleri bulunan hastalarda \u00f6zefagus kanseri dahil ba\u015f boyun b\u00f6lgesinde ikincil bir kanser meydana gelmesi olas\u0131l\u0131\u011f\u0131 artm\u0131\u015ft\u0131r.<\/p>\n
<\/p>\n
\u00d6zefagus kanserlerinde korunmaya y\u00f6nelik en \u00f6nemli etkenler \u00e7evresel fakt\u00f6rlerdir. Ayr\u0131ca t\u00fct\u00fcn ve t\u00fct\u00fcn \u00fcr\u00fcnlerinden uzak durum, alkol\u00fc s\u0131n\u0131rl\u0131 t\u00fcketiniz. \u00c7ok s\u0131cak i\u00e7ecekler t\u00fcketmeyiniz. T\u00fcts\u00fclenmi\u015f g\u0131da ve konserve g\u0131dalar\u0131 \u00e7ok bilin\u00e7li t\u00fcketiniz. Pi\u015fmemi\u015f yani \u00e7i\u011f sebze ve meyvelerin al\u0131m\u0131n\u0131n art\u0131r\u0131lmas\u0131 \u00f6zefagus kanseri olas\u0131l\u0131\u011f\u0131n\u0131 azaltmaktad\u0131r. A\u011f\u0131z sa\u011fl\u0131\u011f\u0131n\u0131za dikkat ediniz. \u00d6zellikle \u00e7ocuklar\u0131 \u00f6zefagusu yak\u0131p tahri\u015f edebilecek \u00e7ama\u015f\u0131r suyu gibi s\u0131v\u0131lardan uzak tutunuz. Refl\u00fc hastal\u0131\u011f\u0131 tedavinizi ve mide \u015fikayetlerinizi mutlaka ciddiye al\u0131n\u0131z.<\/p>\n
<\/p>\n
Genellikle en s\u0131k rastlanan klinik belirtiler; kilo kayb\u0131, yutma g\u00fc\u00e7l\u00fc\u011f\u00fc ve yemek yerken tak\u0131lma hissidir. Sa\u011fl\u0131k kurulu\u015flar\u0131na ba\u015fvurmadan yakla\u015f\u0131k 6 ay \u00f6nce ba\u015flayan yemek yerken a\u011fr\u0131l\u0131 bir yutma ve tak\u0131lma hissi olu\u015fur. Kar\u0131nda \u00fcst b\u00f6lgede yemeklerin geriye ka\u00e7ma duygusu ve a\u011fr\u0131 \u015fikayeti olur. A\u011fr\u0131 s\u0131rtta k\u00fcrek kemikleri aras\u0131nda veya g\u00f6\u011f\u00fcs kemi\u011finin arkas\u0131nda olup bo\u011faza do\u011fru vurabilir. Kilo kayb\u0131 \u00e7ok belirgin olabilir. Bazen de boyunda lenf bezleri ele gelebilir. Kemik a\u011fr\u0131lar\u0131, halsizlik, kuru \u00f6ks\u00fcr\u00fck ve ses k\u0131s\u0131kl\u0131\u011f\u0131 daha az s\u0131kl\u0131kla g\u00f6r\u00fclen di\u011fer belirtilerdir.<\/p>\n
<\/p>\n
Endoskopi denilen optik \u0131\u015f\u0131kl\u0131 kameralarla \u00f6zefagus incelenir ve patolojik tan\u0131 i\u00e7in par\u00e7a (biyopsi) al\u0131n\u0131r. \u00d6zefagusun i\u00e7inden etraf dokulara yap\u0131\u015f\u0131kl\u0131k ara\u015ft\u0131rmas\u0131 i\u00e7in endosonografi denilen ultrason tetkiki yap\u0131l\u0131r. Hastaya bilgisayarl\u0131 tomografi (BT), magnetik rezonans (MR), pozitron emisyon tomografisi (PET) denilen ileri g\u00f6r\u00fcnt\u00fcleme tetkikleri gerekirse istenir. Baz\u0131 kanserlerde oldu\u011fu gibi kanda bak\u0131lan t\u00fcm\u00f6r belirleyicileri ve tarama programlar\u0131 yoktur.<\/p>\n
<\/p>\n
<\/p>\n
\u2022 Evre I: Kanser h\u00fccreleri, yaln\u0131zca \u00f6zefagus i\u00e7 k\u0131sm\u0131n\u0131n en \u00fcst tabakas\u0131nda bulunur<\/strong><\/p>\n \u2022 Evre II: Kanser, \u00f6zefagusun derin tabakalar\u0131n\u0131 tutar veya kom\u015fu lenf nodlar\u0131na yay\u0131lma vard\u0131r.<\/strong><\/p>\n \u2022 Evre III: Kanser, \u00f6zefagus duvar\u0131n\u0131n derin k\u0131s\u0131mlar\u0131n\u0131 istila etmi\u015ftir veya \u00f6zefagus yan\u0131ndaki lenf nodlar\u0131 veya dokulara yay\u0131lma g\u00f6stermi\u015ftir. V\u00fccudun di\u011fer k\u0131s\u0131mlar\u0131na yay\u0131lma yoktur.<\/strong><\/p>\n \u2022 Evre IV: Kanser v\u00fccudun di\u011fer k\u0131s\u0131mlar\u0131na yay\u0131lm\u0131\u015ft\u0131r. \u00d6zefagus kanseri, karaci\u011fer, akci\u011ferler, beyin ve kemikler dahil v\u00fccudun herhangi bir yerine yay\u0131labilmektedir.<\/strong><\/p>\n <\/p>\n \u00d6zefagus Kanserinde Tedavi <\/strong><\/p>\n Tedavi hastan\u0131n genel durumuna, t\u00fcm\u00f6r\u00fcn yayg\u0131nl\u0131\u011f\u0131na, yerle\u015fimine ve b\u00fcy\u00fckl\u00fc\u011f\u00fcne ba\u011fl\u0131d\u0131r. Hastalar s\u0131kl\u0131kla sindirim sistemi cerrah\u0131, medikal ve radyasyon onkolo\u011fu gibi uzmanla\u015fm\u0131\u015f bir grup taraf\u0131ndan tedavi edilirler.<\/p>\n <\/p>\n Hastada t\u00fcm\u00f6r yayg\u0131n evrede de\u011filse ve ba\u015fka organlara s\u0131\u00e7ramalar yoksa ilk tedavi cerrahi ile t\u00fcm\u00f6rl\u00fc \u00f6zefagusun \u00e7\u0131kar\u0131lmas\u0131d\u0131r. Erken d\u00f6nemde te\u015fhis edilen hastalarda \u00fclkemizde \u00e7ok ba\u015far\u0131l\u0131 sonu\u00e7lar al\u0131nmaktad\u0131r. \u00d6zefagusun tamamen \u00e7\u0131kar\u0131lmas\u0131na \u00f6zefajektomi denir. Etraf lenf bezleri temizlenir. Hastan\u0131n yutmas\u0131n\u0131n sa\u011flanmas\u0131 i\u00e7in mide ile \u00f6zefagusun geri kalan k\u0131sm\u0131 birle\u015ftirilir. De\u011fi\u015fik y\u00f6ntemlerle yeniden mideden veya ba\u011f\u0131rsaklardan \u00f6zefagus yap\u0131larak operasyon tamamlan\u0131r. \u00d6zofagus t\u00fcm\u00f6rlerinde temel tedavi y\u00f6ntemi cerrahidir ancak ameliyat mortalitesi nispeten y\u00fcksektir ve t\u00fcm\u00f6r\u00fcn \u00e7\u0131kar\u0131ld\u0131\u011f\u0131 vakalarda bile lokal ve sistematik n\u00fcksler nedeniyle 5 y\u0131l sa\u011fkal\u0131m %20 dolay\u0131ndad\u0131r.<\/p>\n <\/p>\n Kanser h\u00fccrelerini \u00f6ld\u00fcrmek i\u00e7in y\u00fcksek enerjili \u0131\u015f\u0131nlar\u0131n kullan\u0131lmas\u0131n\u0131 i\u00e7ermektedir. Radyasyon tedavisi, yanl\u0131zca tedavi edilen alandaki h\u00fccreleri etkiler. Cerrahi \u00f6ncesinde t\u00fcm\u00f6r\u00fc k\u00fc\u00e7\u00fcltmek i\u00e7in kemoterapi ile radyoterapi kombine edilebilir. Baz\u0131 durumlarda ameliyat sonras\u0131 n\u00fcksleri engellemek amac\u0131 ile radyoterapi verilebilir. E\u011fer t\u00fcm\u00f6r cerrahi olarak \u00e7\u0131kar\u0131lam\u0131yor ise daha kolay yutmay\u0131 sa\u011flamak ve a\u011fr\u0131y\u0131 azaltmak i\u00e7in radyoterapi s\u0131kl\u0131kla kullan\u0131lmaktad\u0131r.<\/p>\n <\/p>\n Kanser h\u00fccrelerini \u00f6ld\u00fcrmek i\u00e7in antikanser ila\u00e7lar\u0131n kullan\u0131lmas\u0131d\u0131r. \u00d6zefagus kanserlerinde ameliyat \u00f6ncesi veya sonras\u0131 hastalar\u0131n genel durumlar\u0131 dikkate al\u0131narak kemoterapi denilen ila\u00e7 tedavisi uygulanabilir. Kemoterapi, cerrahi \u00f6ncesinde t\u00fcm\u00f6r\u00fc k\u00fc\u00e7\u00fcltmek i\u00e7in veya cerrahinin yerine primer tedavi olarak radyoterapi ile birlikte kullan\u0131labilir.<\/p>\n <\/p>\n \u00d6zefagus t\u0131kan\u0131kl\u0131\u011f\u0131 olan alana stent denilen geni\u015fletici \u015femsiye uygulamas\u0131 yap\u0131larak besinlerin ge\u00e7mesi sa\u011flan\u0131r, bazen mideye gastrostomi denilen hortumlar yerle\u015ftirilerek d\u0131\u015far\u0131dan beslenme sa\u011flanabilir. T\u0131kan\u0131kl\u0131\u011f\u0131n rahatlat\u0131lmas\u0131 \u00f6zellikle yutma problemlerine ba\u011fl\u0131 semptomlar\u0131 azaltmaya yard\u0131mc\u0131 olur.<\/p>\n","protected":false},"excerpt":{"rendered":" \u00d6zefagus yiyecek ve i\u00e7ecekleri bo\u011fazdan mideye ta\u015f\u0131yan i\u00e7i bo\u015f t\u00fcp \u015feklinde bir organd\u0131r. \u00d6zefagus a\u011f\u0131z bo\u015flu\u011funun sonundan ba\u015flayarak g\u00f6\u011f\u00fcs kafesi i\u00e7inde soluk borusunun arkas\u0131nda devam eder ve kar\u0131nda mide ba\u015flang\u0131c\u0131nda diyafram d\u00fczeyinde sonlan\u0131r. Ki\u015fi yuttu\u011fu zaman, \u00f6zefagus kas tabakalar\u0131 kas\u0131larak yiyecekleri mide i\u00e7ine do\u011fru iter. Eri\u015fkinlerde \u00f6zefagus yakla\u015f\u0131k 25 cm kadard\u0131r. Yemek borusu kanseri y\u00f6resel …<\/p>\n","protected":false},"author":1,"featured_media":124,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,18],"tags":[],"class_list":["post-123","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-cerrahi","category-kanser-cerrahisi"],"_links":{"self":[{"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/posts\/123","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=123"}],"version-history":[{"count":1,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/posts\/123\/revisions"}],"predecessor-version":[{"id":125,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/posts\/123\/revisions\/125"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/media\/124"}],"wp:attachment":[{"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=123"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=123"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=123"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}Cerrahi:<\/h4>\n
Radyasyon Tedavisi (Radyoterapi):<\/h4>\n
Kemoterapi:<\/h4>\n
Palyatif Tedavi Y\u00f6ntemleri:<\/h4>\n