Meme Kanseri Cerrahisi Sonrası Üst Ekstremite Sorunları ve Yeti Yitimi

Year 2024, Issue: 23, 750 - 766, 31.08.2024

Murat Can Mollaoglu , Mukadder Mollaoğlu , Esra Başer Akın , Kürşat Karadayı

https://doi.org/10.38079/igusabder.1442184

Abstract

Amaç: Bu çalışmanın amacı meme cerrahisi sonrası hastaların üst ekstremite sorunları, lenfödem ve yeti yitimlerinin incelenmesidir.
Yöntem: Tanımlayıcı ve kesitsel nitelikte olan araştırma 74 hasta üzerinde yapılmıştır. Araştırma verileri Hasta Tanıtım Formu, kısa Yeti Yitimi Anketi, Omuz Ağrı ve Özürlülük İndeksi (OAÖİ), Quick Disabilities of the Arm, Shoulder and Hand (Quick DASH) Anketi ile toplanmıştır. Lenfödem varlığı koldan ölçüm yapılarak değerlendirilmiştir. Verilerin değerlendirmesi SPSS paket programında yapılmıştır.
Bulgular: Hastaların üst ekstremite sorunları incelendiğinde %31’inde omuz ağrısı, %28,3’ünde omuzda kısıtlılık, %22,9’unda kolda güçsüzlük, %21,6’sında lenfödem ve %14,8’inde kolda uyuşma olduğu saptanmıştır. Omuz ağrı puan ortalaması 24,43±10,88, özürlülük indeksi puanı 31,53±17,52; OAÖİ ortalamasının 55,96±26,17 ve Quick DASH puan ortalaması 52,19±23,08 olarak bulunmuştur. Hastaların %18,9’unda ağır yeti yitimi, %41,9’unda orta ağırlıkta yeti yitimi olduğu belirlenmiştir. Yeti yitimi ölçeği, Quick DASH ve OAÖİ ölçek toplam puanları arasında pozitif yönlü istatistiksel anlamlı korelasyon bulunmuştur (p<0.05).
Sonuç: Sonuç olarak, meme cerrahisi geçiren hastalarda omuz ağrısı, omuzda kısıtlılık, kolda güçsüzlük, uyuşma ve lenfödem gibi morbiditelerin geliştiği belirlenmiştir. Hastalarda üst ekstremite sorunlarına bağlı orta düzeyde omuz ağrısı ve özürlülük olduğu saptanmıştır. Gelişen bu üst ekstremite sorunları aynı zamanda hastaların büyük çoğunluğunda yeti yitimine neden olmuştur. Bu sonuçlar doğrultusunda cerrahi ekibin meme cerrahisi sonrası hastalarda üst ekstremite sorunlarını rutin olarak izlemeleri ve gerekli önleyici uygulamaları yapmalarının önemi ve gereği açıktır.

Keywords

Meme kanseri, cerrahi, üst ekstremite, omuz, lenfödem

Upper Extremity Problems and Disability After Breast Cancer Surgery

Abstract

Aim: The aim of this study is to examine the upper extremity problems, lymphedema and disability of patients after breast surgery.
Method: The descriptive and cross-sectional study was conducted with 74 patients. The research data were collected with the Patient Information Form, Brief Disability Questionnaire (BDQ), Shoulder Pain-Disability Index (SPDI), Quick Disabilities of the Arm, Shoulder and Hand (Quick DASH) Questionnaire. The presence of lymphedema was evaluated by arm measurement. Data were evaluated using the SPSS package program.
Results: When the upper extremity problems of the patients were analyzed, it was found that 31% had shoulder pain, 28.3% had shoulder restriction, 22.9% had arm weakness, 21.6% had lymphedema and 14.8% had numbness in the arm. The mean shoulder pain score was 24.43±10.88; the mean disability index score was 31,53±17,52; the mean SPDI score was 55.96±26.17 and the mean Quick DASH score was 52.19±23.08. It was determined that 18.9% of the patients had a severe disability and 41.9% had a moderate disability. A statistically significant positive correlation was found between the total scores of the disability questionaire, Quick DASH and SPDI (p<0.05).
Conclusion: As a result, it was determined that morbidities such as shoulder pain, shoulder limitation, arm weakness, numbness and lymphedema developed in patients who underwent breast surgery. It was determined that the patients had moderate shoulder pain and disability due to upper extremity problems. These developing upper extremity problems also caused disability in the majority of patients. In line with these results, it is clear that the surgical team should routinely monitor upper extremity problems in patients after breast surgery and make the necessary preventive practices.

Keywords

Breast cancer, surgery, upper extremity, shoulder, lymphedema

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