Üst lobektomiler sonrasında inferior pulmoner ligamentin diseksiyonun apikal ölü boşluğun obliterasyonundaki yeri; retrospektif çalışma
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Date
2015
Authors
Çolak, Mehmet Ali
Journal Title
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Publisher
Uludağ Üniversitesi
Abstract
Giriş ve amaç: Üst lobektomisonrası yapılan pulmoner ligament diseksiyonunun postoperatif akciğer ekspansiyonu ve space üzerine olan etkisini göstermeyi amaçladık. Materyal ve metod: Kliniğimizde 23 Ocak 2011-26 Şubat 2013 tarihleri arasında üst lobektomi yapılan tüm hastalar retrospektif olarak inceledik. Her iki grupta 20 hasta, toplamda 40 hasta olacak şekilde inferior pulmoner ligament diseksiyonu yapılan ve yapılmayan hastalardaniki grup oluşturduk. Postoperatif çekilen akciğer grafisinde %20 den veya üç cm fazla olan hava boşluklarını space, postoperatif beşinci günden fazla devam eden hava kaçağını ise uzamış hava kaçağı olarak kabul ettik.Hastaların gelişen komplikasyonları, negatif aspirasyon ihtiyacı, ilave tüp torakostomi, dren çekilme zamanı, hastanede kalış süresini kaydettik. Her bir hastanın postoperatif birinci, üçüncü, beşinci, yedinci, 30., ve 90. gün çekilen akciğer grafilerini inceledik ve pnömotoraks yüzdelerini hesapladık. Tüm verileri Statistical Packageforthe Social Sciences (SPSS-22.0) istatistik paket programı kullanılarak karşılaştırdık. Bulgular: Çalışmaya dahil edilen hastaların %40'ında (n=16) postoperatif komplikasyon saptandı [grup 1 (n=9), grup 2 (n=7)]. En sık görülen komplikasyon 8 (%20) hasta ile uzamış hava kaçağı ve space idi. Yedi hastaya ilave tüp torakostomi uygulandı [grup 1 (n=3), grup 2 (n=4). Hastaların tamamında üçüncü ay akciğer grafilerinde akciğerin tam ekspanse olduğu görüldü. Komplikasyon sıklığı, space varlığı ve pnömotoraksdeğişim değerleri karşılaştırıldığında iki grup arasında istatistiksel olarak anlamlı farklılık saptanmadı. Sonuç: Çalışmamız sonucunda inferior pulmoner ligament diseksiyonunun olumlu ya da olumsuz sonuçlarını gösteren ikna edici kanıta ulaşılamamıştır. Geleneksel olarak uygulanan inferior pulmoner ligament diseksiyonun anlamlığını gösterebilmek için daha çok hasta sayısı içeren çok merkezli çalışmalara ihtiyaç vardır.
Introduction and objective: We aimed to evaluate the effects of pulmonary ligament dissection following upper lobectomy on postoperative lung expansion and space. Material and method: We retrospectively assessed the patients who underwent upper lobectomy surgery between 23 January 2011 and 26 February 2013 in our clinic. We organized two groups of 20 patients due to undergoing inferior pulmonary ligament dissection or not undergoing this procedure, totally 40 patients were evaluated. If more than %20 or 3 cm space occurred in postoperative chest radiogram, we defined it as 'space'. If the air leak had still persisted after postoperative 5th day, we accepted it as prolonged air leak. Postoperative complications, requirement of negative aspiration, additional tube thoracostomy, drain removal time and hospitalization time was recorded. Chest radiograms of each patient were inspected on postoperative 1st, 3rd, 5th, 7th, 30th and 90th days and percentage of pneumothorax was calculated. All data has been compared with the use of Statistical Package for the Social Sciences (SPSS 22.0) pack programme. Results: %40 (n=16) of included patients had postoperative complications (group1:9, group 2: 7). The most frequent complication was prolonged air leak and space which was observed in 8 (%20) of patients. 7 patients underwent additional tube thoracostomy (group 1=3 and group 2=4). All of the patients had full pulmonary expansion at postoperative 3rd month. Complication frequency, presence of space and pneumothorax resolution time of two groups were compared and no statistically significant difference was observed. Conclusion: We could not obtain convincing evidence that indicates the favorable or unfavorable effects of inferior pulmonary ligament dissection as a result of our study. Multicenter studies that evaluate more cases are needed to assess the significance of inferior pulmonary ligament dissection.
Introduction and objective: We aimed to evaluate the effects of pulmonary ligament dissection following upper lobectomy on postoperative lung expansion and space. Material and method: We retrospectively assessed the patients who underwent upper lobectomy surgery between 23 January 2011 and 26 February 2013 in our clinic. We organized two groups of 20 patients due to undergoing inferior pulmonary ligament dissection or not undergoing this procedure, totally 40 patients were evaluated. If more than %20 or 3 cm space occurred in postoperative chest radiogram, we defined it as 'space'. If the air leak had still persisted after postoperative 5th day, we accepted it as prolonged air leak. Postoperative complications, requirement of negative aspiration, additional tube thoracostomy, drain removal time and hospitalization time was recorded. Chest radiograms of each patient were inspected on postoperative 1st, 3rd, 5th, 7th, 30th and 90th days and percentage of pneumothorax was calculated. All data has been compared with the use of Statistical Package for the Social Sciences (SPSS 22.0) pack programme. Results: %40 (n=16) of included patients had postoperative complications (group1:9, group 2: 7). The most frequent complication was prolonged air leak and space which was observed in 8 (%20) of patients. 7 patients underwent additional tube thoracostomy (group 1=3 and group 2=4). All of the patients had full pulmonary expansion at postoperative 3rd month. Complication frequency, presence of space and pneumothorax resolution time of two groups were compared and no statistically significant difference was observed. Conclusion: We could not obtain convincing evidence that indicates the favorable or unfavorable effects of inferior pulmonary ligament dissection as a result of our study. Multicenter studies that evaluate more cases are needed to assess the significance of inferior pulmonary ligament dissection.
Description
Keywords
Üst lobektomi, Postoperatif komplikasyon, Inferior pulmoner ligament, Space, Apikal ölü boşluk, Upper lobectomy, Postoperative complication, Inferior pulmonary ligament
Citation
Çolak, M. A. (2015). Üst lobektomiler sonrasında inferior pulmoner ligamentin diseksiyonun apikal ölü boşluğun obliterasyonundaki yeri; retrospektif çalışma. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.