Dekompresif Kraniyektomide Erken Komplikasyonlara Genel Bakış

Öz

Amaç: Bu çalışmanın amacı dikişsiz duraplasti hastalarında ters soru işareti kesisi sonrası komplikasyon görülme sıklığı ve ortaya çıkma zamanı ile ameliyat sonrası morbidite ve mortalite oranlarının araştırılmasıdır. Gereç ve Yöntemler: 2019 ve 2023 yılları arasında farklı supratentoryal endikasyonlarla başvuran ve dekompresif kranyektomi ve dikişsiz duraplasti uygulanan 24 hasta geriye dönük olarak bu çalışmaya dahil edildi. Hastaların yaşı, cinsiyeti, başvuru sırasındaki etiyolojik nedeni ve ameliyat öncesi Glasgow koma skoru kaydedildi. Komplikasyonların türleri, oluşma zamanları, birbirleriyle ilişkileri ve yapılan işlemler kaydedildi. Bulgular: Bir aylık takipte komplikasyona kadar geçen medyan süre 7 (aralık, 1-28) gündü. Hastaların 15'inde (%62,5) toplam 18 komplikasyon görüldü. Komplikasyon gelişen 15 hastanın 7'si (%46,7) bir aylık takip süresi içinde hayatını kaybederken, komplikasyon gelişmeyen 9 hastanın 7'si (%77,8) hayatını kaybetti. Komplikasyon gelişmeyen hastalarda mortalite oranı daha yüksek olmasına rağmen komplikasyon gelişen ve gelişmeyen hastalar arasında istatistiksel olarak anlamlı fark yoktu (p=0,210). İlk ay sağkalım oranı, komplikasyon gelişen hastalarda %53,3 ve gelişmeyen hastalarda %22,2, ortanca sağkalım süresi komplikasyon gelişen hastalarda 5 gün, komplikasyon gelişmeyen hastalarda ise 8 gün idi (p=0,214). Sonuç: Mortalite ve morbidite oranları yüksek olan dekompresif kranyektomi sonrası ilk bir ay içerisinde komplikasyonların birbirine neden olabilmesi ve aynı zamanda ciddi ekonomik ve iş gücü kaybına yol açması nedeniyle komplikasyonların başlangıç zamanı ve yönetimi oldukça önemlidir.

Anahtar Kelimeler

• Dekompresif kranyektomi
• komplikasyon
• erken dönem

Overview of Early Complications in Decompressive Craniectomy

Abstract

Aim: The aim of this study was to investigate the prevalence and time of occurrence of complications in patients with seamless duraplasty after reverse question mark incision, and the morbidity and mortality rates after surgery. Material and Methods: Twenty-four patients admitted with different supratentorial indications and underwent decompressive craniectomy and seamless duraplasty between 2019 and 2023, were retrospectively included in this study. The patient's age, gender, etiological reason at admission, and Glasgow coma score before surgery were recorded. The types of complications, their time of occurrence, their relationships with each other, and the procedures performed were recorded. Results: The median time for complications during one-month follow-up was 7 (range, 1-28) days. A total of 18 complications were observed in 15 (62.5%) patients. While 7 (46.7%) of 15 patients with complications died within one month of follow-up, 7 (77.8%) of 9 patients without complications died. Although the mortality rate was higher in patients without complications, there was no statistically significant difference between patients with and without complications (p=0.210). The survival rate in the first month was 53.3% in patients with complications and 22.2% in patients without, and the median survival time was 5 days in patients with complications and 8 days in patients without complications (p=0.214). Conclusion: The onset time and management of the complications is crucial during the first month after decompressive craniectomy which has high mortality and morbidity rates, since the complications can lead to each other, and also these complications can cause serious economic and labor loss.

Keywords

• Decompressive craniectomy
• complication
• early period

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