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YELKEN GÖĞÜSTE TORAKS DUVARI STABİLİZASYONU AMELİYATLARININ SAĞ KALIMA OLUMLU ETKİSİ

Year 2020, Volume: 3 Issue: 3, 117 - 123, 31.12.2020
https://doi.org/10.33713/egetbd.796878

Abstract

ÖZET
AMAÇ: künt otoraks travmaları sonrasında gelişen yelken göğüs patolojisinin cerrahi yöntemlerle tedavi edilmesinin sağ kalıma olumlu etkisini göstermek istedik.
HASTALAR VE YÖNTEM: 2010-2020 yılları arasında Alaaddin Keykubat Üniversitesi Alanya Eğitim Araştırma hastanesi göğüs cerrahisi kliniğinde takip ve tedavisi yapılan yelken göğüs vakaları retrospektif olarak incelendi. Cerrahi yöntem olarak; metal plaklarla kırık kostaların ve sternumun stabilizasyonu ile Judet Struts isimli titanyum plaklar kullannıldı.
BULGULAR: Vakaların 17 (%43,6) sına toraks duvarı stabilizasyonu ameliyatı yapıldı, 22 (%56,4) vaka ise konservatif yaklaşımlarla tedavi edilmeye çalışıldı. konservatif yaklaşımda bulunulan hastaların hem yoğun bakımda hem de serviste kalış sürelerine göre anlamlı şekilde düşüktü. Stabiliasyon ameliyatı yapılan 17 hastamızdan 1 hastamız (%5,8) mortaliteyle sonuçlanırken, konservatif yaklaşılan 22 hastadan 6(%27,2) tanesi mortalite ile sonuçlandı. Stabilizasyon ameliyatının sağ kalıma olumlu katkısı anlamlı bulundu. Pnömoni gelişen vakaların 1(%7,7) tanesi stabilasyon ameliyatı yapılan vaka iken, 12 (%92,3) tanesi konservatif yaklaşılan vakalardı. Pnömoni gelişme oranı açısından ise konservatif yaklaşılan vakalar istatistiksel olarak anlamlı oranda yüksek tespit edildi.
SONUÇ: Yelken göğüs patolojisi gelişen künt toraks travmalı vakalarda toraks stabiliasyonu ameliyatlarının akciğer kontüzyonu insidansını, pnömoni insidansını, ventilatörde ve yoğun bakımda kalma sürelerini önemli ölçüde azaltarak sağ kalıma önemli ölçüde katı sağladığını düşünüyoruz.
ANAHTAR SÖZCÜKLER: Yelken göğüs, kaburga kırığı, stabilizasyon ameliyatı

References

  • 1. Bastos R, Calhoon JH, Baisden CE, editors. Flail chest and pulmonary contusion. Seminars in thoracic and cardiovascular surgery; 2008: Elsevier.
  • 2. Dehghan N, De Mestral C, McKee MD, Schemitsch EH, Nathens A. Flail chest injuries: a review of outcomes and treatment practices from the National Trauma Data Bank. Journal of Trauma and Acute Care Surgery. 2014;76(2):462-8.
  • 3. Pettiford BL, Luketich JD, Landreneau RJ. The management of flail chest. Thoracic surgery clinics. 2007;17(1):25-33.
  • 4. Simon B, Ebert J, Bokhari F, Capella J, Emhoff T, Hayward III T, et al. Management of pulmonary contusion and flail chest: an Eastern Association for the Surgery of Trauma practice management guideline. Journal of Trauma and Acute Care Surgery. 2012;73(5):S351-S61.
  • 5. Althausen PL, Shannon S, Watts C, Thomas K, Bain MA, Coll D, et al. Early surgical stabilization of flail chest with locked plate fixation. Journal of orthopaedic trauma. 2011;25(11):641-7.
  • 6. Balci AE, Eren Ş, Çakir Ö, Eren MN. Open fixation in flail chest: review of 64 patients. Asian Cardiovascular and Thoracic Annals. 2004;12(1):11-5.
  • 7. Slobogean GP, MacPherson CA, Sun T, Pelletier M-E, Hameed SM. Surgical fixation vs nonoperative management of flail chest: a meta-analysis. Journal of the American College of Surgeons. 2013;216(2):302-11. e1.
  • 8. Marasco SF, Davies AR, Cooper J, Varma D, Bennett V, Nevill R, et al. Prospective randomized controlled trial of operative rib fixation in traumatic flail chest. Journal of the American College of Surgeons. 2013;216(5):924-32.
  • 9. Tanaka H, Yukioka T, Yamaguti Y, Shimizu S, Goto H, Matsuda H, et al. Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. Journal of Trauma and Acute Care Surgery. 2002;52(4):727-32.
  • 10. Freedland M, Wilson RF, Bender JS, Levison MA. The management of flail chest injury: factors affecting outcome. J Trauma. 1990;30(12):1460-8.
  • 11. Nirula R, Diaz JJ, Trunkey DD, Mayberry JC. Rib fracture repair: indications, technical issues, and future directions. World journal of surgery. 2009;33(1):14-22.
  • 12. Granetzny A, Abd El-Aal M, Emam E, Shalaby A, Boseila A. Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status. Interactive cardiovascular and thoracic surgery. 2005;4(6):583-7.
  • 13. Lardinois D, Krueger T, Dusmet M, Ghisletta N, Gugger M, Ris H-B. Pulmonary function testing after operative stabilisation of the chest wall for flail chest. European Journal of Cardio-Thoracic Surgery. 2001;20(3):496-501.
  • 14. Lafferty PM, Anavian J, Will RE, Cole PA. Operative treatment of chest wall injuries: indications, technique, and outcomes. JBJS. 2011;93(1):97-110.
Year 2020, Volume: 3 Issue: 3, 117 - 123, 31.12.2020
https://doi.org/10.33713/egetbd.796878

Abstract

References

  • 1. Bastos R, Calhoon JH, Baisden CE, editors. Flail chest and pulmonary contusion. Seminars in thoracic and cardiovascular surgery; 2008: Elsevier.
  • 2. Dehghan N, De Mestral C, McKee MD, Schemitsch EH, Nathens A. Flail chest injuries: a review of outcomes and treatment practices from the National Trauma Data Bank. Journal of Trauma and Acute Care Surgery. 2014;76(2):462-8.
  • 3. Pettiford BL, Luketich JD, Landreneau RJ. The management of flail chest. Thoracic surgery clinics. 2007;17(1):25-33.
  • 4. Simon B, Ebert J, Bokhari F, Capella J, Emhoff T, Hayward III T, et al. Management of pulmonary contusion and flail chest: an Eastern Association for the Surgery of Trauma practice management guideline. Journal of Trauma and Acute Care Surgery. 2012;73(5):S351-S61.
  • 5. Althausen PL, Shannon S, Watts C, Thomas K, Bain MA, Coll D, et al. Early surgical stabilization of flail chest with locked plate fixation. Journal of orthopaedic trauma. 2011;25(11):641-7.
  • 6. Balci AE, Eren Ş, Çakir Ö, Eren MN. Open fixation in flail chest: review of 64 patients. Asian Cardiovascular and Thoracic Annals. 2004;12(1):11-5.
  • 7. Slobogean GP, MacPherson CA, Sun T, Pelletier M-E, Hameed SM. Surgical fixation vs nonoperative management of flail chest: a meta-analysis. Journal of the American College of Surgeons. 2013;216(2):302-11. e1.
  • 8. Marasco SF, Davies AR, Cooper J, Varma D, Bennett V, Nevill R, et al. Prospective randomized controlled trial of operative rib fixation in traumatic flail chest. Journal of the American College of Surgeons. 2013;216(5):924-32.
  • 9. Tanaka H, Yukioka T, Yamaguti Y, Shimizu S, Goto H, Matsuda H, et al. Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. Journal of Trauma and Acute Care Surgery. 2002;52(4):727-32.
  • 10. Freedland M, Wilson RF, Bender JS, Levison MA. The management of flail chest injury: factors affecting outcome. J Trauma. 1990;30(12):1460-8.
  • 11. Nirula R, Diaz JJ, Trunkey DD, Mayberry JC. Rib fracture repair: indications, technical issues, and future directions. World journal of surgery. 2009;33(1):14-22.
  • 12. Granetzny A, Abd El-Aal M, Emam E, Shalaby A, Boseila A. Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status. Interactive cardiovascular and thoracic surgery. 2005;4(6):583-7.
  • 13. Lardinois D, Krueger T, Dusmet M, Ghisletta N, Gugger M, Ris H-B. Pulmonary function testing after operative stabilisation of the chest wall for flail chest. European Journal of Cardio-Thoracic Surgery. 2001;20(3):496-501.
  • 14. Lafferty PM, Anavian J, Will RE, Cole PA. Operative treatment of chest wall injuries: indications, technique, and outcomes. JBJS. 2011;93(1):97-110.
There are 14 citations in total.

Details

Primary Language Turkish
Subjects Surgery
Journal Section Original Investigation
Authors

Oktay Aslaner 0000-0002-2952-6677

Publication Date December 31, 2020
Acceptance Date October 16, 2020
Published in Issue Year 2020 Volume: 3 Issue: 3

Cite

EndNote Aslaner O (December 1, 2020) YELKEN GÖĞÜSTE TORAKS DUVARI STABİLİZASYONU AMELİYATLARININ SAĞ KALIMA OLUMLU ETKİSİ. Ege Tıp Bilimleri Dergisi 3 3 117–123.

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