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Dudak Damak Yarıklarının Primer Onarımında Erken Postoperatif Komplikasyonlar: 328 Olgunun Retrospektif Analizi

Year 2021, , 617 - 621, 17.09.2021
https://doi.org/10.16899/jcm.831955

Abstract

Amaç
Primer dudak damak yarığı (DDY) onarımı, yaşam boyu en kritik aşamadır. DDY ameliyatı, ameliyata ve anesteziye bağlı komplikasyon risklerini içerir. Bu çalışmada, primer DDY cerrahisi sonrası erken dönemde meydana gelen komplikasyonların değerlendirilmesi ve bu durumları tetikleyen erken dönemdeki faktörlerin belirlenmesi amaçlanmıştır.
Gereç ve Yöntem
Bu çalışmaya 271 DDY hastasının 328 ameliyatı dahil edildi. Komplikasyonlar, ilk 3 günde ortaya çıkan ateş gibi komplikasyonlar minör komlikasyon olarak sınıflandırıldı. Palyatif bakımla tedavi edilemeyen veya yoğun bakıma transfer edilmesi gereken komplikasyonlar ise majör komplikasyonlar olarak kabul edildi. Erken komplikasyonların epidemiyolojisi ve nedensel bağlantısı istatistiksel olarak değerlendirildi.
Bulgular
Dudak damak yarığı nedeniyle ameliyat edilen tüm olguların %19'unda (n: 63) erken komplikasyonlar görüldü. Bunlar arasında minör komplikasyon oranı %9 (n: 25) idi. Anestezinin uzamasının ağızdan beslenmede yetersizlik gibi minör komplikasyonların artmasına neden olduğu belirlendi. Majör komplikasyonlar %11 (n: 38) oranında görüldü. Bu majör komplikasyonlar, bilateral dudak yarığı olanlarda, sendromik olgularda, damak yarığı olanlarda ve erkek hastalarda daha sıktı. Komplike vakaların ortalama hastanede kalış süresi 3.35 gündü. Komplike olmayan vakalarla karşılaştırıldığında hastanede kalış süresinde artış vardı (p <0.05).
Sonuç
Dikkatli entübasyon ile anestezi ve ameliyat süresinin kısaltılması küçük komplikasyonları önleyebilir. Tüm bu önlemlere rağmen iki taraflı dudak yarıklarında, sendromlu hastalarda ve erkek hastalarda majör komplikasyonlar hala çok önemli problemlerdir. Bu nedenle bu komplikasyonların yönetiminin mümkün olduğu merkezlerde dudak damak yarıkğı ameliyatlarının yapılması zorunludur.

References

  • 1. Takemura, H., et al., Correlation of cleft type with incidence of perioperative respiratory complications in infants with cleft lip and palate. Paediatric Anaesthesia, 2002. 12: 585–588.
  • 2. Tiret, L., et al., Complications related to anaesthesia in infants and children. A prospective survey of 40240 anaesthetics. Br J Anaesth, 1988. 61(3): 263-9.
  • 3. Druschel, C.M., J.P. Hughes, and C.L. Olsen, First year-of-life mortality among infants with oral clefts: New York State, 1983-1990. Cleft Palate Craniofac J, 1996. 33(5): 400-5.
  • 4. Cohen, M.M., C.B. Cameron, and P.G. Duncan, Pediatric anesthesia morbidity and mortality in the perioperative period. Anesthesia & Analgesia, 1990. 70(2): 160-167.
  • 5. Denk, M.J. and W.P. Magee, Jr., Cleft palate closure in the neonate: preliminary report. Cleft Palate Craniofac J, 1996. 33(1): 57-61; discussion 62-6.
  • 6. Cronin, E.D., et al., Short stay after cleft palate surgery. Plast Reconstr Surg, 2001. 108(4): 838-40; discussion 841.
  • 7. Jaffe, B.F. and C.B. DeBlanc, Sinusitis in children with cleft lip and palate. Arch Otolaryngol, 1971. 93(5): 479-82.
  • 8. Deshpande, G.S., et al., Early complications after cleft palate repair: a multivariate statistical analysis of 709 patients. J Craniofac Surg, 2014. 25(5): 1614-8.
  • 9. Schonmeyr, B., L. Wendby, and A. Campbell, Early Surgical Complications After Primary Cleft Lip Repair: A Report of 3108 Consecutive Cases. Cleft Palate Craniofac J, 2015. 52(6): 706-10.
  • 10. Tiret, L., et al., Complications associated with anaesthesia--a prospective survey in France. Can Anaesth Soc J, 1986. 33(3 Pt 1): 336-44.
  • 11. Fillies, T., et al., Perioperative complications in infant cleft repair. Head Face Med, 2007. 3: 9.
  • 12. Desalu, I., et al., Airway and respiratory complications in children undergoing cleft lip and palate repair. Ghana Med J, 2010. 44(1): 16-20.
  • 13. Ramamoorthy, C., et al., Anesthesia-related cardiac arrest in children with heart disease: data from the Pediatric Perioperative Cardiac Arrest (POCA) registry. Anesthesia & Analgesia, 2010. 110(5): 1376-1382.
  • 14. Park, E., et al., Improved early cleft lip and palate complications at a surgery specialty center in the developing world. The Cleft Palate-Craniofacial Journal, 2018. 55(8): 1145-1152.
  • 15. DeMey, A., et al., Early postoperative complications in primary cleft lip and palate surgery. European Journal of Plastic Surgery, 1997. 20(2): 77-79.

Early Postoperative Complications in Primary Cleft Lip and Palate Repair: A Retrospective Analysis of 328 Cases

Year 2021, , 617 - 621, 17.09.2021
https://doi.org/10.16899/jcm.831955

Abstract

Aim
Primary cleft lip and palate (CLP) repair is the most critical stage throughout lifetime. CLP surgery involves risks of surgery and anaesthesia related complications. In this study, it was aimed to evaluate complications occurred in early period after primary CLP surgery and to determine early factors that trigger these conditions.
Materials and Methods
In this study 328 surgeries of 271 CLP patients were included. Complications were classified as minor complications such as fever occurring within first 3 days. Complications that cannot be treated with palliative care or required transfer to intensive care were considered as major complications. Epidemiology and causal link of early complications were statistically evaluated.
Results
Early complications were seen in 19% (n: 63) of all cases that operated for cleft lip and palate. Among them rate of minor complications were 9% (n: 25). It was determined that prolongation of anaesthesia lead to rising of minor complications such as deficiency in oral feeding. Major complications were observed in 11% (n: 38). These major complications were more common in bilateral cleft lip, syndromic, palate and male patients. Mean hospitalisation of complicated cases were 3.35 days. When compairing to noncomplicated cases there was increasing in hospitalisation time (p<0.05).
Conclusion
Minor complications can be prevented with careful intubation, anaesthesia and shortening surgery duration. Despite all these precautions, major complications still are very important problems in bilateral cleft lip, syndromic patients and male patients. Therefore, it is mandatory issue to be performed in centres where management of these complications are possible.

References

  • 1. Takemura, H., et al., Correlation of cleft type with incidence of perioperative respiratory complications in infants with cleft lip and palate. Paediatric Anaesthesia, 2002. 12: 585–588.
  • 2. Tiret, L., et al., Complications related to anaesthesia in infants and children. A prospective survey of 40240 anaesthetics. Br J Anaesth, 1988. 61(3): 263-9.
  • 3. Druschel, C.M., J.P. Hughes, and C.L. Olsen, First year-of-life mortality among infants with oral clefts: New York State, 1983-1990. Cleft Palate Craniofac J, 1996. 33(5): 400-5.
  • 4. Cohen, M.M., C.B. Cameron, and P.G. Duncan, Pediatric anesthesia morbidity and mortality in the perioperative period. Anesthesia & Analgesia, 1990. 70(2): 160-167.
  • 5. Denk, M.J. and W.P. Magee, Jr., Cleft palate closure in the neonate: preliminary report. Cleft Palate Craniofac J, 1996. 33(1): 57-61; discussion 62-6.
  • 6. Cronin, E.D., et al., Short stay after cleft palate surgery. Plast Reconstr Surg, 2001. 108(4): 838-40; discussion 841.
  • 7. Jaffe, B.F. and C.B. DeBlanc, Sinusitis in children with cleft lip and palate. Arch Otolaryngol, 1971. 93(5): 479-82.
  • 8. Deshpande, G.S., et al., Early complications after cleft palate repair: a multivariate statistical analysis of 709 patients. J Craniofac Surg, 2014. 25(5): 1614-8.
  • 9. Schonmeyr, B., L. Wendby, and A. Campbell, Early Surgical Complications After Primary Cleft Lip Repair: A Report of 3108 Consecutive Cases. Cleft Palate Craniofac J, 2015. 52(6): 706-10.
  • 10. Tiret, L., et al., Complications associated with anaesthesia--a prospective survey in France. Can Anaesth Soc J, 1986. 33(3 Pt 1): 336-44.
  • 11. Fillies, T., et al., Perioperative complications in infant cleft repair. Head Face Med, 2007. 3: 9.
  • 12. Desalu, I., et al., Airway and respiratory complications in children undergoing cleft lip and palate repair. Ghana Med J, 2010. 44(1): 16-20.
  • 13. Ramamoorthy, C., et al., Anesthesia-related cardiac arrest in children with heart disease: data from the Pediatric Perioperative Cardiac Arrest (POCA) registry. Anesthesia & Analgesia, 2010. 110(5): 1376-1382.
  • 14. Park, E., et al., Improved early cleft lip and palate complications at a surgery specialty center in the developing world. The Cleft Palate-Craniofacial Journal, 2018. 55(8): 1145-1152.
  • 15. DeMey, A., et al., Early postoperative complications in primary cleft lip and palate surgery. European Journal of Plastic Surgery, 1997. 20(2): 77-79.
There are 15 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Mustafa Sutcu 0000-0001-5106-0159

Cemil Isık This is me 0000-0002-5852-489X

Ahmet Dogramaci This is me 0000-0001-8294-626X

Celal Irgın 0000-0002-1535-3402

Osman Akdag This is me 0000-0001-9347-5192

Zekeriya Tosun 0000-0002-3987-8748

Publication Date September 17, 2021
Acceptance Date May 25, 2021
Published in Issue Year 2021

Cite

AMA Sutcu M, Isık C, Dogramaci A, Irgın C, Akdag O, Tosun Z. Early Postoperative Complications in Primary Cleft Lip and Palate Repair: A Retrospective Analysis of 328 Cases. J Contemp Med. September 2021;11(5):617-621. doi:10.16899/jcm.831955