Robotik Yardımlı Radikal Prostatektomi Vakalarında Anestezi Uygulamalarının Retrospektif İncelenmesi

Year 2023, Volume: 6 Issue: 3, 453 - 457, 31.12.2023

Ömer Uğur , Fatma Ertuğrul

https://doi.org/10.36516/jocass.1318830

Abstract

Giriş: Çalışmamızda AÜTF’de opere edilen RYRP olgularında anestezi uygulamamızı; derin trendelenburg, pneumoperitoneum ve cerrahi sebebiyle oluşabilecek hemodinamik değişiklikler ve komplikasyonları incelemeyi ve ilk sonuçlarımızı değerlendirmeyi amaçladık.
Gereç ve Yöntemler:Ocak 2015 – Şubat 2018 tarihleri arasında Akdeniz Üniversitesi Tıp Fakültesi’nde Üroloji Kliniği tarafından prostat adenokarsinomu tanısıyla, RYRP operasyonu yapılan hastalar retrospektif olarak değerlendirilmiştir. Hastaların demografik verileri, intraoperatif hemodinamik ve solunumsal verileri, postoperatif transfer yerleri, ekstübasyon zamanları, ekstübasyon sonrası kan gazı değerleri, komplikasyonlar ve taburculuk zamanları kaydedilmiştir. Elde edilen veriler IBM SPSS® 23.0 programı ile analiz edilmiştir.
Bulgular: Çalışmaya dahil edilen 131 hastanın yaş ortalaması 62,9, VKİ ortalaması 27,6 kg/m2 olarak bulunmuştur. Ayrıca hastalarımızın 47’si ASA-I, 69’u ASA-II, 15’i de ASA-III’tür. Genel değerlendirme sonrası bütün hastalarda intraoperatif dönemde KH, SKB, DKB ve OAB’nin anlamlı olarak azaldığı görüldü. Aynı zamanda pneumoperitoneuma bağlı olarak hastalarda anlamlı şekilde pH düşüşü ve pCO2 yükselmesi olduğu da görüldü. Çalışmamızda, en sık görülen postoperatif komplikasyon bulantı-kusma, ikinci sıklıkta görülen ise anastomoz kaçağı olmuştur. Ancak hiçbir hastamızda kalıcı komplikasyon olmadığı görülmüştür.
Sonuç: RYRP anestezisinin yönetilebilmesi için trendelenburg pozisyonu ve pneumoperitoneumun sistemler üzerine fizyolojik etkilerini ve yaşlılıkta oluşan fizyolojik değişiklikleri bilmek gerekmektedir.

Keywords

Anestezi, robotik cerrahi, prostatektomi

Retrospectif Analysing of Anesthesia Manegement in Robotic Assisted Radical Prostatectomy Cases

Abstract

Aim: In our study, we aimed to investigate anesthesia management, hemodynamic changes and complications that may ocur due to steep trendelenburg, pneumoperitoneum and sugery in RARP patients operated in A.U.T.F, and to evaluate our initial results.
Methods: Patients who underwent RARP operation with the diagnosis of prostate adenocarcinoma by the Urology Clinic at Akdeniz University Faculty of Medicine between January 2015 and February 2018 were evaluated retrospectively. Patient’s demographic data, intraoperative hemodynamic and respiratory data, postoperative transfer sites, extubation times, post-extubation blood gas values, complications and discharge times were recorded. Obtained data were analyzed with IBM SPSS® 23.0 program.
Results: We found that mean age of the 131 patients included study was 62 years, and mean BMI was 27,6 kg/m2. Also we found that 47 of patients were ASA-I, 69 of patients were ASA-II and 15 of patients were ASA-III. After general evaluation, it was seen that HR, SBP, DBP and MAP decreased significantly in intraoperative period in all patients. There was also a significant decrease in pH and increase in pCO2 in patients due to pneumoperitoneum. In our study, we found thah the most common postoperative complication was nause and vomiting, and the second common was anastomotic leakage. However, none of our patients had a permanent complication.
Conclusion: In order to manage anesthesia in RARP, it is necessary to know the physiologic effects of trendelenburg position and pneumoperitoneum on the systems and physiological changes in old age.

Keywords

Anesthesia, robotic surgery, prostatectomy

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