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İnce barsak acil cerrahisinde hangisi daha güvenli? İleostomi, anastomoz ve primer onarım

Year 2018, Volume: 11 Issue: 1, 1 - 6, 01.01.2018

Abstract

Giriş: İnce barsak perforasyonları hem hastalar hemde cerrahlar için dünya genelinde önemli cerrahi sorunlardan birisidir. Tedavi seçiminde farklı cerrahi prosedürler uygulanabilmekte olup henüz kesinleşmiş bir seçenek yoktur. Gereç ve yöntemler: Acil ince barsak patolojisine bağlı ameliyat edilen olgular çalışmaya dahil edildi. Olgular yapılan cerrahi tipine göre ince barsak anastomozu yapılan (Grup I), ileostomi açılan (Grup II) ve primer tamir yapılanlar (Grup III) olarak gruplandırıldı. Bulgular: Toplam 107 olgu çalışmaya dahil edildi. Gruplar arası mortalite oranları Grup I’de %23, Grupta II’de %52 ve Grup III’te %39 idi ve aralarında anlamlı farklılık saptandı(p<0,05). Primer tamir ve anastomoz uygulanan gruplar arasında kaçak oranları arasında anlamlı fark yoktu (p: 0,6). Farklı nedenler ile re-operasyon oranları Grup I, II ve III’te sırasıyla %17, %23 ve %17 idi ve aralarında anlamlı farklılık saptanmadı (p: 0,804). Gruplardan bağımsız olarak mortalite ile ilişkili faktörlere bakıldığında organ yetmezliği varlığı, ileri yaş ve ASA anlamlı idi (p<0,05). Sonuç: İnce barsak acil cerrahisinin hangi yöntem uygulanırsa uygulansın mortalitenin ve morbiditesinin oldukça yüksek olabileceğini gördük. İleostomi grubunda her ne kadar anastomoz kaçağı riski olmasa da komplikasyonlarına bağlı re-operasyon ve mortalite daha fazla görüldü.

Which more safe in small intestine emergency surgery? İleostomy, anastomosis and primary repair

Year 2018, Volume: 11 Issue: 1, 1 - 6, 01.01.2018

Abstract

Introduction: Small intestine perforations are one of the major surgical problems in the worldwide for both patients and surgeons. Different surgical procedures can be applied in the choice of treatment and there is no definite option yet. Materials and methods: The cases who operated due to emergency small intestine pathology were included in the study. The cases were grouped according to the type of surgery: small intestinal anastomosis (Group I), ileostomy opened (Group II) and primary repair (Group III). Results: A total of 107 cases were included in the study. The mortality rates between the groups were 23% in Group I, 52% in Group II and 39% in Group III and there was a significant difference between them (p <0,05). There was no statistically significant difference between the leakage rates between the groups treated with primary repair and anastomosis (P: 0.6). Re-operation rates for different reasons were 17%, 23% and 17% for Groups I, II and III respectively and there was no significant difference between them (P: 0,804). The presence of organ failure, older age and ASA were significant (P <0.05) when the factors related to mortality were examined independently of the groups. Conclusion: We have seen that mortality and morbidity rate in small intestine emergency surgery can be very high no matter which method is applied surgically. Although there was no risk of anastomosis in the Ileostomy group, re-operation and mortality due to complications were more frequent.

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Details

Primary Language Turkish
Subjects Clinical Sciences
Other ID JA55FA44MH
Journal Section Research Article
Authors

Orhan Üreyen This is me

Enver İlhan This is me

Murat Uz This is me

Emrah Dadalı This is me

Uğur Gökçelli This is me

Hüseyin Fenercioğlu This is me

Publication Date January 1, 2018
Submission Date January 1, 2018
Published in Issue Year 2018 Volume: 11 Issue: 1

Cite

Vancouver Üreyen O, İlhan E, Uz M, Dadalı E, Gökçelli U, Fenercioğlu H. İnce barsak acil cerrahisinde hangisi daha güvenli? İleostomi, anastomoz ve primer onarım. JSurgArts. 2018;11(1):1-6.

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