Mersin’de Tip 1 Aort Diseksiyonunda doku yapıştırıcısı kullanımının kanama üzerine etkisi: Kanama kontrolünün tarihsel kısa analizi

Abstract

Amaç: Mersin Şehir Eğitim ve Araştırma Hastanesi’nde Tip 1 aort diseksiyonu nedeniyle acil operasyona alınan hastalarda doku yapıştırıcısı kullanımının kanama üzerine etkisini ortaya koymaktır. Kalp cerrahisinde kullanılan kanama durdurucu yöntemler ve ilaçların tarihsel gelişimini incelemektir.

Yöntem: Mersin Şehir Eğitim ve Araştırma Hastanesi kalp ve damar cerrahisi kliniğinde 2014-2019 yılları arasında Tip 1 aort diseksiyonu nedeniyle acil operasyona alınan 40 olgu geriye dönük olarak incelendi. Çalışmaya ardışık 34 hasta dâhil edildi. Hastalar ameliyatta doku yapıştırıcısı kullanılıp kullanılmamasına göre iki gruba ayrıldı. Doku yapıştırıcısı kullanılmayanlar grup 1 (n=20), kullanılanlar grup 2 (n=14) olarak tanımlandı. Tanımlayıcı analizlerde, kategorik değişkenler frekans ve yüzdeyle, sayısal değişkenler medyan kullanılarak yapıldı. İkili grup karşılaştırmalarında kategorik değişkenler için Pearson Ki Kare testi, sayısal değişkenler için Man Whitney U testi kullanıldı.

Bulgular: Grup 1’deki hastaların medyan yaşı 63 iken, grup 2’de medyan yaşı 54’tü ( p=0,03). Grup 2’deki hastalarda hipertansiyon ve postoperatif solunumsal komplikasyonlar daha fazla görüldü (p=0,03). Toplam mortalite (p=0,03) ve operasyon sırasındaki mortalite (p=0,02) grup1’de daha yüksekti. Kalp cerrahisi tarihinde kullanılan kanama önleyici ajanlar ve yöntemlerin aort diseksiyon cerrahisinde de kullanıldığı görüldü.

Sonuç: Tip 1 aort diseksiyonu ameliyatlarında doku yapıştırıcısı kullanımının kanama miktarı, kanama nedeniyle reoperasyon ve kan tranfüzyon ihtiyacı üzerine etkisi yoktur.

Keywords

• Tip 1 aort diseksiyonu,doku yapıştırıcısı

Effect of tissue sealants on bleeding in type 1 aortic dissections in Mersin: short-historical analysis of bleeding control

Abstract

Objective: To investigate the effect of tissue sealants on bleeding in patients who have been taken to emergency operation for type 1 aortic dissection. To investigate the methods and medications that were used to control bleeding throughout the history of cardiac surgery.

Methods: All patients who underwent emergency operation for Type 1 aortic dissection in Mersin City Education and Research Hospital between 2014 and 2019 were retrospectively evaluated 40 patients. 34 consecutive patients were included to the study. Patients were divided into two groups. Patients in group 1 (n=20) didn’t receive tissue sealants and patients in group 2 (n=14) received tissue sealants. In descriptive analyzes, categorical variables were made by frequency and percentage, numerical variables were median. In Binary group comparisons Pearson chi-square test was used for categorical variables and Man Whitney U test was used for numerical variables.

Results: Median age for Group 1 was 63, whereas it was 54 in group 2 (p=0,03). Hypertension and post operative respiratory complications were more frequent in Group 2 (p=0,03). Overall mortality and intraoperative mortality was higher in group 1 (p=0,03) and (p=0,02) respectively. Hemorrhage control agents and techniques that were used in history of cardiac surgery were also used in aortic dissection operations.

Conclusion: Usage of tissue sealants in Type 1 Aortic dissection operations is ineffective on the amount of post operative bleeding, reoperation due to bleeding and the need for blood transfusions.

Keywords

• Type 1 aortic dissections,tissue sealants

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