Research Article
BibTex RIS Cite

Devlet hizmet yükümlülüğü süresinde spontan pnömotorakslara yaklaşım

Year 2019, Volume: 11 Issue: 1, 1 - 5, 31.03.2019
https://doi.org/10.21601/ortadogutipdergisi.456161

Abstract

Amaç: Spontan
pnömotoraks dışarıdan bir etki olmadan plevral aralığa hava geçişidir ve göğüs
cerrahi acilleri içinde tedavisi, kliniği ve altta yatan hastalıklar açısından
önemlidir. Bu çalışmada devlet hizmet yükümlülüğü süresinde, spontan
pnömotoraks tanılı hastalara devlet hastanesi şartlarında yaklaşımın sunulması
amaçlandı.

Gereç ve Yöntem: Çalışmaya,
kliniğimizde Haziran 2017 ve Ocak 2018 tarihleri arasında spontan pnömotoraks
tanısıyla tedavi edilen hastalar dahil edildi. Hastaların cinsiyet, yaş, sigara
kullanım durumu, tedavi şekli ve hastanede yatış süreleri kaydedildi.

Bulgular: Çalışmaya
18 (2’si kadın, 16’sı erkek) hasta dahil edildi. Hastaların 11’i (%61,1) sigara
kullanıyordu. Hastaların 7’sine (%38,8) cerrahi tedavi uygulandı. Cerrahi
yaklaşım olarak, 5 hastada videotorakoskopik wedge rezeksiyon ve parsiyel
plevral dekortikasyon, 1 hastada videotorakoskopik bül ligasyonu ve parsiyel
plevral dekortikasyon ve 1 hastada torakotomi bül ligasyonu uygulandı. On hasta
tüp torakostomi ile, 1 hasta ise nazal oksijen ile tedavi edildi. Hastalarda
komplikasyon görülmedi.







Sonuç: Spontan
pnömotoraks, acil tanı ve tedavi gerektiren bir durumdur. Tedavisinde amaç
akciğerin tam ekspansiyonunu sağlamak ve tekrarlamasının önlenmesidir. Tüp
torakostomi çoğunlukla ilk yaklaşımdır, ancak ameliyat endikasyonu sağlayan
hastalarda avantajları nedeniyle videotorakoskopik cerrahinin devlet hastanesi
şartlarında da uygulanmasını öneriyoruz.



References

  • Kara HV, Demir A. Pnömotoraks ve pnömomediastinum. In: Yuksel M (ed). Erişkin Göğüs Cerrahisi. İstanbul: Nobel Tıp Kitabevi; 2011: 917-24.
  • Baysungur V. Pnömotoraks. In: Göğüs Cerrahisi Cilt II, Ökten İ, Kavutçu HŞ (eds). Türk Göğüs Cerrahisi Derneği, 2. Baskı. İstanbul: İstanbul Tıp Kitabevi; 2013: 1493-518.
  • Turna A. Pnömotoraks cerrahisi ve teknikler. In: Çağdaş Videotorakoskopik Cerrahide Teknikler ve Sonuçlar, Toker A, Batırel HF (eds). İstanbul: Nobel Tıp Kitabevi; 2014: 27-34.
  • Park CB, Moon MH, Jeon HW et al. Does oxygen therapy increase the resolution rate of primary spontaneous pneumothorax? J Thorac Dis 2017; 9(12): 5239–43.
  • M Henry, T Arnold, J Harvey. BTS guidelines for the management of spontaneous pneumothorax. Thorax 2003; 58(Suppl 2): 39–52.
  • Gogakos A, Barbetakis N, Lazaridis G et al. Heimlich valve and pneumothorax Ann Transl Med 2015; 3(4): 54.
  • Salati M, Brunelli A, Xiumè F, Refai M, Sciarra V, Soccetti A, et al. Uniportal video-assisted thoracic surgery for primary spontaneous pneumothorax: clinical and economic analysis in comparison to the traditional approach. Interact Cardiovasc Thorac Surg 2008; 7(1): 63-6.
  • Abouarab AA, Rahouma M, Kamel M, Ghaly G, Mohamed A. Single Versus Multi-Incisional Video-Assisted Thoracic Surgery: A Systematic Review and Meta-analysis. J Laparoendosc Adv Surg Tech A 2018; 28(2): 174-85.
  • Zhenrong Z, Lanfang D, Hongxiang F, Chaoyang L, Deruo L. Pleural abrasion should not routinely preferred in treatment of primary spontaneous pneumothorax. J Thorac Dis 2017; 9(4): 1119-25.
  • Ooi A, Ling Z. Uniportal video assisted thoracoscopic surgery bullectomy and double pleurodesis for primary spontaneous pneumothorax. J Vis Surg 2016; 2: 17.
  • Perikleous P, Rathinam S, Waller DA. VATS and open chest surgery in diagnosis and treatment of benign pleural diseases. J Vis Surg 2017; 3: 84.
  • Divisi D, Di Leonardo G, Crisci R. Vats Versus Axillary Minithoracotomy in the Management of the Second Episode of Spontaneous Pneumothorax: Cost-Benefit Analysis. World J Surg 2016; 40(9): 2171-7.

The approach to the spontaneous pneumothorax in period of compulsory public service

Year 2019, Volume: 11 Issue: 1, 1 - 5, 31.03.2019
https://doi.org/10.21601/ortadogutipdergisi.456161

Abstract

Aim: There
is air in the pleural space without an external effect in the case of spontaneous
pneumothorax, and it is important in terms of treatment, clinic, and underlying
diseases in thoracic surgery. In this study, it was aimed to present the
approach to the patients with spontaneous pneumothorax in the period of
compulsory public service.

Material and method: The
patients who were treated with spontaneous pneumothorax between June 2017 and
January 2018 in our clinic were included in this study. Gender, age, smoking
status, type of treatment and length of hospital stay were recorded.

Result: 18
patients (2 female, 16 male) were included in the study. Eleven of the patients
(61.1%) were smoking. Surgical treatment was applied to 7 (38.8%) of the
patients. As a surgical approach, videothoracoscopic wedge resection and
partial pleural decortication in 5 patients, videothoracoscopic bulla ligation
and partial pleural decortication in 1 patient and thoracotomy bulla ligation
in 1 patient were applied. Ten patients were treated with tube thoracostomy and
one patient was treated with nasal oxygen. Complications did not occur in the
patients.







Conlusion: Spontaneous
pneumothorax is a disease requiring urgent diagnosis and treatment. The purpose
of the treatment is to provide the lung totally expanded and to prevent
recurrence of pneumothorax. Tube thoracostomy is usually the first approach,
but we recommend that the videothoracoscopic surgery can be used in the
conditions of the public hospital because of its advantages for the patients who
have surgical indications.

References

  • Kara HV, Demir A. Pnömotoraks ve pnömomediastinum. In: Yuksel M (ed). Erişkin Göğüs Cerrahisi. İstanbul: Nobel Tıp Kitabevi; 2011: 917-24.
  • Baysungur V. Pnömotoraks. In: Göğüs Cerrahisi Cilt II, Ökten İ, Kavutçu HŞ (eds). Türk Göğüs Cerrahisi Derneği, 2. Baskı. İstanbul: İstanbul Tıp Kitabevi; 2013: 1493-518.
  • Turna A. Pnömotoraks cerrahisi ve teknikler. In: Çağdaş Videotorakoskopik Cerrahide Teknikler ve Sonuçlar, Toker A, Batırel HF (eds). İstanbul: Nobel Tıp Kitabevi; 2014: 27-34.
  • Park CB, Moon MH, Jeon HW et al. Does oxygen therapy increase the resolution rate of primary spontaneous pneumothorax? J Thorac Dis 2017; 9(12): 5239–43.
  • M Henry, T Arnold, J Harvey. BTS guidelines for the management of spontaneous pneumothorax. Thorax 2003; 58(Suppl 2): 39–52.
  • Gogakos A, Barbetakis N, Lazaridis G et al. Heimlich valve and pneumothorax Ann Transl Med 2015; 3(4): 54.
  • Salati M, Brunelli A, Xiumè F, Refai M, Sciarra V, Soccetti A, et al. Uniportal video-assisted thoracic surgery for primary spontaneous pneumothorax: clinical and economic analysis in comparison to the traditional approach. Interact Cardiovasc Thorac Surg 2008; 7(1): 63-6.
  • Abouarab AA, Rahouma M, Kamel M, Ghaly G, Mohamed A. Single Versus Multi-Incisional Video-Assisted Thoracic Surgery: A Systematic Review and Meta-analysis. J Laparoendosc Adv Surg Tech A 2018; 28(2): 174-85.
  • Zhenrong Z, Lanfang D, Hongxiang F, Chaoyang L, Deruo L. Pleural abrasion should not routinely preferred in treatment of primary spontaneous pneumothorax. J Thorac Dis 2017; 9(4): 1119-25.
  • Ooi A, Ling Z. Uniportal video assisted thoracoscopic surgery bullectomy and double pleurodesis for primary spontaneous pneumothorax. J Vis Surg 2016; 2: 17.
  • Perikleous P, Rathinam S, Waller DA. VATS and open chest surgery in diagnosis and treatment of benign pleural diseases. J Vis Surg 2017; 3: 84.
  • Divisi D, Di Leonardo G, Crisci R. Vats Versus Axillary Minithoracotomy in the Management of the Second Episode of Spontaneous Pneumothorax: Cost-Benefit Analysis. World J Surg 2016; 40(9): 2171-7.
There are 12 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original article
Authors

Hüseyin Yıldıran 0000-0003-0126-2531

Tuba Şahinoğlu

Publication Date March 31, 2019
Published in Issue Year 2019 Volume: 11 Issue: 1

Cite

Vancouver Yıldıran H, Şahinoğlu T. Devlet hizmet yükümlülüğü süresinde spontan pnömotorakslara yaklaşım. omj. 2019;11(1):1-5.

e-ISSN: 2548-0251

The content of this site is intended for health care professionals. All the published articles are distributed under the terms of

Creative Commons Attribution Licence,

which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.