Malign Plevral Efüzyonda Kalıcı Tünelli Kateter Uygulanma Sonrası Spontan Plörodezisi Etkileyen Risk Faktörleri

Yıl 2025, Cilt: 9 Sayı: 2, 77 - 81, 30.08.2025

Hıdır Esme

https://doi.org/10.33716/bmedj.1621439

Öz

Amaç: Malign plevral efüzyonlarda kalıcı tünelli kateter ile spontan plörodezis oluşması hastaların nefes dağrılığı ve hayat kalitesinin düzelmesinde çok önemli bir role sahiptir. Bu çalışmadaki amacımız malign plevral efüzyonda kalıcı tünelli kateter (KTK) uygulanmasının etkinliği ve spontan plörodezisin oluşumunu etkileyen risk faktörlerini saptamaktır.
Materyal ve Metod: Çalışmaya Ağustos 2020 ile Ağustos 2022 tarihleri arasında göğüs cerrahi kliniğimizde malign plevral efüzyon nedeniyle Kalıcı Tünelli Kateter uygulanan 34 hasta dahil edildi. Hastaların demografik verileri, primer malignite, malign plevral efüzyon için uygulanan plevral işlemler, KTK uygulanma endikasyonu, KTK uygulanma öncesi serum albümin seviyesi, hastane yatış süresi, KTK’ya bağlı komplikasyonlar ve taburculuk sonrası takipler kayıt altına alındı.
Bulgular: Çalışmaya dahil edilen 34 hastanın altta yatan primer malignitesi; 18 hastada metastatik akciğer kanseri, 6 hastada meme kanseri, 5 hastada kolon kanseri, 3 hastada mezotelyoma ve 2 hastada ise malign melonom idi. KTK uygulanma nedeni 18 hastada tuzaklanmış akciğer, 11 hastada daha önceki drenaj ve kimyasal plörodezise rağmen tekrarlayan efüzyon ve 5 hastada yüksek debili drenaj idi. Tuzaklanmış akciğer yokluğu, malign plevral efüzyonun ortaya çıkmasıyla KTK uygulanması arasındaki sürenin azlığı, masif efüzyon hikayesinin yokluğu ve KTK’nın sonlandırılma süresisinin uzunluğu ile spontan plörodezis başarısı arasında istatistiksel olarak anlamlı ilişki vardı.
Sonuç: KTK malign plevral efuzyonlarda spontan plörodezisin elde edilmesinde komplikasyonu az, güvenli bir yöntemdir. Spontan plörodezisin oluşumunda tuzaklanmış akciğer varlığı, masif efüzyon varlığı, malign plevral efüzyonun ortaya çıkması ile KTK uygulanması arasındaki süre ve KTK’nın sonlandırılma süresi önemli risk faktörleridir.

Anahtar Kelimeler

Efüzyon , Kalıcı Tünelli Kateter , Plöredezis

Risk Factors Affecting Spontaneous Pleurodesis After Indwelling Tunneled Catheter Application in Malignant Pleural Effusion

Öz

Objective: Spontaneous pleurodesis with indwelling tunneled catheter in malignant pleural effusions has a very important role in the improvement of dyspnea and quality of life of patients. Our aim in this study was to determine the efficacy of indwelling tunneled catheterization in malignant pleural effusion and the risk factors affecting the occurrence of spontaneous pleurodesis.
Materials and Methods: The study included 34 patients who underwent Indwelling Tunneled Catheter (ITC) for malignant pleural effusion in our thoracic surgery clinic between August 2020 and August 2022. Demographic data of the patients, primary malignancy, pleural procedures performed for malignant pleural effusion, indication for ITC, serum albumin level before ITC, duration of hospitalization, complications related to ITC and post-discharge follow-up were recorded.
Results: The underlying primary malignancy of the 34 patients included in the study was metastatic lung cancer in 18 patients, breast cancer in 6 patients, colon cancer in 5 patients, mesothelioma in 3 patients and malignant melonoma in 2 patients. The reason for ITC was entrapped lung in 18 patients, recurrent effusion despite previous drainage and chemical pleurodesis in 11 patients, and high-flow drainage in 5 patients. There was a statistically significant correlation between the absence of an entrapped lung, the short interval between the onset of malignant pleural effusion and the application of ITC, the absence of a history of massive effusion, and the length of time to terminate ITC and the success of spontaneous pleurodesis.
Conclusion: ITC is a safe method with few complications for achieving spontaneous pleurodesis in malignant pleural effusions. In the occurrence of spontaneous pleurodesis, the presence of an entrapped lung, the presence of massive effusion, the time between the onset of malignant pleural effusion and the application of ITC, and the duration of termination of ITC are important risk factors.

Anahtar Kelimeler

Effusion , Indwelling tunelled catheter , Pleurodesis

Etik Beyan

Var

Destekleyen Kurum

Yok

Kaynakça

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