İntraabdominal Sepsiste Bogota BagUygulaması

Yıl 2006, Cilt: 3 Sayı: 3, 77 - 81, 01.12.2006

Ahmet Tekin Tevfik Küçükkartallar Celalettin Vatansev Faruk Aksoy Metin Belviranlı Adil Kartal

Öz

Amaç: İntra abdominal enfeksiyonu, özellikle de abdominal hipertansiyon ile birlikte bulunan hastalara nasıl ve ne tür bir ameliyat yapılacağına karar vermek genel cerrahlar için en önemli sorunlardan birisidir. Son zamanlarda abdominal sepsisi ve hipertansiyonu bulunan hastalara karın tansiyonunu azaltmak ve sepsisi kontrol altına almak için prostetik meshler kullanılarak kapama teknikleri popülarite kazanmıştır. Bu çalışmada intraabdominal sepsis nedeniyle tedavi edilen bazı olgularımızda uyguladığımız açık abdomen veya geçici kapama yöntemlerinden biri olan “Bogota Bag” tekniği ile ilgili tecrübelerimizi sunmayı amaçladık. Materyal ve Metod: Selçuk Üniversitesi Meram Tıp Fakültesi Genel Cerrahi Kliniği’nde Mart 2000-Aralık2003 tarihleri arasında karın içi enfeksiyon sekonder peritonit nedeniyle tedavi edilen ve cerrahi tedavisi esnasındaki bir dönemde Bogota Bag uygulanan 7 hastanın dosya bilgileri retrospektif olarak incelendi. Bulgular: Olguların 4’ü erkek % 57.14 , 3’ü kadındı %42.86 . Ortalama yaş erkeklerde 51.25 , kadınlarda 60.66 idi. Oluşan intraabdominal enfeksiyonun nedeni 3 olguda gastrointestinal perforasyon sonrası gecikmiş yaygın peritonit, 4 olguda ise postoperatif peritonitti. Sonuç: İntraabdominal sepsise neden olan primer peritonitli hastaların karın içi enfeksiyonlarının kontrolünde birçok cerrahi yöntem birlikte ve ardışık olarak kullanılabilir. Bu hastalarda karınları kapatıldığında intraabdominal basınçları yükseleceği gözönüne alınarak geçici kapatma yöntemlerinden biri olan Bogota Bag tekniği iyi bir alternatif olabilir

Anahtar Kelimeler

İntra abdominal sepsis, Bogota bag, Alternatif tedavi

Applıed Of Bogota Bag In Intraabdominal Sepsis

Öz

Aim: It’s one of the most important problems for general surgeons to decide on what kind of operation should me applied to patients with intraabdominal infection, specially with concomitant abdominal hypertension. Lately, closing techniques by using prosthetic meshes in order to retain abdominal tension and to control sepsis, for patients with abdominal sepsis and hypertension have become very popular. With this studty, we aimed to present our experiences about the technique “Bogota bag” that we used for some of our patients who are treated for intraabdominal sepsis, which is one of the open abdomen or transient closing methods. Material ve Method: File data of 7 patients who had been treated in Selçuk University Meram Medicine Faculty General Surgery Clinics between March 2000- December 2003 for intraabdominal infection secondary peritonitis and for whom the technique Bogota Bag had been used in a period during surgical treatment, were examined retrospectively. Findings: 4 of the cases were male 57.14% and 3 of them were female 42.86% . Mean ages were 51.25 4371 for men and 60.66 for women. The reasons for intraabdominal infection were late disseminated peritonitis after gastrointestinal perforation at 3 cases and postoperative peritonitis for 4 cases. Result: Lots of surgical methods may be used together and consecutively for the control of intraabdominal infections at patients with primary peritonitis causing intraabdominal sepsis. Considering that the intraabdominal pressure will increase when the abdomen is closed, the technique Bogota bag which is a temporary closing method may be a good alternative

Anahtar Kelimeler

Intraabdominal sepsis, Bogota bag, Alternative treatment

Kaynakça

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