İATROJENİK PNÖMOTORAKSLI TAVŞANLARDA FARKLI TORASİK DRENLERİN PLEVRAL REAKSİYONLARI

Öz

Bu çalışmada intratorasik kullanım için yapılmış farklı dren materyallerinin oluşturduğu doku reaksiyonlarının incelenmesini amaçladık 15 tavşan PVC (polivinil klorid), lastik ve silikon dren olmak üzere 3 gruba ayrıldı. Genel anestezi altında, intratorasik drenler sağ hemitorakslara yerleştirildi. Drenlerin şekil ve boyutları benzerdi. Oluşturulan iatrojenik pnömotoraks iğne aspirasyonu ile tedavi edildi. Yedi gün sonra denekler sakrifiye edilerek toraksları patolojik inceleme için anblok çıkarıldı. Makroskopik olarak, lastik dren grubunda belirgin adezyon bantları mevcuttu. Mikroskopik inceleme semikantitatif olarak yapıldı ve plevral kalınlaşma, plevral inflamasyon, fibrozis 0-4 arası derecelendirildi. İnflamatuar reaksiyon lastik dren grubunda diğerlerinden anlamlı olarak fazla bulundu. Her bir grubun parametrelere göre p değerleri; Plevral adezyon=0.03, Plevral inflamasyon=0.04, Plevral kalınlık=0.005, Plevral fibrozis=0.006. Pnömotoraksta lastik ve PVC drenlerin silikon drenlere tercih edilmesi görüşündeyiz. Oluşan bu ılımlı inflamasyonun rekürren pnömotoraksı önlemede yardımcı olacağını düşünüyoruz.

Anahtar Kelimeler

• Pnömotoraks, göğüs dreni, plevra, tavşan

PLEURAL REACTIONS TO THE DIFFERENT THORACIC CATHETER MATERIALS IN RABBITS WITH IATROGENIC PNEUMOTHORAX

Abstract

In this study, we aimed to analyze the tissue reactions to the different drain materials that are designed for use intrathoracically. 15 rabbits were grouped into 3 as PVC (Polyvinyl chloride), silicon and rubber drain groups. Under general anesthesia, intrathoracic catheters were implanted into right hemithoraxes. The shape and size of each catheters were similar. Iatrogenic pneumothoraxes were treated by needle aspiration. After 7 days animals were sacrified and their thoraces were removed unblock for pathologic examination. In rubber group, definitive adhesive bands were seen macroscopically. Microscopic examinations were performed semiquantitavely, and pleural thickening, pleural inflammation, fibrosis were scored from 0 to 4. Inflammatory reaction was significantly higher in rubber and PVC groups than the silicone groups. PÐvalues of each groups were according to parameters; pleural adhesion (p=0.03), pleural inflammation (0.04), pleural thickening (p=0.005), pleural fibrosis (p=0.006). We claime that PVC and rubber catheters should be preferred instead of silicon ones in pneumothorax. We think that this moderate inflammation might help to prevent recurrence pneumothorax.

Keywords

• Pneumothorax, chest tube, pleura, rabbit

Kaynakça

1. Teixeira LR, Wu W, Chang DS, et al. The effect of corticosteroids on pleurodesis induced by doxycycline in rabbits. Chest 2002; 121: 216-9.
2. Hood RH, Dooling JA, Beddingfield GW. Drainage of the pleural space. Drainage tube composition in relation to complications. Ann Thorac Surg 1966; 2: 94.
3. Gregoire J, Deslauriers J. Surgical Techniques in the pleura. Pearson FG, Cooper JD, Deslauriers J, Ginsberg RJ, Hiebert CA, Patterson GA, Urschel HC.eds.Thoracic surgery. 2000 Philadelphia, Churchill Livingstone, 1281-1300.
4. Kam AC,O'Brian M, Kam PCA. Pleural drainage system. Anesthesia 1993; 48: 154.
5. Edwards LE, Lock R, Powell C, Jones P. Post- catheterisation urethral strictures. A clinical and experimental study. Br J Urol 1983;55(1):53-6.
6. Estrada Salo G, Farina Rios C, Fibla Alfara JJ, Gomez Sebastian G, Unzueta MC, Leon Gonzalez C. Spontaneous pneumothorax: pleurodesis with an iodo-povidone hydroalcoholic solution. Arch Bronconeumol 2003; 39(4): 171-4.
7. de Campos JR, Vargas FS, de Campos Werebe E, Cardoso P, Teixeira LR, Jatene FB, Light RW. Thoracoscopy talc poudrage: a 15-year expe- rience. Chest 2001; 119(3): 801-6. Yazıflma Adresi:
8. Dr. Kenan Can CEYLAN

9. Dr. Suat Seren Göğüs Hastalıkları ve Cerrahisi
10. Eğitim ve Arafltırma Hastanesi, 2. Göğüs Cerrahisi
11. Kliniği, Yeniflehir/İZMİR
12. Tel : [phone] GSM: 0505 349 54 46
13. E-mail: [e-mail]