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BENİGN HASTALIKLARDA PNÖMONEKTOMİ

Yıl 2007, Cilt: 21 Sayı: 2, 29 - 32, 01.10.2007

Öz

Benign akciğer hastalıklarında intraoperatif ve postoperatif komplikasyonlar nedeniyle pnömo-nektomiden kaçınma eğilimi mevcuttur. Mayıs 2000 ile Ocak 2007 tarihleri arasında benign akciğer hastalıkları nedeni ile kliniğimizde cerrahi girişim uygulanan 157 hasta retrospektif olarak incelendi. Bunların 14'ünde uygun cerrahi rezeksiyon seçeneği pnömonektomiydi. Bu olgular, yaş, cins, etyoloji, yapılan operasyon açısından sınıflandırılarak, postoperatif komplikasyonları değerlendirildi. Post operatif mortalite oranları hesaplandı. Hastaların sekizi erkek altısı kadın, yaş ortalaması 41.64 (± 25.36) idi. Olgulara, Hamartom, Karsinoid Tümör, Bronşektazi, Harap olmuş Akciğer, Akciğer Absesi, Aspergilloma, Tüberküloz tanılarıyla yedisi sağ yediside sol olmak üzere pnömonektomi operasyonları uygulandı. Postoperatif dördüncü günde bir olgu kaybedilirken, iki olguda geç dönem bronkoplevral fistül saptandı. Diğer olgularda herhangi bir komplikasyon izlenmedi. Ortalama hastanede kalış süresi 15.5 gün (±10.5 gün) olarak saptandı. Mortalite oranı %7.13, Morbidite oranı %14.2 olarak hesaplandı. Sonuçta, benign akciğer lezyonlarında pnömonektominin, mortalite ve morbidite riski nedeniyle tercih edilmemekle beraber, zorunlu hallerde uygulanabilecek bir tedavi yöntemi olduğu kanısındayız.

Kaynakça

  • 1. Can E. Bronflektaziye cerrahi yaklafl›m. Uzmanl›k tezi, 1994, Ankara.
  • 2. Sanderson JM, Kennedy MCS, Johnson MF, Manley DCE. Bronchiectasis: results of surgical and conservative management. A review of 393 cases. Thorax 1974; 29: 407-16.
  • 3. Piccione W Jr, Faber LP. Management of complications related to resection. In: Waldhausen JA, Orringer MB; eds. Complications in Cardiothoracic Surgery. St Louis: CV Mosby; 1991: 379-81.
  • 4. Türker T, Karakurt Z, Ak›n H, Erdem E. Pulmonary aspergilloma in a Turkish hospital population. Turkish Respir J 2002; 3: 7-14.
  • 5. Babatasi G, Massetti M, Chapelier A, et al. Surgical treatment of pulmonary aspergilloma: current outcome. J Thorac Cardiovasc Surg 2000; 119: 906-12.
  • 6. Reed CE. Pneumonectomy for chronic infection: Fraught with danger? Ann Thorac Surg 1995; 59: 408-11.
  • 7. Jamal M, Nicholson AG, Goldstraw P. The feasibility of conservative resection for carcinoid tumours: is pneumonectomy ever necessary for uncomplicated cases? Eur J Cardiothorac Surg 2000; 18: 301-6.
  • 8. Kurul IC, Topçu S, Tafltepe I, Yaz›c› Ü, Alt›nok T, Güven Ç. Surgery in bronchial carcinoids: experience with 83 patients. Eur J Cardiothorac Surg 2002; 21: 883-7.
  • 9. Kotoulas C, Lazopoulos G, Foroulis C, Konstantinou M, Tomos P, Lioulias A. Wedge resection of the bronchus: an alternative bronchoplastic technique for preservation of lung tissue. Eur J Cardiothorac Surg 2001; 20: 679-83.
  • 10. Kirsh MM, Rothman H, Bove E, et al. Major pulomary resection for bronchogenic carcinoma in the elderly. Ann Thorac Surg 1976; 22: 369-73.
  • 11. Stamatis G, Martini G, Freitag L, et al. Transsternal transpericardial operations in the treatment of bronchopleural fistulas after pneumonectomy. Eur J Cardiothorac Surg 1996; 10: 83-6.
  • 12. Shields TW. General features of pulmonary resection. In: Shields TW, LoCicero J, Ponn RB, eds. General Thoracic Surgery. 5nd ed. Philadelphia: Williams and Wilkins; 2000: 375-84.
  • 13. Reichel J. Assesment of operative risk of pneumonectomy. Chest 1972; 62: 570-6.
  • 14. Patel RL, Townsend ER, Fountain SW. Elective pneumonectomy: Factors associated with morbidity and operative mortality: Ann Thorac Surg 1992; 54: 84-8.

PNEUMONECTOMY FOR BENIGN DISEASES

Yıl 2007, Cilt: 21 Sayı: 2, 29 - 32, 01.10.2007

Öz

Surgeons usually abstain from the pneumonectomy for the benign lung disease because of the intraoperative and postoperative complications. But it is applied in the necessary attitude. Between May 2000 and January 2007, 157 consecutive patients which were underwent surgical resection for benign lung disease were rewieved retrospectively. Pneumonectomy was approve of the surgical procedure in the 14 of these patients. Patients were classified to age, sex, etiologic factors, surgical procedure which was underwent and postoperative complications were evaluated retrospectively. Postoperative mortality rates were calculated. Eight patients were male and age average was 41.64 (± 25.36). The pneumonectomy operations (seven of them left side, seven of them right side) performed to patients whose diagnosis are hamartoma, carcinoid tumor, bronchiectasis, destroyed lung, lung abscess, aspergilloma and tuberculosis. One patient died at the fourth post operative day. Bronchopleural fistula was found in two patients. Any complication was not seen in the other patients. Main of hospitalization day was 15.5 (± 10.5 day). The ratio of mortality and morbidity was calculated respectively 7.13% and 14.2%. As a result, we tought that pneumonectomy cannot be prefered in benign lung lesions because of high mortality and morbidity ratios but, it can be used in obligatory situations as a treatment method.

Kaynakça

  • 1. Can E. Bronflektaziye cerrahi yaklafl›m. Uzmanl›k tezi, 1994, Ankara.
  • 2. Sanderson JM, Kennedy MCS, Johnson MF, Manley DCE. Bronchiectasis: results of surgical and conservative management. A review of 393 cases. Thorax 1974; 29: 407-16.
  • 3. Piccione W Jr, Faber LP. Management of complications related to resection. In: Waldhausen JA, Orringer MB; eds. Complications in Cardiothoracic Surgery. St Louis: CV Mosby; 1991: 379-81.
  • 4. Türker T, Karakurt Z, Ak›n H, Erdem E. Pulmonary aspergilloma in a Turkish hospital population. Turkish Respir J 2002; 3: 7-14.
  • 5. Babatasi G, Massetti M, Chapelier A, et al. Surgical treatment of pulmonary aspergilloma: current outcome. J Thorac Cardiovasc Surg 2000; 119: 906-12.
  • 6. Reed CE. Pneumonectomy for chronic infection: Fraught with danger? Ann Thorac Surg 1995; 59: 408-11.
  • 7. Jamal M, Nicholson AG, Goldstraw P. The feasibility of conservative resection for carcinoid tumours: is pneumonectomy ever necessary for uncomplicated cases? Eur J Cardiothorac Surg 2000; 18: 301-6.
  • 8. Kurul IC, Topçu S, Tafltepe I, Yaz›c› Ü, Alt›nok T, Güven Ç. Surgery in bronchial carcinoids: experience with 83 patients. Eur J Cardiothorac Surg 2002; 21: 883-7.
  • 9. Kotoulas C, Lazopoulos G, Foroulis C, Konstantinou M, Tomos P, Lioulias A. Wedge resection of the bronchus: an alternative bronchoplastic technique for preservation of lung tissue. Eur J Cardiothorac Surg 2001; 20: 679-83.
  • 10. Kirsh MM, Rothman H, Bove E, et al. Major pulomary resection for bronchogenic carcinoma in the elderly. Ann Thorac Surg 1976; 22: 369-73.
  • 11. Stamatis G, Martini G, Freitag L, et al. Transsternal transpericardial operations in the treatment of bronchopleural fistulas after pneumonectomy. Eur J Cardiothorac Surg 1996; 10: 83-6.
  • 12. Shields TW. General features of pulmonary resection. In: Shields TW, LoCicero J, Ponn RB, eds. General Thoracic Surgery. 5nd ed. Philadelphia: Williams and Wilkins; 2000: 375-84.
  • 13. Reichel J. Assesment of operative risk of pneumonectomy. Chest 1972; 62: 570-6.
  • 14. Patel RL, Townsend ER, Fountain SW. Elective pneumonectomy: Factors associated with morbidity and operative mortality: Ann Thorac Surg 1992; 54: 84-8.
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Diğer ID JA44HJ96PR
Bölüm Araştırma Makalesi
Yazarlar

Soner Gürsoy Bu kişi benim

Ahmet Üçvet Bu kişi benim

Sinan Anar Bu kişi benim

Cemil Kul Bu kişi benim

Halil Tözüm Bu kişi benim

Ali Ata Öztürk Bu kişi benim

Oktay Başok Bu kişi benim

Yayımlanma Tarihi 1 Ekim 2007
Yayımlandığı Sayı Yıl 2007 Cilt: 21 Sayı: 2

Kaynak Göster

APA Gürsoy, S., Üçvet, A., Anar, S., Kul, C., vd. (2007). BENİGN HASTALIKLARDA PNÖMONEKTOMİ. İzmir Göğüs Hastanesi Dergisi, 21(2), 29-32.