Kardiyopulmoner Bypass Eşliğinde Yapılan Konvansiyonel ve Minimal İnvazif Kalp Cerrahisinin İnflamatuar, Hepatik ve Renal Parametreler Üzerine Etkilerinin Karşılaştırılması

Öz

Giriş: Kalp cerrahisi uzun yıllar konvansiyonel yöntemlerle yapılmıştır, ancak son yıllarda minimal invazif kalp cerrahisi yöntemi de ön plana çıkmıştır. Bu çalışmada KPB eşliğinde yapılan konvansiyonel ve minimal invazif kalp cerrahisinin inflamatuar, hepatik ve renal parametreler üzerine etkilerinin karşılaştırılmasını değerlendirmek amaçlandı. Gereç ve Yöntemler: Retrospektif olarak yapılan bu çalışmada, KPB eşliğinde geleneksel kalp cerrahisi uygulananlar Grup 1, minimal invazif kalp cerrahisi uygulananlar ise Grup 2 olarak belirlendi. Çalışmada grupların tanımlayıcı verileri, preoperatif ve postoperatif inflamatuar, hepatik ve renal fonksiyonların göstergeleri olan üre, kreatin, ALT, AST, GGT, WBC, CRP verileri ve peroperatif değişkenlerinden entübe kalış süresi, ICU time, hastanede kalış süresi verileri değerlendirildi. Bulgular: Bu çalışmada iki grubun demografik verileri benzerdi (p > 0.05). Grupların preoperatif ve postoperatif inflamatuar, hepatik, renal parametreleri (üre, kreatin, WBC, CRP, AST, ALT, GGT), ICU time, hastanede kalış süresi ve mortalite oranları da benzerdi (p > 0.05). Ancak AKK süresi (p = 0.021), total perfüzyon süresi (p = 0.001) ve mekanik ventilasyon süresi (p = 0.005) açısından gruplar arasında istatistiksel olarak anlamlı farklılıklar vardı ve bu değerler Grup 2'de daha yüksekti. Sonuç: KPB eşliğinde gerçekleştirilen minimal invazif kalp cerrahisinin, konvansiyonel kalp cerrahisine kıyasla daha uzun AKK süresi, total perfüzyon süresi ve mekanik ventilasyon süresi ile ilişkili olduğu görülmüştür. Bununla birlikte, inflamatuar, renal ve hepatik parametrelerde belirgin farklılıklar olmamakla birlikte, benzer sonuçlar gösterdikleri de görülmüştür.

Anahtar Kelimeler

• kardiyopulmoner bypass
• konvansiyonel bypass
• minimal invazif bypass
• inflamatuar parametreler
• hepatik parametreler
• renal parametreler

Comparison of the Effects of Conventional and Minimally Invasive Cardiac Surgery with Cardiopulmonary Bypass on Inflammatory, Hepatic and Renal Parameters

Abstract

Aim: Cardiac surgery has been performed by conventional methods for many years, but in recent years, minimally invasive cardiac surgery has come to the forefront. The aim of this study was to evaluate the effects of conventional and minimally invasive cardiac surgery performed under CPB guidance on inflammatory, hepatic and renal parameters. Methods: In this retrospective study, those who underwent conventional cardiac surgery with CPB were defined as Group 1 and those who underwent minimally invasive cardiac surgery were defined as Group 2. Descriptive data of the groups, preoperative and postoperative urea, creatinine, ALT, AST, GGT, WBC, CRP data which are indicators of inflammatory, hepatic and renal functions, and peroperative variables such as intubation time, ICU time and hospital stay time were evaluated. Results: In this study, demographic data of the two groups were similar (p > 0.05). Preoperative and postoperative inflammatory, hepatic, renal parameters (urea, creatinine, WBC, CRP, AST, ALT, GGT), ICU time, hospital stay and mortality rates were also similar (p > 0.05). However, there were statistically significant differences between the groups in terms of duration of AKI (p = 0.021), total perfusion time (p = 0.001) and mechanical ventilation time (p = 0.005), and these values were higher in Group 2. Conclusion: Minimally invasive cardiac surgery performed under CPB guidance was associated with longer LOS, total perfusion time and duration of mechanical ventilation compared to conventional cardiac surgery. However, inflammatory, renal and hepatic parameters showed similar results, although there were no significant differences.

Keywords

• cardiopulmonary bypass
• conventional bypass
• minimally invasive bypass
• inflammatory parameters
• hepatic parameters
• renal parameters

Kaynakça

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