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

Etik Beyan

Bu çalışmada, çalışmanın yapıldığı kurumdan ve yerel etik kuruldan (Harran Üniversitesi Klinik Araştırmalar Etik Kurulu) onay alınmıştır (Tarih: 22.07.2024 - Onay no: HRÜ/24.10.18). Çalışma Helsinki Deklarasyonu ilkelerine uygun olarak yürütülmüştür. Yalnızca anonimleştirilmiş hasta verileri kullanıldığından ve hasta bakımı üzerinde herhangi bir risk veya etki olmadığından, bilgilendirilmiş onam gerekmemiştir. Bu onam feragati Kurumsal İnceleme Kurulu ve Etik Kurul tarafından onaylanmıştır ve retrospektif çalışmalar için düzenleyici ve etik kılavuzlara uygundur.

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

Öz

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.

Anahtar Kelimeler

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

Etik Beyan

In this study, approval was obtained from the institutions and the local ethics committee (Harran University Clinical Research Ethics Committee) (Date: 22.07.2024 - Approval no: HRÜ/24.10.18). The study was conducted following the principles of the Declaration of Helsinki. Since only anonymized patient data was used and there was no risk or impact on patient care, informed consent was not required. This consent waiver was approved by the Institutional Review Board and Ethics Committee and complies with regulatory and ethical guidelines for retrospective studies.

Kaynakça

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