The Role of General Surgery in the Disaster of the Century in Our Country: Our First Surgical Results

Öz

Abstract Aim: The aim is to guide the clinical practices of general surgeons in extraordinary disaster situations and to contribute to the preparation processes and surgical procedures for large-scale disasters that may occur in the future. Methods: This study was planned as a retrospective descriptive study. Twenty-nine patients who underwent emergency fasciotomy by general surgery were excluded from the study. In the study, data of 50 patients who were admitted to the general surgery clinic and underwent surgery due to earthquake-related injuries between February 6-28 were analyzed. Demographic data, affected organs, surgical procedures performed, complications, intensive care unit stay, hospital stay, and outcomes of the patients were recorded. Results: Twenty-nine of the patients were women (58%), and 21 were men (42%). The average age was 38.78 years. The number of patients who were followed up for non-surgical reasons was 33 (66%), and 3 patients were pregnant. In our study, 30 (52%) of the patients admitted to our clinic for follow-up and treatment had intra-abdominal fluid findings following intra-abdominal organ bleeding. In our study, when the affected organs were evaluated, the liver was the most frequently injured organ. Of the patients followed up non-surgically in our study, 14 had liver trauma. The most frequent complication was acute renal failure, which occurred in 38 patients (76%). Conclusion: Considering the limited diagnostic and treatment options in large-scale earthquakes, it should be taken into account that intraperitoneal free air detected on abdominal CT may not always indicate gastrointestinal perforation, and selected patients can be managed without emergency laparotomy under appropriate clinical monitoring. Keywords: Earthquake, abdominal injuries, general surgery, complications, mortality.

Anahtar Kelimeler

• Earthquake
• abdominal injuries
• general surgery
• complications
• mortality.

Ülkemizde Yüzyılın Felaketinde Genel Cerrahinin Rolü: İlk Cerrahi Sonuçlarımız

Öz

Özet Amaç: Bu çalışmanın amacı, olağanüstü afet durumlarında genel cerrahların klinik uygulamalarına rehberlik etmek ve gelecekte meydana gelebilecek büyük ölçekli afetler için hazırlık süreçlerine ve cerrahi prosedürlere katkıda bulunmaktır. Metot: Bu çalışma, retrospektif tanımlayıcı bir çalışma olarak planlanmıştır. Genel cerrahi tarafından acil fasyotomi yapılan 29 hasta çalışmadan çıkarıldı. Çalışmada, 6-28 Şubat tarihleri arasında depremle ilgili yaralanmalar nedeniyle genel cerrahi kliniğine başvuran ve ameliyat edilen 50 hastanın verileri analiz edilmiştir. Hastaların demografik verileri, etkilenen organlar, yapılan cerrahi işlemler, komplikasyonlar, yoğun bakım ünitesinde kalış süresi, hastanede kalış süresi ve sonuçları kaydedilmiştir. Bulgular: Hastaların 29'u (%58) kadın, 21'i (%42) erkekti. Ortalama yaş 38,78 idi. Cerrahi dışı nedenlerle takip edilen hasta sayısı 33 (%66) olup, 3 hasta hamileydi. Çalışmamızda, takip ve tedavi için kliniğimize başvuran hastaların 30'unda (%52) karın içi organ kanaması sonrası karın içi sıvı bulguları saptandı. Çalışmamızda etkilenen organlar değerlendirildiğinde, en sık yaralanan organ karaciğer oldu. Çalışmamızda cerrahi dışı takip edilen hastaların 14'ünde karaciğer travması görüldü. En sık görülen komplikasyon, 38 hastada (%76) görülen akut böbrek yetmezliğiydi. Sonuç: Büyük depremlerde sınırlı tanı ve tedavi seçenekleri göz önüne alındığında, karın BT'sinde saptanan intraperitoneal serbest havanın her zaman gastrointestinal perforasyonu göstermeyebileceği ve seçilmiş hastaların uygun klinik izleme altında acil laparotomi yapılmadan yönetilebileceği dikkate alınmalıdır. Anahtar Kelimeler: Deprem, karın yaralanmaları, genel cerrahi, komplikasyonlar, mortalite.

Anahtar Kelimeler

• Deprem
• karın yaralanmaları
• genel cerrahi
• komplikasyonlar
• mortalite.

Kaynakça

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