Klasik cerrahi tedavinin spinal anestezi altında varisli hastalarda venöz tromboembolizme etkisi

Öz

Amaç: Varis tedavisinde minimal invaziv yöntemler özellikle son yıllarda hızla gelişme göstermesine rağmen klasik cerrahi tedavi olan yüksek ligasyon+stripping (S/L) halen altın standart kabul edilir. Varis hastalığına bağlı bazı tromboembolik olaylar meydana gelebilmektedir. Amacımız, spinal anestezi ve S/L uygulaması olan hastalarda işlem sonrası ortalama trombosit parametrelerindeki değişiklikleri belirlemek ve bu işlemin tromboembolik olaylara etkisini araştırmaktır. Yöntemler: Bu çalışma retrospektif kohort çalışması olarak tasarlandı. Çalışmaya dahil edilen hastalar Adıyaman Üniversitesi Tıp Fakültesi Anestezi Reanimasyon polikliniğine başvuran ve spinal anestezi ile S/L yapılan hastalardan seçildi. Veriler elektronik ortamda dosya taraması şeklinde toplandı. Dosya taramasından operasyon öncesi ve 1 gün sonrası hemogram alınan hastalar çalışmaya dahil edildi. Laboratuar tetkiklerinden MPV, PLT, trombosit dağılım genişliği (PDW) ve plateletcrit (PCT) tespit edilerek kaydedildi. İstatistiksel analizler SPSS 22,0 kullanılarak yapıldı. Bulgular: Postoperatif MPV (P<0,001) ve PLT (P=0,01) değeri preoperatif döneme göre anlamlı düşüş gösterdi. PDW (P=0,194) ve PCT (P=0,863) değerlerinde postoperatif 1. gün, preoperatif döneme göre anlamlı bir değişim olmadığı görüldü. Sonuç: Spinal anestezi altında S/L uygulanan hastalarda postoperatif MPV değerinde anlamlı bir düşüş gözlenmesi, varis hastalığının ve MPV ün tromboembolik olaylarla ilişkili olduğu varsayılırsa uygulanan cerrahi tromboembolik olayları azaltır.

Anahtar Kelimeler

• Mean platelet volüm
• Tromboembolizm
• Stripping ve ligasyon
• Spinal anestezi

Effect of classical surgical treatment under spinal anesthesia on venous thromboembolism in varicose veins patients

Abstract

Aim: Although minimally invasive methods have developed rapidly in the treatment of varicose veins in recent years, high ligation + stripping (S/L), which is the classical surgical treatment, is still considered gold standard. Some thromboembolic events may occur due to varicose disease. Our aim is to determine the changes in mean platelet parameters after the procedure in patients who underwent S/L with spinal anesthesia and investigate the effect of this procedure on thromboembolic events. Methods: Patients who visited the Anesthesia Reanimation outpatient clinic of Adiyaman University Faculty of Medicine and underwent S/L with spinal anesthesia were evaluated in this retrospective cohort study. Data was collected electronically with file scanning. Patients whose hemograms were obtained before and 1 day after the operation were included. Among the laboratory tests, MPV, PLT, platelet distribution width (PDW) and plateletcrit (PCT) were noted. Results: Postoperative MPV (P<0,001) and PLT (P=0.01) values showed a significant decrease compared to the preoperative period, while PDW (P=0.194) and PCT (P=0.863) values remained similar. Conclusion: If it is assumed that varicose veins and MPV are associated with thromboembolic events, a significant decrease in postoperative MPV value in patients who underwent S / L with spinal anesthesia will reduce thromboembolic events.

Keywords

• Mean platelet volume
• Thromboembolism
• Stripping and ligation
• Spinal anesthesia

Kaynakça

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