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Tiroid cerrahisinde oksitlenmiş selüloz kullanımının postoperatif hipokalsemi üzerine etkisi

Yıl 2021, Cilt: 16 Sayı: 2, 214 - 218, 07.07.2021
https://doi.org/10.17517/ksutfd.794176

Öz

Giriş
Hipokalsemi, tiroid cerrahisi sonrası hastalarda sık görülen bir komplikasyondur. Özellikle kalıcı hipokalsemi en sık görülen komplikasyondur ve önemli morbiditeye neden olabilir. Ayrıca postoperatif hemoraji, tiroid cerrahisinin nadir görülen, hayatı tehdit eden bir komplikasyonudur. Bu çalışmada, oksitlenmiş rejenere selüloz gazlı bezi (OC) + geleneksel hemostaz ile geleneksel hemostazı tiroid cerrahisi ile ilgili komplikasyonla ve kalsiyum seviyelerinin farkını inceleyerek karşılaştırıyoruz..
YÖNTEMLER
İki yüz seksen sekiz hasta iki gruba ayrıldı: Grup 1 (144 hasta) konvansiyonel hemostaz, grup 2 (144 hasta) Okside selüloz + konvansiyonel hemostaz. Preoperatif ve postoperatif Ca düzeyleri, operasyon süresi, hastanede kalış süresi, komplikasyonlar (kanama, rekürren laringeal sinir yaralanması, hipokalsemi) değerlendirildi.
SONUÇLAR
Gruplar arasında cinsiyet, ameliyat öncesi ve sonrası Ca düzeyleri, hastanede kalış süresi, kanama, tekrarlayan sinir yaralanması açısından anlamlı fark yoktu. Ortalama yaş grup 1'de grup 2'ye göre anlamlı olarak daha yüksekti (52,4 yıla karşı 49,6 yıl, p <0,05). Grup 2'de operasyon süresi grup 1'e göre anlamlı olarak daha düşüktü (77,2 dk.vs 87,2 dk., P <0,05).
SONUÇ
Klasik hemostaz yöntemlerine kıyasla hemostaz için Oksitlenmiş Selüloz gazlı bezin hemostaza amaçlı kullanımının kalsiyum metabolizmasında pozitif-negatif fark yaratmadığını ve operasyon süresini kısaltırken komplikasyon oranlarında fark oluşturmadığını düşünüyoruz.

Destekleyen Kurum

yok

Kaynakça

  • 1. Khadra H, Bakeer M, Hauch A, Hu T, Kandil E. Hemostatic agent use in thyroid surgery: a meta-analysis, Gland Surg 2018;(Suppl 1): S34-S41.doi: 10.21037/gs.2018.03.02
  • 2. Aleksandar K, Miodagl D, Nebojsa D, Ilija G. Effect of fibrin vs cellulose based haemostatic agents with traditional haemostatic procedures in thyroid surgery. Pak J Med Sci. 2017;33(6): 1360-1365. doi: https// doi.org/10.12669/pjms.336.13692
  • 3. Testini M, Marzaioli R, Lissidini G, Lippoli A, Logoluso F, Gurrado A, Lardo D, Poi E Piccini G. The effevtiveness of FloSeal matrix hemostatic agent in thyroid urgery: a prospective, randomized, control study. Langenbecks arch Surg(2009) 394:837-842 doi:10.1007/s00423-009-0497-5
  • 4. Kim JH, Chung Mk, Son Y. Reliable early prediction for different types of post-thyroidectomy hypocalcemia. Clin Exp Otorhinolaryngol. 2011 Jun;4(2):95-100. doi: 10.3342/ceo.2011.4.2.95.
  • 5. Amit M, Binenbaum Y, Cohen JT, Gil Z. Effectiveness of an oxidized cellulose patch hemostatic agent in thyroid surgery: A prospective, randomized, controlled study. J Am Coll Surg 2013;217:221-225 http://dx.doi.org/10.1016/j.jamcollsurg.2013.03.002
  • 6. Royds J, Kieran S, Timon C. Oxidized cellulose (Surgicel)based reaction post thyroidectomy mimicking an abcess: A case report In J Surg Case Rep.2012;3(7):338-339 doi: 10.1016/j.jscr.2012.03.034
  • 7. Lewis KM, Schivis A, Hedrich HC, Regenbogen J, Goppelt A. Hemostatic efficacy of a novel, PEG-coated collagen pad in clinically relevant animal models. Int J Surg. 2014;12(9):940-4. doi: 10.1016/j.ijsu.2014.07.017.
  • 8. Fischer CP, Bochicchio G, Shen J, Patel B, Batiller J, Hart JC. A prospective, randomized, controlled, trial of the efficacy and safety of fibrin pad as an adjunct to control soft tissue bleeding during abdominal, retroperitoneal, pelvic,and thoracic surgery. J Am Coll Surg 2013; 216:385-393. http://dx.doi.org/10.1016/j.jamcollsurg.2013.02.036
  • 9. Tartaglia N, Di Lascia A, Lizzi V, Cianci P, Fersini A, Ambrosi A, Neri V. Haemostasis in thyroid surgery: Colage-fibrinogen-thrombin patch versus cellulose gauze-our experience Surg Res Pract. 2016;2016:3058754. doi: 10.1155/2016/3058754.
  • 10. Liu J, Hong W, Wu W, Ni H, Zhou M. Delayed absorption of oxidized cellulose (surgicel) in post-thyroidectomy patients. J Ultrasound Med 2016; 35: 1349-1351 doi: 10,7863/ultra.15.08014
  • 11. Park KS, Lee KE, Ku DH, Kim SJ, Park SJ, Kim HY, Kwon MR, Youn YK. Antiadhesive effect and safety of oxidized regenerated cellulose after thyroidectomy: a prospective, randomized controlled study. J Korean Surg Soc 2013;84:321-329 http// dxdoi.org/10.4174/jkss.2013.84.6.321
  • 12. De Palma M, Rosato L, Zingone F, Orlando G, Antonino A, Vitale M, Puzziello A. Post-thyroidectomy complications.The role of the device: bipolar vs ultrasonic device: Collection of data from 1,846 consecutive patients undergoing thyroidectomy. Am J Surg. 2016 Jul;212(1):116-21. doi: 10.1016/j.amjsurg.2015.05.024.
  • 13. Erdas E, Medas F, Podda F, Furcas S, Pisano G, Nicolosi A, Calo PG. The use of a biologic topical haemostatic agent (TachoSil(®)) for the prevention of postoperative bleeding in patients on antithrombotic therapy undergoing thyroid surgery: A randomised controlled pilot trial. Int J Surg. 2015 Aug;20:95-100. doi: 10.1016/j.ijsu.2015.06.027.
  • 14. Rosato L, Avenia N, Bernante P. Et al. Complications of thyroid surgery : anlysis of a multicenteric study on14934 patients operated on Italy over 5 yerars. World J Surg 2004 28:271-276 doi: 10/1007/s00268-003-6903-1
  • 15. Cheng, H., Soleas, I., Ferko, N.C. et al. A systematic review and meta-analysis of Harmonic Focus in thyroidectomy compared to conventional techniques. Thyroid Res 8, 15 (2015). https://doi.org/10.1186/s13044-015-0027-1
  • 16. Lorante-Poch L, Sancho JJ, Munoz-Noca JL, Sanchez-Velaquez P, Sitges-Serra A. Defining the syndromes of parathyroid failure after total thyroidectomy. Glan Surg 2015;4(1):82-90 http// dx.doi.org/10.3978/j.issn.2227-684X.2014.12.04
  • 17. Oran E, Yetkin G, Mihmanlı M, Celayir F, Aygün N,Çoruh B, Peker E, Uludağ M. The risk of hypocalcemia in patients with parathyroid autotransplatation during thyroidectomy Ulus Cerrahi Dergisi 2016;32:6-10 Doi: 10.5152/UCD.2015.3013
  • 18. Albuja-Cruz MB, Pozdeyev N, Robbins S, Chandramouli R, Raeburn CD, Klopper J, Haugen BR, McIntyre R Jr. A "safe and effective" protocol for management of post-thyroidectomy hypocalcemia. Am J Surg. 2015 Dec;210(6):1162-8; discussion 1168-9. doi: 10.1016/j.amjsurg.2015.07.010.
  • 19. Kala F, Sarici IS, Ulutaş KT, Sevim Y, Doğu A, Sarigöz T, Tastan B, Topuz Ö, Ertan T. Intact parathormone measurment 1 hour after total thyroidectomy as a predictor of symptomtic hypocalcemia Int J Clin Exp Med 2015;8 (10):18813-18818
  • 20. Kocián P, Neumann J, Bavor P, Hoch J. Disekční a koagulační technika - má vliv na výsledky totální tyreoidektomie? [Dissection and coagulation technique in thyroid surgery - is it the key to a successful outcome?]. Rozhl Chir. 2014;93(5):255‐259.

The effect of oxidized cellulose use on postoperative hypocalcemia development in thyroid surgery

Yıl 2021, Cilt: 16 Sayı: 2, 214 - 218, 07.07.2021
https://doi.org/10.17517/ksutfd.794176

Öz

BACKGROUND
Hypocalcemia is a frequent complication in patients after thyroid surgery. Especially permanent hypocalcemia is the most common complication and it can cause significant morbidity. Also postoperative haemorhage is uncommon life-threatening complication of thyroid surgery. In this study we compare calcium metabolism and complications between oxidized regenerated cellulose gauze (OC) + conventional haemostasis versus conventional haemostasis in thyroid surgery.
METHODS
Two hundred and eighty eight patients were divided in to two groups: Group 1(144 patients) conventional haemostasis, group 2 (144 patients) Oxidized cellulose + conventional haemeostasis. Preoperative and postoperative Ca levels, operation time, hospital stay, complications (bleeding, recurrent laringeal nerve injury, hypocalcemia) were evaluated.
RESULTS
There was no significant difference between groups in sex, preoperative and postoperative Ca levels, hospital stay, bleeding, recurrent nerve injury. The avarage age was significantly higher in group 1 compared to group 2( 52,4 years vs 49,6 years, p< 0,05). The operation time was significanly lower in group 2 compared to group 1(77,2 min.vs 87,2 min., p< 0,05).
CONCLUSION
Compared with conventional haemostasis methods, we think that addition Oxidized Cellulose gauze for haemostasis does not create a positive- negative difference in calcium matebolism and does not make a difference in complication rates, while shortening the operation time.

Kaynakça

  • 1. Khadra H, Bakeer M, Hauch A, Hu T, Kandil E. Hemostatic agent use in thyroid surgery: a meta-analysis, Gland Surg 2018;(Suppl 1): S34-S41.doi: 10.21037/gs.2018.03.02
  • 2. Aleksandar K, Miodagl D, Nebojsa D, Ilija G. Effect of fibrin vs cellulose based haemostatic agents with traditional haemostatic procedures in thyroid surgery. Pak J Med Sci. 2017;33(6): 1360-1365. doi: https// doi.org/10.12669/pjms.336.13692
  • 3. Testini M, Marzaioli R, Lissidini G, Lippoli A, Logoluso F, Gurrado A, Lardo D, Poi E Piccini G. The effevtiveness of FloSeal matrix hemostatic agent in thyroid urgery: a prospective, randomized, control study. Langenbecks arch Surg(2009) 394:837-842 doi:10.1007/s00423-009-0497-5
  • 4. Kim JH, Chung Mk, Son Y. Reliable early prediction for different types of post-thyroidectomy hypocalcemia. Clin Exp Otorhinolaryngol. 2011 Jun;4(2):95-100. doi: 10.3342/ceo.2011.4.2.95.
  • 5. Amit M, Binenbaum Y, Cohen JT, Gil Z. Effectiveness of an oxidized cellulose patch hemostatic agent in thyroid surgery: A prospective, randomized, controlled study. J Am Coll Surg 2013;217:221-225 http://dx.doi.org/10.1016/j.jamcollsurg.2013.03.002
  • 6. Royds J, Kieran S, Timon C. Oxidized cellulose (Surgicel)based reaction post thyroidectomy mimicking an abcess: A case report In J Surg Case Rep.2012;3(7):338-339 doi: 10.1016/j.jscr.2012.03.034
  • 7. Lewis KM, Schivis A, Hedrich HC, Regenbogen J, Goppelt A. Hemostatic efficacy of a novel, PEG-coated collagen pad in clinically relevant animal models. Int J Surg. 2014;12(9):940-4. doi: 10.1016/j.ijsu.2014.07.017.
  • 8. Fischer CP, Bochicchio G, Shen J, Patel B, Batiller J, Hart JC. A prospective, randomized, controlled, trial of the efficacy and safety of fibrin pad as an adjunct to control soft tissue bleeding during abdominal, retroperitoneal, pelvic,and thoracic surgery. J Am Coll Surg 2013; 216:385-393. http://dx.doi.org/10.1016/j.jamcollsurg.2013.02.036
  • 9. Tartaglia N, Di Lascia A, Lizzi V, Cianci P, Fersini A, Ambrosi A, Neri V. Haemostasis in thyroid surgery: Colage-fibrinogen-thrombin patch versus cellulose gauze-our experience Surg Res Pract. 2016;2016:3058754. doi: 10.1155/2016/3058754.
  • 10. Liu J, Hong W, Wu W, Ni H, Zhou M. Delayed absorption of oxidized cellulose (surgicel) in post-thyroidectomy patients. J Ultrasound Med 2016; 35: 1349-1351 doi: 10,7863/ultra.15.08014
  • 11. Park KS, Lee KE, Ku DH, Kim SJ, Park SJ, Kim HY, Kwon MR, Youn YK. Antiadhesive effect and safety of oxidized regenerated cellulose after thyroidectomy: a prospective, randomized controlled study. J Korean Surg Soc 2013;84:321-329 http// dxdoi.org/10.4174/jkss.2013.84.6.321
  • 12. De Palma M, Rosato L, Zingone F, Orlando G, Antonino A, Vitale M, Puzziello A. Post-thyroidectomy complications.The role of the device: bipolar vs ultrasonic device: Collection of data from 1,846 consecutive patients undergoing thyroidectomy. Am J Surg. 2016 Jul;212(1):116-21. doi: 10.1016/j.amjsurg.2015.05.024.
  • 13. Erdas E, Medas F, Podda F, Furcas S, Pisano G, Nicolosi A, Calo PG. The use of a biologic topical haemostatic agent (TachoSil(®)) for the prevention of postoperative bleeding in patients on antithrombotic therapy undergoing thyroid surgery: A randomised controlled pilot trial. Int J Surg. 2015 Aug;20:95-100. doi: 10.1016/j.ijsu.2015.06.027.
  • 14. Rosato L, Avenia N, Bernante P. Et al. Complications of thyroid surgery : anlysis of a multicenteric study on14934 patients operated on Italy over 5 yerars. World J Surg 2004 28:271-276 doi: 10/1007/s00268-003-6903-1
  • 15. Cheng, H., Soleas, I., Ferko, N.C. et al. A systematic review and meta-analysis of Harmonic Focus in thyroidectomy compared to conventional techniques. Thyroid Res 8, 15 (2015). https://doi.org/10.1186/s13044-015-0027-1
  • 16. Lorante-Poch L, Sancho JJ, Munoz-Noca JL, Sanchez-Velaquez P, Sitges-Serra A. Defining the syndromes of parathyroid failure after total thyroidectomy. Glan Surg 2015;4(1):82-90 http// dx.doi.org/10.3978/j.issn.2227-684X.2014.12.04
  • 17. Oran E, Yetkin G, Mihmanlı M, Celayir F, Aygün N,Çoruh B, Peker E, Uludağ M. The risk of hypocalcemia in patients with parathyroid autotransplatation during thyroidectomy Ulus Cerrahi Dergisi 2016;32:6-10 Doi: 10.5152/UCD.2015.3013
  • 18. Albuja-Cruz MB, Pozdeyev N, Robbins S, Chandramouli R, Raeburn CD, Klopper J, Haugen BR, McIntyre R Jr. A "safe and effective" protocol for management of post-thyroidectomy hypocalcemia. Am J Surg. 2015 Dec;210(6):1162-8; discussion 1168-9. doi: 10.1016/j.amjsurg.2015.07.010.
  • 19. Kala F, Sarici IS, Ulutaş KT, Sevim Y, Doğu A, Sarigöz T, Tastan B, Topuz Ö, Ertan T. Intact parathormone measurment 1 hour after total thyroidectomy as a predictor of symptomtic hypocalcemia Int J Clin Exp Med 2015;8 (10):18813-18818
  • 20. Kocián P, Neumann J, Bavor P, Hoch J. Disekční a koagulační technika - má vliv na výsledky totální tyreoidektomie? [Dissection and coagulation technique in thyroid surgery - is it the key to a successful outcome?]. Rozhl Chir. 2014;93(5):255‐259.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Mehmet Fatih Ekici 0000-0002-1247-1139

Sezgin Zeren 0000-0002-9342-1706

Ali Cihat Yıldırım 0000-0001-5379-2804

Faik Yaylak 0000-0002-1216-0429

Özlem Arık 0000-0002-6516-9726

Uğur Deveci 0000-0003-4449-1190

Mustafa Algın 0000-0003-2152-878X

Yayımlanma Tarihi 7 Temmuz 2021
Gönderilme Tarihi 15 Eylül 2020
Kabul Tarihi 8 Ekim 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 16 Sayı: 2

Kaynak Göster

AMA Ekici MF, Zeren S, Yıldırım AC, Yaylak F, Arık Ö, Deveci U, Algın M. The effect of oxidized cellulose use on postoperative hypocalcemia development in thyroid surgery. KSÜ Tıp Fak Der. Temmuz 2021;16(2):214-218. doi:10.17517/ksutfd.794176