Torasik Outlet Sendromunda Cerrahi Tedavinin Etkinliği

Yıl 2020, , 270 - 277, 29.10.2020

Oktay Aslaner

https://doi.org/10.30565/medalanya.792279

Öz

Amaç: Bu çalışmada, Torasik outlet sendromu tanısı konulan hastalarda cerrahi tedavinin etkinliğini değerlendirmeyi amaçladık.

Hastalar ve Yöntem: 1991 ile 2004 yılları arasında Torasik Outlet Sendromu tanısı almış ve tedavi yöntemi olarak cerrahi uygulanmış otuz yedi olgunun yaş, cins, meslek dağılımı, anamnez ve fizik muayene bulguları, semptomları, preoperatif tetkikleri, operasyon bulguları, postoperatif komplikasyonları, postoperatif hastanede kalış süreleri ve operasyon sonuçlan incelenerek yapıldı.

Bulgular: Olguların çoğu 15-35 yaş grubunda (% 72.97) ve kadınlardan (% 91,9) oluşmaktaydı. Bu olguların çoğu ev hanımıydı (% 51.4). En sık rastlanılan semptomlar ağrı (%94,6) ve uyuşma (% 78.4) idi. Fizik muayenede en sık kullanılan test Adson testi idi.
Adson testi %86 oranında pozitif bulundu. Radyolojik testlerde en sık karşılaşılan patoloji servikal kosta anomalisiydi (% 37.8). üst ekstremite EMG sinin %48.6, üst ekstremite arteriel doplerinde% 13.5 oranında TOS u desteklediği bulundu. Cerrahide transaksiller girişim ile birinci kosta ve servikal kosta rezeksiyonu. skalenektomi fibromüsküler bantların kesilmesi işlemlerini uyguladık. Cerrahiden sonra erken dönemde %78.4 oranında tam düzelme görüldü. Olguların hiçbirinde mortalite olmadı.

Sonuç: Bu çalışmada TOS hastalarda, uygun olgularda ve iyi cerrahi teknik ile sonuçlar tatmin edici bulundu. Cerrahi başarı oranı %97 lere kadar çıkabilmektedir.

Anahtar Kelimeler

Torasik Outlet Sendromu;, Servikal Kosta;, Transaksiller yaklaşım

Teşekkür

tez danışmanım rahmetli prof.dr.Abid DEMİRCAN'a sonsuz teşekkürlerimle

Thoracic Outlet Syndrom: Efficiency Of Surgery

Öz

Aim: In this study, we aimed to evaluate the effectiveness of surgical treatment in patients diagnosed with thoracic outlet syndrome.

Patients and Methods: This study was conducted by analyzing the age, sex, occupational distribution, anamnesis and physical examination findings, symptoms, preoperative examinations, operation findings, postoperative complications, postoperative hospital stay and operation results of thirty seven patients who were diagnosed with Thoracic Outlet Syndrome, and were operated on between 1991 and 2004.

Results: Most of the patients were in the 15-35 age group (72.97%) and female (91.9%). Most of these cases were housewives (51.4%). The most common symptoms were pain (94.6%) and numbness (78.4%). The most commonly used test in physical examination was the Adson test, which provided an 86% positive rate. The most common pathology encountered in radiological tests was cervical rib anomaly (37.8%). It was found that EMG of upper extremity supported TOS with a rate of 48.6% and arterial doppler of upper extremity supported TOS with a rate of 13,5%. We applied first rib and cervical rib resection scalenectomy and cutting of fibromuscular bands as a surgery by transaxillary approach. A 78.4% complete recovery was observed in the early period after surgery and there was no mortality in any of the cases.

Conclusion: In this study, the results were satisfactory in TOS patients on suitable cases and with good surgical technique. Surgical success rate can reach up to 97%.

Anahtar Kelimeler

thorasic outlet syndrom,, servgical costa,, transaxiller apporach,

Kaynakça

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