Trakeal Stenoz tedavisinde Cerrahi ve Stent Uygulamasının Karşılaştırılması

Abstract

Amaç Trakeal stenoz giderek artan ve müdahale gerektiren bir patolojidir. Cerrahi tedavi yıllardır altın standart olarak uygulanmaktadır fakat komorbiditeleri olan ve cerrahi riski yüksek hastalarda operasyon kararı vermek zordur. Merkezimizde uygulanan her iki tedavi yönteminin verilerini değerlendirmeyi amaçladık. Yöntem ve Gereçler Çalışmamız retrospektif ve gözlemsel olarak tasarlandı. Merkezimizde Mayıs 2002 - Mayıs 2019 arasında trakeal stenoz nedeniyle rezeksiyon & rekonstrüksiyon veya stent uygulanan 61 hastanın verileri analiz edildi. Dahil edilme kriterlerini karşılayan 54 hasta çalışmaya dahil edildi. Bulgular Dahil edilme kriterlerini karşılayan 44 hasta ile çalışıldı. Her 2 tedavi yöntemi de darlığın azaltılmasında ve şikayetlerin gerilemesinde etkili bulundu. Stent grubunda yaş ortalaması cerrahi gruba göre daha yüksekti. Entübe durumda yoğun bakım süresi uzadıkça; ciddi darlık ve kıkırdak bütünlüğünün bozulması arttı. Steroid kullananlarda antibiyotik değişim oranlarında artış gözlendi. İşlem sonrası komplikasyon oranı ameliyat grubunda %22.5, stent grubunda %53.5idi. Cerrahi grup memnuniyet skoru stent grubuna göre daha yüksekti. Sonuç İki tedavi yöntemi de solunum fonksiyonlarını ve yaşam kalitesini arttırmada etkilidir. Cerrahi grupta lezyon daha üst yerleşimli, stent grubunda daha uzundu. Ciddi darlığı olan hastaların yatış süreleri daha uzundu ve steroid kullanan hastalarda antibiyotik değişimi daha fazlaydı, istatistiksel olarak anlamlı fark bulunamadı.

Keywords

• Trakea
• darlık
• rezeksiyon
• rekonstrüksiyon
• stent uygulanması

Comparison of Surgery and Stent Application in the Treatment of Tracheal Stenosis

Abstract

Introduction: Tracheal stenosis is a pathology that is gradually increasing and requires intervention. Surgical treatment has been used as the gold standard for years, but it is difficult to decide on surgery in patients with comorbidities and high surgical risk. We aimed to evaluate the data of both treatment methods applied in our center. Materials: Our study was designed as retrospective and observational. The data of 61 patients who underwent resection & reconstruction and Methods or stent due to tracheal stenosis in our center between May 2002 - May 2019 were analyzed. Tracheal stenosis classifications, etiology, demography and treatment data, imaging measurements, and a satisfaction survey were used. Results: 53 patients who met the inclusion criteria were studied. Both treatment methods were found to be effective in reducing the stenosis and regressing the complaints. The average age in the stent group was higher than in the surgery group. As the intensive care period in the intubated state increases; Severe stenosis and deterioration of cartilage integrity increased. The satisfaction score of the surgery group was higher than the stent group. Conclusion: Both treatment methods are effective in improving respiratory functions and quality of life. The lesion was located higher in the surgical group and was longer in the stent group. Hospitalization times were longer in patients with severe stenosis and antibiotic changes were more frequent in patients using steroids. No statistically significant difference was found.

Keywords

• Trachea
• Stenosis
• Resection
• Reconstruction
• Stent implantation

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