Spontan pnömotoraksta tedavi seçenekleri
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Tarih
2014
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada, 2000-2011 yılları arasında Ondokuz Mayıs Üniversitesi Tıp Fakültesi Göğüs Cerrahisi Kliniği’nde tedavi edilmiş spontan pnömotorakslı hastaları geriye dö- nük olarak değerlendirmek amaçlandı. Gereç ve Yöntem: Spontan pnömotoraks tanısı ile takip ve tedavi edilmiş 160 hasta yaş, cinsiyet, sigara kullanımı, eti- yoloji, tanı yöntemleri, tedavi şekillerine göre geriye dönük olarak değerlendirildi. Bulgular: Hastaların 144’ü erkek, 16’sı kadındı. 86 hastada primer spontan pnömotoraks (PSP), 74 hastada sekonder spontan pnömotoraks (SSP) tespit edildi. SSP’li hastalarda en sık etiyolojik nedenler kronik obstrüktif akciğer hastalı- ğı (KOAH) ve tüberkülozdu. Hastaların 149’una kapalı su altı drenajı, 53’üne cerrahi tedavi, 20’sine plörodezis, 18’ine na- zal oksijen tedavisi uygulandı. Cerrahi tedavi ve plörodezis uygulanan hastalarda nüks izlenmezken, nazal oksijen teda- visi alan hastaların beşinde, tüp torakostomi uygulanan has- taların 21’inde nüks tespit edildi. Ortlama hastanede kalış 10 gün, mortalite oranı %1.8 idi. Sonuç: Spontan pnömotorakslı hastalarda tüp torakos- tominin yetersiz kaldığı durumlarda video yardımlı toraks cerrahisi ya da torakotomi ile cerrahi tedavi altın standart- tır. Cerrahi tedavi seçeneklerinin kullanılamadığı hastalar- da, nüksü önlemek için plörodezis akılda bulundurulmalı- dır.
Background: In this study we retrospectively evaluated pa- tients with spontaneous pneumothorax diagnosis in Ondokuz Mayıs University, Faculty of Medicine, Department of Thoracic Surgery between 2000-2011. Methods: We retrospectively evaluated 160 patients diag- nosed with spontaneous pneumothorax on the basis of age, gender, smoking habits, etiology, methods of diagnosis, and treatment. Results: Patients included 144 males and 16 females. There were 86 primary SP and 74 secondary SP patients. COPD and tuberculosis were the most common cause in secondary SP pa- tients. In 149 patients, lung expansion was provided with tube thoracostomy. Fifty-three patients were operated on. In 20 pa- tients, chemical pleurodesis was performed. Eighteen patients were treated with nasal oxygen therapy. No recurrence was de- termined in the groups of surgical treatment and pleurodesis. The 5 patients who received nasal oxygen therapy and 21 pa- tients treated with tube thoracostomy had symptoms reoccur. Mean hospital stay was 10 days and mortality rate was 1.8%. Conclusion: In patients with spontaneous pneumothorax, video-assisted thoracoscopic surgery or surgical treatment with thoracotomy is the gold standard when tube thoracos- tomy has failed. To prevent recurrence, pleurodesis should be considered for patients in whom no surgical treatment choices can be used.
Background: In this study we retrospectively evaluated pa- tients with spontaneous pneumothorax diagnosis in Ondokuz Mayıs University, Faculty of Medicine, Department of Thoracic Surgery between 2000-2011. Methods: We retrospectively evaluated 160 patients diag- nosed with spontaneous pneumothorax on the basis of age, gender, smoking habits, etiology, methods of diagnosis, and treatment. Results: Patients included 144 males and 16 females. There were 86 primary SP and 74 secondary SP patients. COPD and tuberculosis were the most common cause in secondary SP pa- tients. In 149 patients, lung expansion was provided with tube thoracostomy. Fifty-three patients were operated on. In 20 pa- tients, chemical pleurodesis was performed. Eighteen patients were treated with nasal oxygen therapy. No recurrence was de- termined in the groups of surgical treatment and pleurodesis. The 5 patients who received nasal oxygen therapy and 21 pa- tients treated with tube thoracostomy had symptoms reoccur. Mean hospital stay was 10 days and mortality rate was 1.8%. Conclusion: In patients with spontaneous pneumothorax, video-assisted thoracoscopic surgery or surgical treatment with thoracotomy is the gold standard when tube thoracos- tomy has failed. To prevent recurrence, pleurodesis should be considered for patients in whom no surgical treatment choices can be used.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp
Kaynak
Kartal Eğitim ve Araştırma Hastanesi Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
25
Sayı
1
