Laparoskopik splenektomi klinik deneyimimiz: 38 hastanın sonuçları
Yükleniyor...
Tarih
2015
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Dicle Üniversitesi Tıp Fakültesi
Erişim Hakkı
CC0 1.0 Universal
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Amaç: Laparoskopik splenektomi hematolojik hastalıkların tedavisinde son dönemlerde yaygın olarak kabul görmeye başlamıştır. Bu çalışmada laparoskopik splenektomi uyguladığımız hastalarımızın sonuçlarını sunmayı amaçladık. Yöntemler: Kliniğimizde 2012 – 2015 yılları arasında hematolojik hastalıklar nedeniyle laparoskopik splenektomi yapılan 38 hastanın kayıtları retrospektif olarak incelendi.
Bulgular: Laparoskopik splenektomi uygulanan hastaların 15’i erkek, 23’ü kadın olup, ortalama yaş 33,9 ±
12,9 idi. Splenektomi endikasyonları; 34 hasta idiyopatik trombositopenik purpura (ITP), 4 hasta herediter sferositoz (HS) idi. Cerrahi eksplorasyonda 7 hastada aksesuar dalak tespit edilerek çıkarıldı. Safra kesesinde taş olan 2 HS’li hastaya aynı seansta laparoskopik kolesistektomi uygulandı. Bir hastada diseksiyon esnasında görüşü engelleyen hemoraji nedeniyle açığa geçildi. Postoperatif dönemde bir hastada atelektazi ve bir hastada yara yerinde yağ nekrozu gelişti. Ayrıca bir hastada trombositoz
gözlendi. ITP’li 4 hastada geçici, iki hastada kalıcı refrakter trombositopeni nedeniyle hematolojik tedaviye devam edildi. Bu hastalara operasyon sonrası yapılan dalak sintigrafisinde bir hastada aksesuar dalak tespit edildi. Ortalama hastanede yatış süresi 2,6 ± 0,7 gün olarak bulundu. Sonuç: Hematolojik hastalık nedeniyle uygulanacak splenektomilerde laparoskopik splenektomi; daha az hastanede kalış süresi ve morbidite ile ilk seçenek tedavi modalitesi olarak düşünülebilir.
Objective: Laparoscopic splenectomy has gained widespread acceptance in the treatment of hematological diseases in recent years. In this study, we aimed to present the outcomes of the patients who underwent laparoscopic splenectomy. Methods: Between 2012 and 2015, the data of 38 patients, who underwent laparoscopic splenectomy for hematological diseases at our clinic, were evaluated retrospectively. Results: 15 males and 23 females patients were underwent laparoscopic splenectomy, and the average age was 33.9 ± 12.9 years. Indications for splenectomy were idiopathic thrombocytopenic purpura (ITP) in 34 patients, and hereditary spherocytosis in 4 patients. During the surgical exploration, accessory spleen was detected in 7 patients, and removed. Laparoscopic cholecystectomy was performed at the same session in 2 hereditary spherocytosis patients who had stones in the gallbladder. One patient was converted to the open surgery due to the bleeding which was eliminated the exposure during the dissection. At the postoperative period, we observed atelectasis in one patient, and wound fat necrosis in one patient. In addition, thrombocytosis was observed in one patient. Hematological treatment was continued because of persistent refractory thrombocytopenia in two patients, and temporary thrombocytopenia in four patients. An accessory spleen was detected with splenic scintigraphy in one of these patients at the postoperative period. The average hospitalization time was 2.6 ± 0.7 days. Conclusion: Laparoscopic splenectomy for hematological diseases may be considered as first-line therapy with less hospital stay and morbidity.
Objective: Laparoscopic splenectomy has gained widespread acceptance in the treatment of hematological diseases in recent years. In this study, we aimed to present the outcomes of the patients who underwent laparoscopic splenectomy. Methods: Between 2012 and 2015, the data of 38 patients, who underwent laparoscopic splenectomy for hematological diseases at our clinic, were evaluated retrospectively. Results: 15 males and 23 females patients were underwent laparoscopic splenectomy, and the average age was 33.9 ± 12.9 years. Indications for splenectomy were idiopathic thrombocytopenic purpura (ITP) in 34 patients, and hereditary spherocytosis in 4 patients. During the surgical exploration, accessory spleen was detected in 7 patients, and removed. Laparoscopic cholecystectomy was performed at the same session in 2 hereditary spherocytosis patients who had stones in the gallbladder. One patient was converted to the open surgery due to the bleeding which was eliminated the exposure during the dissection. At the postoperative period, we observed atelectasis in one patient, and wound fat necrosis in one patient. In addition, thrombocytosis was observed in one patient. Hematological treatment was continued because of persistent refractory thrombocytopenia in two patients, and temporary thrombocytopenia in four patients. An accessory spleen was detected with splenic scintigraphy in one of these patients at the postoperative period. The average hospitalization time was 2.6 ± 0.7 days. Conclusion: Laparoscopic splenectomy for hematological diseases may be considered as first-line therapy with less hospital stay and morbidity.
Açıklama
Anahtar Kelimeler
Laparoskopik splenektomi, Hematolojik hastalıklar, Sonuçlar, Laparoscopic splenectomy, Hematologic disease, Outcome
Kaynak
Dicle Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
42
Sayı
4
Künye
Bozdağ, Z., Türkoğlu, A., Taşdemir, B., Oğuz, A., Dal, S., Karakuş, A. ve diğerleri. (2015). Laparoskopik splenektomi klinik deneyimimiz: 38 hastanın sonuçları . Dicle, Tıp Dergisi, 42(4), 480-484.
