Stoma kapatılma komplikasyonları (Retrospektif çalışma)
| dc.contributor.advisor | Yılmaz, Gülşen | |
| dc.contributor.author | Kan, Tamer | |
| dc.date.accessioned | 2017-02-22T12:08:05Z | |
| dc.date.available | 2017-02-22T12:08:05Z | |
| dc.date.issued | 2017 | |
| dc.date.submitted | 2006 | |
| dc.department | Dicle Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı | en_US |
| dc.description.abstract | Bu retrospektif çal mada klini imizde çe itli nedenlerle stoma uygulanan hastalardaki stoma kapat lmas ndan sonra geli en morbidite ve mortaliteye etkili faktörlerin ara t r lmas amaçland . Dicle Üniversitesi T p Fakültesi Genel Cerrahi Klini inde Ocak 2001-Nisan 2006 y llar aras nda stoma revizyonu yap lan 147 olgu ya , cinsiyet, ostomi aç lma nedeni, ostomi tipi, yanda hastal klar, postoperatif komplikasyonlar, morbidite ve mortalite nedenleri, ostomilerin ortalama kapat lma süreleri, kapat lma s ras nda kullan lan insizyon ve kapat lma ekli, ileostomi ve kolostomiler aras ndaki morbidite oran farkl l klar , hastanede kal süresi, retrospektif olarak incelendi. Verilerin analizinde SPSS 12.0 for Windows(SPSS,Inc.,Chicago,IL,USA) kullan ld . Çal maya al nan toplam 147 hasta vard . Bunlar n 104 ü erkek(%70.74), 43 ü kad n idi(%29.26). Ya ortalamas 43.53 ± 23.38 idi. Ço u stoma acil artlarda uyguland . En yayg n endikasyon intestinal perforasyondu. En s k kardiovasküler yanda hastal klar görüldü ( n:30). Stoma aç lan hastalar n ortalama kapat lma süresi, stoma kapat lma insizyonu ve kapat lma ekli incelendi. Ortalama kapat lma süresi 5.03±2.50 ay olarak bulundu. Kapat lma insizyonu yönünden incelendi inde, 64(%43.53) hastada median insizyon, 83(%56.47) hastada da stoma insizyonu kullan larak kapat ld . Stomalar n 26(%17.68) s primer sütür ile, 121(%82.32) si ise anastomoz eklinde kapat ld . Stoma kapat lmas sonras en s k görülen komplikasyonlar; yara yeri enfeksiyonu, postoperatif ileus ve anostomoz kaça olarak belirlendi. Stoma kapat lmas sonras nda görülen komplikasyon oran %55 idi. Stoma kapat lmas nedeniyle ameliyat s ras nda ve sonras nda görülen komplikasyonlarda, ileostomi ve kolostomili olgular aras nda bir farkl l k göstermedi i belirlendi. Stoma kapat lmas operasyonu sonras ortalama hastanede kalma süresi 10.42±4.37 olarak bulundu. Ya ve yanda hastal klar n morbidite ve olu an komplikasyonlarda etkili oldu u görüldü. Mortalite oran ise %6.1 olarak bulundu. Ölüm sebebleri aras nda sepsis ve serebrovasküler emboli etkiliydi. Sonuç olarak stoma uygulanmas n n ve sonra kapat lmas n n morbiditesi ve mortalitesi halen gündemdeki yerini korumaktad r. Bu yüzden özellikle ilerlemi ya taki ve yanda hastal olan hastalarda yüksek morbidite ve mortalite ile 34 uzam hastanede kalma süresine neden oldu undan stoma açmaya karar verirken iyi dü ünmek gerekmektedir. Stoma aç lma nedenlerinin ve postoperatif süreçte kar la lmas olas sorunlar n kapat lma sürecinde de kar m za ç kabilece i unutulmamal d r. | |
| dc.description.abstract | In this retrospective study, we aimed to evaluate the factors affecting on morbidity and mortality after stoma closure in patients who undergone stoma operation forsome reasons in our clinic. 147 patients who had undergone stoma revision at Dicle University Medical Faculty, General Surgery Clinic, between January 2001 and April 2006 were retrospectively studied according to age, gender, reason for ostomia opening, ostomia type , related diseases, postoperative complications, reasons of morbidity and mortality, average closure periods of ostomiae, incision and type of closure, differrences between ileostomy and colostomy according to morbidity,hospitalization period. SPSS 12.0 for Windows (SPSS,Inc., Chicago, IL, USA) was used for data analysis. There were 147 patients in study, of these 104were men ( 70.4% ), 43 were women ( 29.26% ). Mean age was 43.54 ± 23.38. Most of the stoma procedures were in emergency conditions. The most common indications was intestinal perforation. The most common related diseases were of cardiovascular system (n:30). We evaluated mean closure period, closure incision and closure type in patients who had undergone stoma operation.The mean duration between construction and reverseal was 5.03 ± 2.50 months. We performed 64 (43.53%) median and 83(56.47%) stoma incision. 26 stoma (17.68% ) with primary sutures and 121 stoma (82.32.%) were closed with anastomosis. We defined that, the most commonly seen complications after stoma closure were wound infection, postoperative ileus and anastomosis leakage. The complication rate after stoma closure was 55%. There was no difference between the cases with ileostomies and colostomies according to complications during and after the stoma closure operation. The hospitalization period was 10.42 ± 4.37. It was recognized that the age and related diseases were effective on morbidity and complications. Mortality rate was 6.1%. Sepsis and cerebrosvascular embolia were the leading reasons. Stoma operation and its closure's morbidity and mortality are still considerable. For this reason, a surgeon should carefully decide the stoma operation because of it s high mortality and morbidity rate especially in order patients with related diseases. It should always possible postoperative complications may be seen in closure period, too.. | |
| dc.identifier.uri | https://hdl.handle.net/11468/2854 | |
| dc.institutionauthor | Kan, Tamer | |
| dc.language.iso | tr | en_US |
| dc.relation.publicationcategory | Tez | en_US |
| dc.rights | info:eu-repo/semantics/openAccess | en_US |
| dc.subject | Genel cerrahi | en_US |
| dc.subject | General surgery | en_US |
| dc.subject | Stoma | en_US |
| dc.title | Stoma kapatılma komplikasyonları (Retrospektif çalışma) | en_US |
| dc.type | Doctoral Thesis | en_US |
