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Elektif olgularda açık ve laparaskopik splenektominin karşılaştırılması

Year 2019, Volume: 44 Issue: 1, 200 - 205, 31.03.2019
https://doi.org/10.17826/cumj.467031

Abstract

Amaç: Bu çalışmada elektif splenektomi uygulanan olgularda Açık Splenektomi (AS) ile  Laparoskopik Splenektominin (LS) karşılaştırılması amaçlanmıştır. 

Gereç ve Yöntem: Çalışmamıza Çukurova Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı’nda 1 Ocak 2013- 1 Ocak 2018 tarihleri arasında elektif splenektomi ameliyatı yapılan 95 hasta dahil edildi. Hastaların demografik bilgileri etyolojik neden, ameliyat süresi, kan kaybı miktarı, preoperatif dönemde dalak boyut ölçümü yapıldı. Laparoskopik cerrahiden açık cerrahiye geçme zorunluluğu, hastanede yatış süresi, postoperatif kan ürünleri replasmanı ve postoperatif gelişen komplikasyonlar incelendi.

Bulgular: Çalışmamıza dahil edilen hastaların %79‘una (n=75) açık splenektomi, % 21 ‘ine (n=20) laparaskopik splenektomi olmak üzere toplam 95 olgu dahil edildi. Çalışmaya alınan olgularda ortalama yaş AS’ de 43.0±17 (18-78), LS’ de ise 39.3±13.9 idi (19-62). AS uygulanan olguların 31 tanesi erkek (% 41.3), 44 tanesi ise kadın (%58.7) cinsiyette idi. LS uygulanan olguların 7 tanesi erkek (%35), 13 tanesi ise kadın cinsiyette (%65)  idi. AS uygulanan 75 olgudan 19 (% 25.3) olgu splenomegali, 16 (% 21.3) olgu immün trombositopenik purpura (ITP), 11(% 14.7) olgu kitle,7 (% 9.3) olgu ise Talasemi nedeniyle opere edildi.LS uygulanan 20 olgudan 12 (% 60) olgu ITP, 3 (% 15) olgu Hemolitik anemi, 2 (% 10) olgu ise lenfoma nedeniyle opere edildi. LS’de yatış süresi, kanama miktarı ve dalak boyutu üstün iken; AS’de ameliyat süresi anlamlı derecede üstün bulundu .

Sonuç: Komplikasyon oranı, hastanede yatış süresi ve maliyetinin daha az olması nedeni ile LS, OS’ye göre daha güçlü bir alternatiftir. 


References

  • 1- Delaitre B, Maignien B. Splenectomy by the laparoscopic approach. Report of a case. Presse Med .1991;20(44):2263.
  • 2-Katkhouda N, Manhas S, Umbach TW, Kaiser AM. Laparoscopic splenectomy. J Laparoendosc Adv Surg Tech A. 2001;11(6):383-90. CrossRef
  • 3- Akyıldız H, Akcan A, Dal F, Artış T, Küçük C, Ok E, Sözüer EM. Elektif splenektomi: Laparoskopik ve konvansiyonel tekniklerin karşılaştırılması: 13 yıllık deneyim. Turkish Journal of Surgery .2007; 23(1): 24-7.
  • 4- Bulus H, Mahmoud H, Altun H, Tas A, Karayalcin K. Outcomes of laparoscopic versus open splenectomy. J Korean Surg Soc. 2013;84(1):38-42.
  • 5 .Franciosi C, Caprotti R, Romano F, Porta G, Real G, Co-lombo G et al. Laparoscopic versus open splenectomy: a comparative study. Surg Laparosc Endosc Percutan Tech. 2000;10:291-295.
  • 6- Tan S, Kılınç S, Tan A , Kebapcı E,Karaca C,Ölmez M ve ark. Travma Dışı Hastalıklarda Laparoskopik ve Açık Splenektominin Karşılaştırılması J Kartal TR. 2015;26(1):47
  • 7- Rege RV, Joehl RJ. A learning curve for laparoscopic splenectomy at an academic institution. J Surg Res .1999;81(1):27-32.
  • 8- Winslow ER, Brunt LM. Perioperative outcomes of laparoscopic versus open splenectomy: a meta-analysis with an emphasis on complications. Surgery .2003;134(4):647-55. C
  • 9- Pomp A, Gagner M, Salky B, Caraccio A, Nahouraii R, Reiner M et al. Laparoscopic splenectomy: a selected retrospective review. Surg Laparosc Endosc Percutan Tech. 2005;15(3):139-43.
  • 10- Bulus H,Mahmoud H,Altun H,Karayalcin K. Outcomes of laparoscopic versus open splenectomy J Korean Surg Soc .2013;84:38-42

Comparison of open and laparascopic splenectomy in elective cases

Year 2019, Volume: 44 Issue: 1, 200 - 205, 31.03.2019
https://doi.org/10.17826/cumj.467031

Abstract

Purpose: The aim of this study was to compare open splenectomy (OS) and laparoscopic splenectomy (LS) in patients undergoing elective splenectomy. 

Materials and Methods: The study included 95 patients who underwent elective splenectomy between January 1, 2013 and January 1, 2018 in the Department of General Surgery, Faculty of Medicine, Çukurova University. Demographic information, etiology, duration of operation, amount of blood loss and preoperative spleen size were measured. The necessity to switch from laparoscopic surgery to open surgery, duration of hospitalization, postoperative blood products replacement and postoperative complications were examined.

Results: A total of 95 patients, 79% (n=75) who underwent OS, and 21% (n=20) who underwent LS were included in our study. The mean age in the study group was 43.0 ± 17 (18-78) for OS and 39.3 ± 13.9 in LS (19-62). Of the patients who underwent OS, 31 were male (41.3%) and 44 were female (58.7%). Of the patients who underwent LS, 7 were male and 13 were female (65%). Of the 75 cases who underwent OS; 19 (25.3%) were treated for splenomegaly, 16 (21.3%) for immune thrombocytopenic purpura (ITP), 11 (14.7%) for a mass, and 7 (9.3%) cases were operated on for Thalassemia. Of the 20 cases who underwent LS; 12 (60%) cases were operated on for ITP, 3 (15%) cases for hemolytic anemia and 2 (10%) cases for lymphoma.The length of hospital stay, amount of bleeding and spleen size were superior in LS; while the duration of surgery was significantly higher in OS.

Conclusion: LS is a stronger alternative to OS because of its lower complication rate, hospitalization time and cost. 



References

  • 1- Delaitre B, Maignien B. Splenectomy by the laparoscopic approach. Report of a case. Presse Med .1991;20(44):2263.
  • 2-Katkhouda N, Manhas S, Umbach TW, Kaiser AM. Laparoscopic splenectomy. J Laparoendosc Adv Surg Tech A. 2001;11(6):383-90. CrossRef
  • 3- Akyıldız H, Akcan A, Dal F, Artış T, Küçük C, Ok E, Sözüer EM. Elektif splenektomi: Laparoskopik ve konvansiyonel tekniklerin karşılaştırılması: 13 yıllık deneyim. Turkish Journal of Surgery .2007; 23(1): 24-7.
  • 4- Bulus H, Mahmoud H, Altun H, Tas A, Karayalcin K. Outcomes of laparoscopic versus open splenectomy. J Korean Surg Soc. 2013;84(1):38-42.
  • 5 .Franciosi C, Caprotti R, Romano F, Porta G, Real G, Co-lombo G et al. Laparoscopic versus open splenectomy: a comparative study. Surg Laparosc Endosc Percutan Tech. 2000;10:291-295.
  • 6- Tan S, Kılınç S, Tan A , Kebapcı E,Karaca C,Ölmez M ve ark. Travma Dışı Hastalıklarda Laparoskopik ve Açık Splenektominin Karşılaştırılması J Kartal TR. 2015;26(1):47
  • 7- Rege RV, Joehl RJ. A learning curve for laparoscopic splenectomy at an academic institution. J Surg Res .1999;81(1):27-32.
  • 8- Winslow ER, Brunt LM. Perioperative outcomes of laparoscopic versus open splenectomy: a meta-analysis with an emphasis on complications. Surgery .2003;134(4):647-55. C
  • 9- Pomp A, Gagner M, Salky B, Caraccio A, Nahouraii R, Reiner M et al. Laparoscopic splenectomy: a selected retrospective review. Surg Laparosc Endosc Percutan Tech. 2005;15(3):139-43.
  • 10- Bulus H,Mahmoud H,Altun H,Karayalcin K. Outcomes of laparoscopic versus open splenectomy J Korean Surg Soc .2013;84:38-42
There are 10 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research
Authors

Abdullah Ülkü This is me 0000-0001-5180-1543

Uğur Topal 0000-0003-1305-2056

Ahmet Gökhan Sarıtaş 0000-0002-2039-3994

Ahmet Rencüzoğulları 0000-0002-5993-9536

Tolga Akçam This is me 0000-0001-7525-3107

İsmail Cem Eray This is me 0000-0002-1560-7740

Orçun Yalav 0000-0001-9239-4163

Kubilay Dalcı This is me 0000-0002-3156-4269

İshak Aydın This is me 0000-0002-6366-2461

Publication Date March 31, 2019
Acceptance Date November 17, 2018
Published in Issue Year 2019 Volume: 44 Issue: 1

Cite

MLA Ülkü, Abdullah et al. “Elektif Olgularda açık Ve Laparaskopik Splenektominin karşılaştırılması”. Cukurova Medical Journal, vol. 44, no. 1, 2019, pp. 200-5, doi:10.17826/cumj.467031.