Kliniğimize yatarak tedavi gören akciğer hidatik kistli vakaların retrospektif değerlendirilmesi
Küçük Resim Yok
Tarih
2002
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
1988 ve 2001 yıllan arasında Selçuk Üniversitesi Meram Tıp Fakültesi Göğüs Cerrahisi Kliniği'mizde yatarak tedavi gören 136 akciğer hidatik kistli olguyu, cerrahi tekniklerimizi değerlendirerek gözden geçirdik. Bunların 43 'ü çocuk (24 erkek, 19 kız), 93 'ü erişkin (45 erkek, 48 kadın) idi. Olguların çoğu, 1 1-25 yaş grupları arasındaydı. Semptomların ve göğüs radyografilerinin klinik değerlendirmesi, 126 olguda doğru tam koymaya yeterli olmuştur. Ultrasonografi ve bilgisayarlı tomografi gibi görüntüleme yöntemleri de tanıda kullanılmıştır. Tüm olgularda hemogram ve idrar tetkikleri de, rutin olarak yapılmıştır. Kistlerin yoğun olarak alt loblarda lokalize oldukları, tespit edildi. Onaltı olgu dışında torakotomi uygulandı. Bu 1 6 olgudan 3 olguya median sternotomi 12 olguya torakofrenolaparatomi ve 1 olguya da drenaj uygulandı. Wedge rezeksiyonu 7 olguda, segmentektomi 4 olguda, lobektomi 7 olguda, kistotomi+kapitonaj 109 olguda, kistektomi+kapitonaj 7 olguda ve dekortikasyon 30 vakada uygulandı. Lobektomi, segmentektomi ve wedge rezeksiyonu gibi radikal yöntemlere nazaran kistotomi veya kistektomi+kapitonaj gibi parankim koruyucu cerrahi yöntemler öncelikli olarak tercih edilmiştir. Akciğer hidatik kistlerin esas tedavisi cerrahidir. Medikal tedaviler, cerrahi tedavileri takiben gelişebilecek rekürrensleri önlemek için kullanılır. Hastaların çoğunda, akciğer parankim koruyucu cerrahi yaklaşımlar tercih edilir. Radikal cerrahi uygulamaların, ancak büyük akciğer hidatik kistli ve irreversibl akciğer hasan oluşmuş olgularda yapılması uygundur. Akciğer yerleşimli hidatik kistli olgularda ilave olarak karaciğer kubbesinde yerleşmiş karaciğer hidatik kisti mevcut ise torakofrenolaparatomi, aynı seansta kistlerin çıkarılmasını sağlar.
Retrospective Analysis of Cases With Pulmonary Hydatid Cysts Who Treated in Our Clinic.We review a series of 136 patients treated for pulmonary hydatid cyst who operated in The Thoracic Surgery Clinic, University of Selçuk in our center between 1988-2001, assessing the results with our surgical techniques. There were 43 children (24 boys, 19 girls) 93 adult (45 males, 48 females). Most of patients were 1 1-25 years of age.Clinical assessment of the symptoms and plain chest x-ray led to the correct diagnosis in 122 cases. Imaging studies such as ultrasonography, computed tomography were also used for diagnosis. Complete blood count with urine examination is also made routinely. The cyts were located in the lower lobes more intensively.Thoracotomy was used in all but sixteen. Median sternotomy was performed in 3 cases, twelve patients were treated by thoracophrenolaparatomy and one was managed with drainage. Wedge resection in 7 cases, segmentectomy in 4 cases, lobectomy in 4 cases, cystotomy-capitonnage in 109 cases, cystectomy-capitonnage in 7 cases and decortication in 30 cases. Cystotomy or cytectomy and capitonnage were choice of treatment as conservative interventions while lobectomy, segmentectomy and wedge resection as radical procedures.The treatment of pulmonary hydatid disease is essentially surgical. In general, chemotherapy is used as a complemeant to operative treatment to avoid recurrence. Lung preserving surgical interventions are the treatment of choice for most patients with pulmonary hydatid disease. Radical interventions were only performed for large cyts and irreversibly damaged lung parenchyma. In the presence of right lung and concomitant liver hydatid cyst with dome localization thoracophrenolaparatomy is safe and allowed the lung and liver cysts to be removed at the same session.
Retrospective Analysis of Cases With Pulmonary Hydatid Cysts Who Treated in Our Clinic.We review a series of 136 patients treated for pulmonary hydatid cyst who operated in The Thoracic Surgery Clinic, University of Selçuk in our center between 1988-2001, assessing the results with our surgical techniques. There were 43 children (24 boys, 19 girls) 93 adult (45 males, 48 females). Most of patients were 1 1-25 years of age.Clinical assessment of the symptoms and plain chest x-ray led to the correct diagnosis in 122 cases. Imaging studies such as ultrasonography, computed tomography were also used for diagnosis. Complete blood count with urine examination is also made routinely. The cyts were located in the lower lobes more intensively.Thoracotomy was used in all but sixteen. Median sternotomy was performed in 3 cases, twelve patients were treated by thoracophrenolaparatomy and one was managed with drainage. Wedge resection in 7 cases, segmentectomy in 4 cases, lobectomy in 4 cases, cystotomy-capitonnage in 109 cases, cystectomy-capitonnage in 7 cases and decortication in 30 cases. Cystotomy or cytectomy and capitonnage were choice of treatment as conservative interventions while lobectomy, segmentectomy and wedge resection as radical procedures.The treatment of pulmonary hydatid disease is essentially surgical. In general, chemotherapy is used as a complemeant to operative treatment to avoid recurrence. Lung preserving surgical interventions are the treatment of choice for most patients with pulmonary hydatid disease. Radical interventions were only performed for large cyts and irreversibly damaged lung parenchyma. In the presence of right lung and concomitant liver hydatid cyst with dome localization thoracophrenolaparatomy is safe and allowed the lung and liver cysts to be removed at the same session.
Açıklama
Anahtar Kelimeler
akciğer, lungs, hidatik kistli, with hydatid cyst
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Poyraz, A. S. (2002). Kliniğimize yatarak tedavi gören akciğer hidatik kistli vakaların retrospektif değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Göğüs Cerrahisi Anabilim Dalı, Konya.
