Kostal kartilaj rezeksiyonu yapılan tavşanlarda toraks duvar gelişminin morfometrik değerlendirmesi
Küçük Resim Yok
Tarih
2005
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmadaki amacımız, kostal kartilaj rezeksiyonu yapılan genç tavşanlarda büyümeye bağlı olarak hemitoraks gelişiminin etkilenip etkilenmediğinin araştırılması ve varsa bunu etkileyen faktörleri belirlemektir. 6 haftalık 50 tane erkek Yeni Zelanda beyaz tavşanı beş eşit gruba ayrıldı. Kontrol grubunda (n=10) her hangi bir cerrahi müdahale yapılmadı. Normal toraks gelişimi izlendi. İki adet kostal kartilajın subperikondrial rezeksiyonu Grup 2'de parsiyel (Sağ 3 ve 4); Grup 3'de aynı kostal kartilajların total rezeksiyonu yapıldı. Grup 4'de dört adet kostakondral rezeksiyonu (Sağ 3- 6 arası) parsiyel ve sonunda Grup 5'de bu kostal kartilajın total gerçekleştirildi. Tavşanların göğüs duvarı ön-arka (anteroposterior), sağ-sol (horizantal) ve yukarı-aşağı (vertikal) çapları ölçüldü. Karşılaştırma hem kendi hem de gruplar arasında yapıldı. Ön-arka göğüs çapı yan grafide dördüncü (D3) ve yedinci (D4) vertebradan diafragmaya paralel olarak ölçüldü. PA akciğer grafisinden, dördüncü ve yedinci vertebradan her iki hemitoraks için sağ-sol çap (horizantal- torasik genişlik) ölçüldü ( D6; sağ dördüncü vertebra, D7; sağ yedinci vertebra, D8; sol dördüncü vertebra, D9; sol yedinci vertebra). 6. ve 24. haftada yapılan ölçümlerin farkının yüzde değişimleri arasında D3, D4, D8 ve D9 parametrelerinde farklılık istatistiksel olarak anlamlıydı. Rezeksiyonun gerçekleştirildiği sağ hemitoraksa ait D6 (Grup 3 hariç) ve D7 (Grup 2 hariç) parametrelerinde bütün gruplarda azalma göstermiştir. Rezeksiyon yapılamayan sol hemitoraksa ait simetrik D8 ve D9 parametrelerinde ise tersine bütün gruplarda büyümede artış istatistiksel olarak anlamlıydı. Sonuç olarak, toraks gelişimi ve kemik maturasyonunun henüz tamamlanmadığı genç tavşanlarda yaptığımız rezeksiyonlar; toraks duvar gelişimini bütün boyutlarda rezeksiyon yapılamayan alanlara kıyasla az veya çok etkilemiştir. Özellikle ön-arka ve sağ-sol yönde bu etkilenme daha belirgindir. Kostal kartilaj rezeksiyonları zararsız bir işlem değildir. Büyüme merkezinin korunmadığı ve/veya rezeke edilen kosta sayısının en az dört olduğu durumlarda bu etkilenme daha belirgindir. Bu sonuçlara göre, göğüs duvarı rezeksiyonlarının yapılma yaşı ile ilgili kanaatimiz aksi bir zorunluluk 55yoksa kemik gelişiminin tamamlanmasından sonra yapılması yönündedir. Eğer daha erken yapılacaksa da hem büyüme merkezi mutlaka korunmalı hem de rezeke edilecek kosta sayısı mümkün olduğu kadar kısıtlı tutulmalıdır.
THE EFFECT OF COSTAL CARTILAGE RESECTION ON THE CHEST WALL DEVELOPMENT IN RABBITS: MORPHOMETRIC EVALUATION We have made this experimental study to evaluate, if any, the effect of costal cartilage resections on the chest wall development of young rabbits. Fifty apparently healthy, New Zealand, 6 weeks of age, male white rabbits were evaluated in five groups, each including 10 subjects. Rabbits in group I served as a control group for the observation of normal thoracic growth. No surgery was made on this group. Rabbits in group 2 underwent partial subpericondrial resection of the two costal cartilages (right 3rd and 4th costal cartilages); rabbits in group 3 underwent total resection of the same costal cartilages. Those in group 4 underwent partial subpericondrial resection of the four costal cartilages (right 3rd - 6th costal cartilages) and finally rabbits in group 5 underwent total resection of those costal cartilages. Anteroposterior (AP), horizontal and vertical diameters of chest walls of rabbits were measured within 6th and 24th weeks. Comparisons were made between and within groups The AP chest diameter was measured at the levels of both 4th (D3) and 7th (D4) vertebras parallel to the diaphragm by using lateral chest radiograms. From the PA chest radiographs, the horizontal chest diameter (thoracic width) for each hemithorax was measured at the levels of 4th and 7th vertebra (D6;right at 4th, D7;right at 7th, D8;left at 4th, D9;left at 7th vertebrae). The differences were statistically significant for the percentage change ratios of the parameters of D3, D4, D8 and D9 for each subject between 6th and 24th week measurements. The percentage change ratios of the parameters of AP (D4, D3) and horizontal (D6, D7, D8, D9) diameters were affected by the operations except the vertical diameter (D5). A significant decrease in the parameters of D6 (excluding group 3) and D7 (excluding group 2) was observed in subjects operated on the right hemithorax. There was a statistically significant increase in the percentage change ratios of the parameters of D8 and D9 (for left hemithorax). 57In conclusion; this study has revealed that the costal cartilage resections performed in young rabbits whose skeletal maturation and thoracic development has not been completed affected the chest wall development in resected hemithoraces of all subjects compared to the unresected left hemithoraces, and it was, especially, more significant in AP and horizontal diameters. The costal cartilage resection is not an innocent procedure. This effect is more prominent in the setting of unsaved growth center of rib and/or at least four cartilages resection. Our opinion about the age onset of such chest wall resections is to postpone these operations, if not urgent, until the maturation of skeletal development is completed. If the operation is mandatory, both the growth centers of ribs should be saved and the number of costal cartilages that will be resected should be limited and, possibly, less than four.
THE EFFECT OF COSTAL CARTILAGE RESECTION ON THE CHEST WALL DEVELOPMENT IN RABBITS: MORPHOMETRIC EVALUATION We have made this experimental study to evaluate, if any, the effect of costal cartilage resections on the chest wall development of young rabbits. Fifty apparently healthy, New Zealand, 6 weeks of age, male white rabbits were evaluated in five groups, each including 10 subjects. Rabbits in group I served as a control group for the observation of normal thoracic growth. No surgery was made on this group. Rabbits in group 2 underwent partial subpericondrial resection of the two costal cartilages (right 3rd and 4th costal cartilages); rabbits in group 3 underwent total resection of the same costal cartilages. Those in group 4 underwent partial subpericondrial resection of the four costal cartilages (right 3rd - 6th costal cartilages) and finally rabbits in group 5 underwent total resection of those costal cartilages. Anteroposterior (AP), horizontal and vertical diameters of chest walls of rabbits were measured within 6th and 24th weeks. Comparisons were made between and within groups The AP chest diameter was measured at the levels of both 4th (D3) and 7th (D4) vertebras parallel to the diaphragm by using lateral chest radiograms. From the PA chest radiographs, the horizontal chest diameter (thoracic width) for each hemithorax was measured at the levels of 4th and 7th vertebra (D6;right at 4th, D7;right at 7th, D8;left at 4th, D9;left at 7th vertebrae). The differences were statistically significant for the percentage change ratios of the parameters of D3, D4, D8 and D9 for each subject between 6th and 24th week measurements. The percentage change ratios of the parameters of AP (D4, D3) and horizontal (D6, D7, D8, D9) diameters were affected by the operations except the vertical diameter (D5). A significant decrease in the parameters of D6 (excluding group 3) and D7 (excluding group 2) was observed in subjects operated on the right hemithorax. There was a statistically significant increase in the percentage change ratios of the parameters of D8 and D9 (for left hemithorax). 57In conclusion; this study has revealed that the costal cartilage resections performed in young rabbits whose skeletal maturation and thoracic development has not been completed affected the chest wall development in resected hemithoraces of all subjects compared to the unresected left hemithoraces, and it was, especially, more significant in AP and horizontal diameters. The costal cartilage resection is not an innocent procedure. This effect is more prominent in the setting of unsaved growth center of rib and/or at least four cartilages resection. Our opinion about the age onset of such chest wall resections is to postpone these operations, if not urgent, until the maturation of skeletal development is completed. If the operation is mandatory, both the growth centers of ribs should be saved and the number of costal cartilages that will be resected should be limited and, possibly, less than four.
Açıklama
Anahtar Kelimeler
Kostal kartilaj rezeksiyonu, Costal cartilage resection, toraks duvar gelişimi, thoracic wall development
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Çalık, M. (2005). Kostal kartilaj rezeksiyonu yapılan tavşanlarda toraks duvar gelişminin morfometrik değerlendirmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Göğüs Cerrahisi Anabilim Dalı, Konya.
