Yıl: 2012 Cilt: 39 Sayı: 1 Sayfa Aralığı: 49 - 53 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

İdiopatik trombositopenik purpuralı hastalarda splenektomi: 109 olgununun analizi

Öz:
Amaç: Splenektomi, medikal tedaviye dirençli ve şiddetli seyreden İdiopatik trombositopenik purpuralı hastalarda tedavi sağlamak amacıyla yapılmaktadır. Bu çalışmada İdiopatik trombositopenik purpura tanısıyla splenektomi uygulanan hastalarda postoperatif ve uzun dönem sonuçların irdelenmesi amaçlandı. Gereç ve Yöntem: Dicle Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniğinde 2002-2010 tarihleri arasında İdiopatik trombositopenik purpura tanısıyla splenektomi uygulanan 109 hasta retrospektif olarak değerlendirildi. Hastalarda yaş, cinsiyet, aksesuar dalak varlığı ve yerleşimi, operasyon süresi, preoperatif transfüzyone edilen trombosit ünite sayısı, preoperatif ve postoperatif kan transfüzyon ünite sayısı, hastanede yatış süresi, takip süresi ve sonuçları, morbidite ve mortalite kaydedildi. Bulgular: Hastaların 88i (%80.7) kadın, 21i (%19.3) erkek idi. Yaş ortalamaları 37.10±16.62 (16-72) yıl idi. Ortalama ameliyat süresi 44.87 ± 10.32 (30-120) dakika idi. Ortalama kan transfüzyonu ve trombosit süspansiyonu sırasıyla 1.63±0.85(0-3) ve 2.01±0.71(1-3) ünite idi. Preoperatif USG ile 20 (%18.3) hastada aksesuar dalak tanımlandı. Hastalarda laparotomide 23ünde (%21.1) patoloji tarafından doğrulanan aksesuar dalak tespit edildi. İntraoperatif en sık aksesuar dalak yerleşimi dalak hilusunda saptandı. Hastaların 16sında (%14.7) postoperatif dönemde komplikasyon gelişti. En sık görülen komplikasyon atelektazi idi. Hastaların ortalama hastanede yatış süresi 4.56±2.45(2-12) gün idi. Hastalar medyan 28 (9-48) ay takip edildi. Hastaların 1inde (%0.9) mortalite gelişti. Sonuç: Splenektomi İdiopatik trombositopenik purpura tedavisinde medikal tedaviye yanıtsız olgularda güvenle uygulanabilen bir cerrahi girişimdir ve splenektomiyle bu hastalarda uzun süreli yanıt almak mümkündür. Nüksü engellemek için aksesuar dalak gözden kaçırılmamalıdır.
Anahtar Kelime:

Konular: Anestezi Hematoloji Geriatri ve Gerontoloji Onkoloji

Splenectomy in patients with idiopathic thrombocytopenic purpura: Analysis of 109 cases

Öz:
Objectives: Splenectomy is performed in order to provide the treatment in the patients with severe idiopathic thrombocytopenic purpura, refractory to medical treatment. In this study, we aimed to investigate the postoperatif and longterm outcomes in the patients who underwent splenectomy with the diagnosis of idiopathic thrombocytopenic purpura. Materials and Methods: Between 2001-2010 at Dicle University Medical Faculty, General Surgery Department, a retrospective review of the 109 patients who had undergone splenectomy for ITP was reviewed. Age, gender, presence of accessory spleens and location, duration of the operation, number of preoperative platelet tranfusion, number of preoperative and postoperative blood transfusion, length of hospital stay, long-term outcomes, morbidity and mortality were recorded. Results: The mean age was 37.10 ± 16.62 (16-72), and there were 88 (80.7%) female and 21 (19.3%) male patients. The mean operation time was 44.87 ± 10:32 (30-120) minutes. The average postoperative blood and preoperative platelet transfusion were 1.63 ± 0.85 (0-3) and 2.01 ± 0.71 (1-3) units, respectively. The accessory spleens were encountered in 20 (18.3%) patients at the ultrasonographic examination. And also the accessory spleens were encountered in 23 (21.1%) patients during operation and confirmed with histopathologic examination. The most common localization of accessory spleens were splenic hilus. The postoperative complications were occurred in 16 patients (14.7%) and the most complication was atelectasia. The mean length of hospital stay was 4:56 ± 2:45 (2-12) days. Patients were followed for an average of 28 (9-48) months. At the follow-up period, 1 (0.9 %) patient had died. Conclusion: Splenectomy can be performed safely in the treatment of the patients with idiopathic thrombocytopenic purpura unresponsive to medical treatment. Long-term good results can be obtained with splenectomy in these patients. The accessory spleens should not be overlooked to prevent recurrences.
Anahtar Kelime:

Konular: Anestezi Hematoloji Geriatri ve Gerontoloji Onkoloji
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA ÖNDER A, Kapan M, gül m, ALİOSMANOĞLU İ, ARIKANOĞLU Z, TASKESEN F, Taş İ, AY E, GİRGİN S (2012). İdiopatik trombositopenik purpuralı hastalarda splenektomi: 109 olgununun analizi. , 49 - 53.
Chicago ÖNDER Akın,Kapan Murat,gül mesut,ALİOSMANOĞLU İbrahim,ARIKANOĞLU Zülfü,TASKESEN FATIH,Taş İlhan,AY Enver,GİRGİN Sadullah İdiopatik trombositopenik purpuralı hastalarda splenektomi: 109 olgununun analizi. (2012): 49 - 53.
MLA ÖNDER Akın,Kapan Murat,gül mesut,ALİOSMANOĞLU İbrahim,ARIKANOĞLU Zülfü,TASKESEN FATIH,Taş İlhan,AY Enver,GİRGİN Sadullah İdiopatik trombositopenik purpuralı hastalarda splenektomi: 109 olgununun analizi. , 2012, ss.49 - 53.
AMA ÖNDER A,Kapan M,gül m,ALİOSMANOĞLU İ,ARIKANOĞLU Z,TASKESEN F,Taş İ,AY E,GİRGİN S İdiopatik trombositopenik purpuralı hastalarda splenektomi: 109 olgununun analizi. . 2012; 49 - 53.
Vancouver ÖNDER A,Kapan M,gül m,ALİOSMANOĞLU İ,ARIKANOĞLU Z,TASKESEN F,Taş İ,AY E,GİRGİN S İdiopatik trombositopenik purpuralı hastalarda splenektomi: 109 olgununun analizi. . 2012; 49 - 53.
IEEE ÖNDER A,Kapan M,gül m,ALİOSMANOĞLU İ,ARIKANOĞLU Z,TASKESEN F,Taş İ,AY E,GİRGİN S "İdiopatik trombositopenik purpuralı hastalarda splenektomi: 109 olgununun analizi." , ss.49 - 53, 2012.
ISNAD ÖNDER, Akın vd. "İdiopatik trombositopenik purpuralı hastalarda splenektomi: 109 olgununun analizi". (2012), 49-53.
APA ÖNDER A, Kapan M, gül m, ALİOSMANOĞLU İ, ARIKANOĞLU Z, TASKESEN F, Taş İ, AY E, GİRGİN S (2012). İdiopatik trombositopenik purpuralı hastalarda splenektomi: 109 olgununun analizi. Dicle Tıp Dergisi, 39(1), 49 - 53.
Chicago ÖNDER Akın,Kapan Murat,gül mesut,ALİOSMANOĞLU İbrahim,ARIKANOĞLU Zülfü,TASKESEN FATIH,Taş İlhan,AY Enver,GİRGİN Sadullah İdiopatik trombositopenik purpuralı hastalarda splenektomi: 109 olgununun analizi. Dicle Tıp Dergisi 39, no.1 (2012): 49 - 53.
MLA ÖNDER Akın,Kapan Murat,gül mesut,ALİOSMANOĞLU İbrahim,ARIKANOĞLU Zülfü,TASKESEN FATIH,Taş İlhan,AY Enver,GİRGİN Sadullah İdiopatik trombositopenik purpuralı hastalarda splenektomi: 109 olgununun analizi. Dicle Tıp Dergisi, vol.39, no.1, 2012, ss.49 - 53.
AMA ÖNDER A,Kapan M,gül m,ALİOSMANOĞLU İ,ARIKANOĞLU Z,TASKESEN F,Taş İ,AY E,GİRGİN S İdiopatik trombositopenik purpuralı hastalarda splenektomi: 109 olgununun analizi. Dicle Tıp Dergisi. 2012; 39(1): 49 - 53.
Vancouver ÖNDER A,Kapan M,gül m,ALİOSMANOĞLU İ,ARIKANOĞLU Z,TASKESEN F,Taş İ,AY E,GİRGİN S İdiopatik trombositopenik purpuralı hastalarda splenektomi: 109 olgununun analizi. Dicle Tıp Dergisi. 2012; 39(1): 49 - 53.
IEEE ÖNDER A,Kapan M,gül m,ALİOSMANOĞLU İ,ARIKANOĞLU Z,TASKESEN F,Taş İ,AY E,GİRGİN S "İdiopatik trombositopenik purpuralı hastalarda splenektomi: 109 olgununun analizi." Dicle Tıp Dergisi, 39, ss.49 - 53, 2012.
ISNAD ÖNDER, Akın vd. "İdiopatik trombositopenik purpuralı hastalarda splenektomi: 109 olgununun analizi". Dicle Tıp Dergisi 39/1 (2012), 49-53.