Koroner arter by-pass greftleme ameliyatı sırasında sol internal mamaryen arteri (LIMA) kullanımının benign meme lezyonları üzerine etkileri

Year 2024, , 413 - 418, 30.09.2024

Serkan Mola , Ersin Turan , Eren Günertem

https://doi.org/10.18663/tjcl.1542878

Abstract

Amaç: Koroner arter bypass cerrahisinde (KABG) olumlu özellikleri ve sonuçları nedeniyle en büyük ilgi gören ve en çok kullanılan graft sol internal mamaryen arterdir. (LIMA). KABG olan hastadalardaki iyi huylu meme hastalıkları (BBD) ile LIMA'nın kullanılması arasındaki ilişkiyi inceleyen yeterli çalışma yoktur. Bu çalışma benign meme hastalıkları olan hastalarda bypass ameliyatı sırasında LIMA çıkarılmasının etkilerini araştıran öncü çalışmalardan biridir. Bu çalışma, bypass ameliyatı geçiren kadın hastalarda ameliyat öncesi ve sonrası meme görüntüleme yöntemlerini analiz ederek LIMA çıkarılmasının iyi huylu meme hastalıkları üzerindeki etkisini değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntemler: Çalışmaya 18 Şubat 2019 ile 31 Aralık 2021 tarihleri arasında KABG geçiren 452 kadın hastadan 47'si dahil edildi. Tüm hastalarda LIMA kullanıldı, bu hastalardaki iyi huylu meme hastalıklarının değişimi değerlendirildi.
Bulgular: Hastaların KABG öncesi ve sonrası Meme Görüntüleme Raporlama ve Veri Sistemi (BI-RADS) sınıfları arasında anlamlı fark vardı (p<0,001). Ameliyat öncesi hastaların %40,4'ü BI-RADS sınıf 1 iken ameliyat sonrası bu oran %14,8'e düştü. 2. sınıf düzeyi önemli bir fark göstermezken, 3. sınıf düzeyi %8,5'ten %31,9'a yükseldi. Ameliyat öncesi ve sonrası BI-RADS sınıfları ile yaş ve Beden Kitle İndeksi (BKİ) arasındaki korelasyon analizi sonuçları analiz edildi ancak anlamlı bir korelasyon saptanmadı. Ameliyat öncesi ve sonrası BI-RADS dereceleri ile Hormon Replasman Tedavisi (HRT) arasındaki korelasyonlar anlamlıydı.
Sonuç: Kadın hastalarda KABG ameliyatı sırasında LIMA kullanımının BBD oluşumunu etkilediği sonucuna varılabilir. Mamografi ile takip edilen hastalarda ameliyat öncesi ve sonrası dönem karşılaştırıldığında lezyonlarda değişim olduğunu belirlenedi. Bypass ameliyatı sonrası mamografide BI-RADS skorlarında anlamlı değişiklik olduğu gösterildi.

Keywords

sol internal mamaryen arter, koroner arter bypass greftleme, benign meme lezyonları, BI-RADS, mamografi

Effects of left internal mammary artery (LIMA) harvesting during coronary artery by-pass grafting surgery on benign breast diseases

Abstract

Aim: Coronary artery bypass surgery of the primary conduits employed in coronary artery bypass grafting surgery (CABG) is the left internal mammary artery (LIMA), which has garnered considerable attention due to its favorable characteristics and outcomes. There are not enough studies examining the relationship between benign breast diseases (BBD) and LIMA removal. This study is one of the pioneering studies investigating the effects of LIMA removal after bypass surgery in patients with benign breast diseases. This study aims to evaluate the effect of LIMA removal on benign breast diseases in female patients undergoing bypass surgery by analyzing pre- and post-operative breast imaging.
Material and Methods: A total of 47 of 452 female patients who underwent bypass surgery between February 18, 2019, and December 31, 2021, were included in the study. All patients’ LIMA were harvested and evaluated, regarding any progression of benign breast diseases.
Results: There was a significant difference between the Breast Imaging Reporting and Data System (BI-RADS) classes of the patients before and after CABG (p<0.001). While 40.4% of the patients were BI-RADS class 1 preoperatively, this rate decreased to 14.8% postoperatively. Class 2 level did not show a significant difference, while class 3 level increased from 8.5% to 31.9%. Correlation analysis results between pre-op and post-op BI-RADS classes and age and Body Mass Index (BMI) were analyzed, but no significant correlation value was found. The correlations between pre-op and post-op BI-RADS grades and Hormone Replacement Therapy (HRT) were significant.
Conclusion: It can be concluded that LIMA harvesting during CABG surgery in female patients affects the occurrence of BBD. The change between the pre-op and post-op period was determined by mammography tests. It was shown that there was a significant change in BI-RADS scores on mammography after bypass surgery.

Keywords

Left internal mammary artery, coronary artery bypass grafting, benign breast diseases, BI-RADS, mammography

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