Laparaskopik apendektomide apendisiyel güdüğün kapatılmasında linear endostapler kullanımı

Yıl 2018, Cilt: 10 Sayı: 2, 98 - 102, 01.06.2018

Özgür Albuz , Hakan Buluş Mustafa Doğan Arzu Boztaş

https://doi.org/10.21601/ortadogutipdergisi.295949

Öz

Amaç
:
Akut apandisit şüphesi veya doğrulanmış hastalarda laparoskopik apandisit
ameliyatı giderek artan bir tercihtir. Bu çalışmanın amacı  stapler kullanımının    appendiks 
güdüğünün kapatılmasındaki 
etkinliğini değerlendirmektir.

Method:
Akut apandisit tanısıyla Nisan 2016- Haziran 2016 tarihleri laparoskopik
apandektomi uygulanan 24 hasta çalışmaya dahil edilmiştir. Çalışma retrospektif
olarak planlanmıştır. Her bir konunun bilgilendirilmiş onayı ve Yerel Etik
Komitesi onayı alındı. Bilgilendirilmiş onam formunu imzalayan hastalar
çalışmaya dahil edildi. İmmün baskılama, diabetes mellitus, 18
yaş altı steroid ilaçları, plastrone apandisit tanısı alan, karın cerrahisi
öyküsü olan ve makroskopik ve histopatolojik olarak kanıtlanmış negatif appendektomi
yapılan hastalar hariç tutuldu. Hastanede kalış süresi,
çalışma süresi, işe geri dönüş, geri dönüş oranı, güdük sızıntısı, yara
enfeksiyon hızı ve maliyet açısından tıbbi kayıtlar retrospektif olarak
tarandı.

 Sonuç:  16 erkek ve 8 kadın olan 24 hastaya
laparoskopik apandektomi uygulandı. (ortalama 
yaş  33.1 – yaş ralığı 15-65  arasıdır) 24 hastada  stapler kullanılarak  laparoskopik appendektomi uygulamıştır.
Ortalama  hastane  yatış süresi 2,8  gündür(2-6 gün aralığında). Sadece 1  hastada 
postoperatif  yara   yeri enfeksiyonu olmuştur(%4). Dönüşüm oranı
%0 ‘dır. Appendiks  güdüğünün açılması
veya  abse formasyonu  vuku bulmamıştır(%4). Ameliyat süresi
ortalama 13 (7-21) dakika, ilk oral gıdaya ve normal günlük aktiviteye başlama
zamanı ise sırasıyla; 16 (12-26) saat, 3.8 (3-9) gün olarak bulunmuştur.
Bunlara ek olarak mevcut maliyet 320 USD artırmıştır.

 

 

Anahtar Kelimeler

Laparoskopik apendektomi, linear spapler, appendiks güdüğü, maliyet

Laparoscopic appendectomy using a linear endostapler to appendicular stump closure

Öz

Aim:
Laparoscopic appendectomy is increasingly accepted as the
operation of choice in patients with suspected or confirmed acute appendicitis.
The aim of the current study was to evaluate the effectiveness of appendiceal
stump closure using stapler.

Methods:
24 patients with acute appendicitis who underwent
laparoscopic appendectomy between April 2016 - June 2016 were included in the
study. It was a retrospective reviewed. Informed consent of each subject and
approval of the Local Ethics Committee was obtained. The patients who had
signed the informed consent form  were
included in the study. Patients with immuno suppression, diabetes mellitus,
using steroid medications, under the age of 18, over 65 were excluded.
Additionally, cases diagnosed as plastrone appendicitis, who had history of
abdominal surgery and negative appendectomy proven macroscopically and
histopathologically were excluded.Medical records were screened  retrospectively,  in terms of hospitalization time, duration of
operation, return to work, rate of return, stump leak, wound infection rate and
cost.

Results: Laparoscopic appendectomy was
performed in 24 patients that is 16 males and 8 females .(mean age of 33.1
years; range of 16 to 65 years). Mean hospital stay was 2,8 days (range 2–6
days). Only one patient had post-operative wound infections (4% ). Conversion
rate was 0%. No appendiceal stump leaks or intra-abdominal abscess occurred.
Mean operative time was 13 (7-21) minute . In addition, time to the onset of
oral feeding and normal daily activity were recorded and were 16 (12-26) hours,
3.8 (3-9) days respectively . Use of stapler for closure of the appendicular
stump increased the current cost of 320$(total 940$).

 

 

 

 

 

Anahtar Kelimeler

Laparoscopic apendectomy, linear stapler, appendiceal stump, cost

Kaynakça

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