Muhammet Yener AKPINAR, Erkin ÖZTAŞ, Derya ARAS, İsmail Hakkı KALKAN, Meral AKDOĞAN, Sabite KACAR, Yasemin ÖZİN ÖZDERİN, Zeki Mesut Yalın KILIÇ, Bülent ÖDEMİŞ, Selçuk DİŞİBEYAZ, Ertuğrul KAYAÇETİN

Dieulafoy lezyonunda endoskopik tedavi

Giriş ve Amaç: Çalışmamızda kliniğimizde Dieulafoy Lezyonu tanısı konulan hastaları, yapılan endoskopik tedavileri ve bu tedavilerin başarı oranlarını ortaya koymayı hedefledik. Gereç ve Yöntem: Kliniğimizde 2008-2016 tarihleri arasında endoskopileri yapılan hastalar ‘Dieulafoy Lezyonu’ tanısı için retrospektif olarak tarandı. Endoskopik tanısı Dieulafoy lezyonu olan hastaların servis yatışları, laboratuvar değerleri, kaç gün yattıkları, hastalıklarının nihai sonucu tespit edildi. Bulgular: 18 hasta çalışmaya alındı. En sık başvuru şikayeti melenaydı. Hastaların yedi tanesinde mortalite gerçekleşti. Klips, tek başına veya kombine olmak üzere en sık başvurulan endoskopik tedavi yöntemiydi. Klipsin tek başına uygulandığı hastalarla, klipsle beraber veya klips olmadan kombine tedavi uygulanan hastalar arasında mortalite açısından fark yoktu (p=0,9). Adrenalinle beraber heater yapılan olgular dışlanarak yapılan subgrup analizinde klips uygulanan hastalarla klipsle beraber diğer yöntemlerin yapıldığı hastalar arasında mortalite karşılaştırıldı. İki grup arasında yine mortalite açısından bir fark yoktu (p=0,6). Sonuç: Çalışmamız klips tedavisine eklenecek adrenalin ve/veya heater koagü- lasyon gibi yöntemlerle yapılan kombine tedavinin mortaliteyi azaltmada klips monoterapisine kıyasla herhangi bir üstünlüklerinin olmadığını göstermiştir.

Anahtar Kelimeler:

Dieulafoy lezyonu, endoskopik tedavi, gastrointestinal sistem kanaması

Endoscopic treatment of Dieulafoy’s lesion

Background and Aims: This study describes the demographic features of patients with Dieulafoy’s lesion, their endoscopic findings, endoscopic treatments, and their response to therapy. Materials and Methods: Endoscopy reports were screened for Dieulafoy’s lesion between 2008 and 2016. Patients with this diagnosis were also screened to determine initial laboratory findings, endoscopic treatments, and response to therapy. Results: A total of 18 patients were diagnosed with Dieulafoy’s lesion. The most frequent presentation was melena. Seven patients died during the follow-up period. Clip was the most frequent endoscopic treatment method either alone or in combination with other endoscopic modalities. There was no difference in mortality between patients who were treated with clip alone and those treated with the combined modality (p=0.9). When patients treated with adrenalin and heater were excluded, no difference in mortality was observed between the clip group and the clip combined with other endoscopic treatment group (p=0.6). Conclusion: This study demonstrated that additional endoscopic methods such as adrenalin and/or heater did not reduce mortality compared with clip monotherapy.

Keywords:

Dieulafoy’s lesion, endoscopic treatment, gastrointestinal system bleeding,

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