TORAKOMYOPLASTİ CERRAHİSİNDE ANESTEZİ YÖNETİMİMİZ
Konnektif doku tutulumu ile seyreden, multisistemik bir hastalık olan Romatoid Artrit (RA), cerrahi müdahaleyi gerektirecekdüzeyde akciğer hasarına yol açabilmektedir. Torakomyoplasti plastik ve rekonstrüktif cerrahi, genel cerrahi, kalp damar vegöğüs cerrahisi gibi çoklu cerrahi prosedürleri gerektiren komplike bir cerrahi uygulamadır. Bu olgu sunumunda RA'e bağlıidiyopatik pulmoner fibrozis ve buna bağlı komplikasyonları gelişmiş bir olgunun anestezi yönetiminin tartışılması amaçlanmıştır
ANESTHETIC MANAGEMENT OF THORACOMYOPLASTY PROCEDURE
Rheumatoid arthritis (RA), which is a multisystemic disease characterized with connective tissue involvement, may causepulmonary damage necessitating surgical intervention. Thoracomyoplasty is a complicated multimodal procedure involving manysurgeries like plastic and reconstructive, general, cardiovascular and thoracic surgeries. The aim of this case report is to discussthe anesthetic management of a patient with idiopathic pulmonary fibrosis and related complications due to RA
___
- 1. Solomon JJ, Ryu JH, Tazelaar HD, et al. Fibrosing interstitial pneumonia predicts survival in patients with rheumatoidarthritisassociated interstitial lung disease (RA-ILD) Respir Med 2013; 107: 1247-1252.
- 2. O'Dwyer DN, Armstrong ME, Cooke G, Dodd JD, Veale DJ, Donnelly SC. Rheumatoid Arthritis (RA) associated interstitial lung disease (ILD). Eur J Intern Med 2013; 9: 649-657.
- 3. Atzeni F, Boiardi L, Sallì S, Benucci M, Sarzi-Puttini P. Lung involvement and drug-induced lung disease in patients with rheumatoidarthritis. Expert Rev Clin Immunol 2013; 9: 649-657.
- 4. Sivrikoz MC, Elbeyli L. Cerrahi Sonras› Ampiyemler. Toraks Dergisi 2002; 3: 17-22.
- 5. Botianu PV, Botianu AM. Thoracomyoplasty in the Treatment of Empyema: Current Indications, Basic Principles, and Results. Pulm Med 2012; 2012: 418514.
- 6. Adelman HM, Dupont EL, Flannery MT, Wallach PM. Case report: recurrent pneumothorax in a patient with rheumatoidarthritis. Am J Med Sci 1994; 308: 171-172.
- 7. Rueth N, Andrade R, Groth S, D'Cunha J, Maddaus M. Pleuropulmonary complications of rheumatoid arthritis: a thoracicsurgeon's challenge. Ann Thorac Surg 2009; 88: e20-21.
- 8. Wolter A, Scholz T, Diedrichson J, Arens-Landwehr A, SchroederFinckh R, Liebau J. Bronchopleural fistula after pneumonectomy: interdisciplinary surgical closure by an ipsilateral pedicled latissimus dorsi flap supported by video-assisted thoracoscopy. J Plast Reconstr Aesthet Surg 2013; 66: 1600-1603.
- 9. Schreiner W, Fuchs P, Autschbach R, Pallua N, Sirbu H. Modified technique for thoracomyoplasty after posterolateral thoracotomy. Thorac Cardiovasc Surg 2010; 58: 98-101.
- 10. Thourani VH, Lancaster RT, Mansour KA, Miller JI Jr. Twenty-six years of experience with the modified eloesser flap. Ann Thorac Surg 2003; 76: 401-406.
- 11. Karamustafao¤lu YA, Cansever L, Çevik AG, Hac› ‹brahimo¤lu G, Kutlu CA, Bedirhan MA. Kronik ampiyem olgular›nda torakomiyoplastinin yeri. Turkish J Thorac Cardiovasc Surg 2003; 11: 174-177.
- 12. Botianu PV, Botianu AM. Muscle Flaps and Thoracomyoplasty: Alternative solution for unresectable primary pulmonary abscesses. Thorac Cardiovasc Surg 2013; 61: 626-630.
- 13. Samanta R, Shoukrey K, Griffiths R. Rheumatoid arthritis and anaesthesia. Anaesthesia 2011; 66: 1146-1159.
- 14. Segebarth PB, Limbird TJ. Peri-operative acute upper airway obstruction secondary to severe rheumatoid arthritis. Journal of Arthroplasty 2007; 22: 916-919.
- 15. Neva MH, Häkkinen A, Mäkinen H, Hannonen P, Kauppi M, Sokka T. High prevalence of asymptomatic cervical spine subluxation in patients with rheumatoid arthritis waiting for orthopaedic surgery. Ann Rheum Dis 2006; 65: 884-888.
- 16. Chen JJ, Branstetter BF, Myers EN. Cricoarytenoid rheumatoid arthritis: an important consideration in aggressive lesions of the larynx. American Journal of Neuroradiology 2005; 26: 970-972.
- 17. Lehmann T, Nef W, Stalder B, et al. Fatal postoperative airway obstruction in a patient with rheumatoid arthritis. Annals of the Rheumatic Diseases 1997; 56: 512-513.