Pınar ERGENOĞLU, Zeynep ERSOY, Anış ARIBOĞAN

Mesane kanserinde radikal sistektomi üriner diversiyon operasyonu yapılan hastalarda perioperatif parametrelerin değerlendirilmesi

Amaç: Bu çalışmada intraoperatif ve postoperatif ilk 24 saatlik dönemde eritrosit transfüzyonu ve/veya inotropik/vazopresör ajan infüzyonunun 30 günlük ve bir yıllık sağkalımı etkisinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Bu çalışmaya final analizinde Kasım 2011 ile Ocak 2019 arasında radikal sistektomi ve üriner diversiyon operasyonu geçiren 133 hasta dahil edildi. Perioperatif anestezi yönetimi erken postoperatif yoğun bakım hasta takipleri esas alındı. Bulgular: İntraoperatif kırmızı kan hücresi transfüzyonu ile bir yıllık mortalite oranları arasında istatistiksel olarak anlamlı bir ilişki bulunmuştur. Yoğun bakım ünitesinde yapılan eritrosit transfüzyonu ile postoperatif 30 günlük mortalite oranları arasında istatistiksel olarak anlamlı bir ilişki bulunmuştur. Yoğun bakım ünitesinde vazopressör/inotrop ajan infüzyonu ile postoperatif 30 günlük mortalite arasında istatistiksel olarak anlamlı bir ilişki bulunmuştur. Sonuç: Radikal sistektomi ve üriner diversiyon operasyonu geçiren hastalarda intraoperatif eritrosit, inotrop/vazopresör ilaç uygulaması ve yoğun bakımda postoperatif ilk 24 saat içinde eritrosit transfüzyonu hem erken hem de geç dönemde daha düşük sağkalım oranları ile ilişkilidir. Gelecekteki çalışmalar, perioperatif kan yönetimi ve hasta hemodinamisinin korunması ile ilgili erken ve geç dönem sonuçları etkileyebilecek farklı stratejiler geliştirmeye ve uygulamaya odaklanmalıdır.

Evaluation of perioperative parameters in patients undergoing radical cystectomy urinary diversion surgery for bladder cancer

Purpose: The aim of this study was to evaluate the effect of red blood cell transfusion and/or inotropic/vasopressor agent infusion during intraoperative and postoperative first 24-hour period on 30-day and one-year survival. Materials and Methods: In the final analysis, 133 patients who underwent radical cystectomy and urinary diversion surgery between November 2011 and January 2019 were included in this study. Perioperative anesthesia management early postoperative intensive care patient follow-ups were based on. Results: A statistically significant relationship was found between intraoperative red blood cell transfusion and one-year mortality rates. A statistically significant relationship was found between red blood cell transfusion in the intensive care unit and postoperative 30-day mortality rates. The relationship between vasopressor/inotrope agent infusion in intensive care unit and postoperative 30-day mortality was statistically significant. Conclusion: In radical cystectomy and urinary diversion, intraoperative red blood cell and/or inotrope/vasopressor drug administration, and red blood cell transfusion within first 24 postoperative hours in intensive care unit are associated with lower survival rates in both early and late periods. Future studies should focus on developing and implementing different strategies for perioperative blood management and maintenance of patient hemodynamics that may affect early and late outcomes.

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