İyad FANSA, Celalettin KARATEPE, Mehmet ACIPAYAM, Cem LALE

Suriye'deki iç savaşta damar cerrahisi deneyimlerimiz

Amaç: Suriyede devam eden iç savaş nedeniyle hastanemize çok sayıda ateşli silah yaralanması sonucu oluşmuş vasküler yaralanmalı hasta başvurmaktadır. Biz çalışmamızda; ateşli silah yaralanması nedeniyle hastanemize başvuran vasküler yaralanmalı hastaların yaralanma bölgeleri, ek yaralanmaları, yapılan cerrahi müdahaleler ve sonuçlarının değerlendirilmesi amaçladık. Yöntemler: Çalışmaya 01.01.2012 ve 01.09.2014 tarihleri arasında Suriye iç savaşında yaralanarak hastanemize başvuran ve vasküler cerrahi müdahale yapılan 58 hasta dâhil edilmiştir. Bulgular: Başvuran 58 hastanın %5,1i Kadın (n=3), %94,9u Erkek (n=55) olarak tespit edilmiştir. Hastaların yaş aralığı 575 olup yaş ortalaması 28,61 olarak tespit edilmiştir. Hastaların % 12,1inde (n=7) yaygın doku defektiyle birlikte olan kas-sinir-kemik yaralanması tespit edilmiş olup, bu hastalarda yapılan vasküler müdahalelere rağmen hastaların %8,6sında (n=5) ekstremite ampute edilmiştir. Müdahale edilen 58 hastadan %15,5i (n:9) ex olmuştur. Sonuç: Ateşli silah yaralanması ile başvuran vasküler yaralanmalı hastalarda yapılan müdahalelere rağmen, geç başvuru, ek yaralanmaların bulunması, yaralanma bölgeleri ve doku defektinin genişliği mortaliteyi etkileyen nedenlerdir.

Our vascular surgery experiences in Syrian civil war

Objective: Due to the ongoing civil war in Syria, numerous vascular injured patients are admitted to our hospital with gunshot wounds. In this study, patients who admitted our hospital, diagnosed with vascular trauma due to gunshot were evaluated with the respect of injury site, additional injuries, surgical interventions and outcomes. Methods: The study included 58 patients wounded in Syrian war and admitted to our hospital between 01.01.2012 and 01.09.2014. Results: There were 5.1% (n=3) female and 94.9% (n=55) male patients. Age range is 5-75 years and the average of age was identified as 28.61. In 12.1% (n=7) of patients with extensive tissue defects of the musclenerve-bone injury has been identified, despite the vascular interventions in these patients, 8.6% (n=5) of patients, the limb has been amputated. Totally 15.5% (n=9) of 58 operated patients died. Two patients died because of major vascular injury with intra-abdominal organ injuries. In one patient; infection induced sepsis and multi organ failure was detected. Six patients were lost due to hypovolemic shock as a result of late arriving. Conclusion: In patients admitted with gunshot vascular injury arrival time, the presence of additional injuries and the location of injury affect mortality rates.

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