Deniz TAZEOĞLU, Ahmet Cem ESMER, Bilal ARSLAN, Akay EDİZSOY, Mehmet GÖKÇEİMAM, Fazıl SAĞLAM

Preoperatif Aneminin Hiatal Herni Cerrahisi ve Postoperatif Komplikasyonlara Etkisi

Amaç: Anemi, cerrahi geçiren tüm hastalarda artmış mortalite ve morbidite ile ilişkilidir. Bu çalışmada, hiatal herni cerrahisi öncesi aneminin ne ölçüde postoperatif komplikasyonlara neden olduğunu ortaya koymak amaçlandı. Gereç ve Yöntemler: Kliniğimizde, 2015 ve 2019 yılları arasında hiatal herni nedeniyle ameliyat edilmiş olan hastalar geriye dönük olarak incelendi. Hastalar demografik, preoperatif laboratuvar değerleri, preoperatif Charlson komorbidite indeksi skoru, hiatal herni tipi, postoperatif yoğun bakım gereksinimi, postoperatif komplikasyon varlığı, Clavien-Dindo skoru, kan transfüzyon ihtiyacı ve hastanede kalış süresi açısından karşılaştırıldı. Bulgular: Hastaların 109’u kadın ve 83’ü erkek idi. Yaş ortalaması 50,1±9,1 yıl idi. Hastaların 54'ü (%28,2) anemik grupta ve 138'i (%71,8) ise anemik olmayan grupta idi. Cinsiyet dağılımı açısından gruplar arasında istatistiksel olarak anlamlı bir fark yoktu (p=0,663). Gruplar yaş dağılımı açısından karşılaştırıldığında, anemik grubun anemik olmayan gruba göre daha yaşlı olduğu ve bu farkın istatistiksel olarak da anlamlı olduğu saptandı (p<0,001). Postoperatif komplikasyon oranı açısından gruplar arasında anlamlı bir fark vardı ve anemik grupta daha sık olduğu görüldü (p<0,001). Postoperatif dönemde yoğun bakım ünitesi ve kan transfüzyonu ihtiyacı açısından da gruplar arasında anlamlı bir fark vardı (sırasıyla p=0,020, p<0,001). Sonuç: Preoperatif anemi, hiatal herni cerrahisinde postoperatif komplikasyonları arttırır. Bu nedenle, hiatal herni ameliyatı öncesi anemi varlığı araştırılmalı ve anemisi olan hastalar postoperatif dönemde yakın takip edilmelidir.

Anahtar Kelimeler:

anemi, hiatal herni, morbidite, mortalite

The Effect of Preoperative Anemia on Hiatal Hernia Surgery and Postoperative Complications

Aim: Anemia is associated with increased mortality and morbidity in all patients undergoing surgery. This study aimed to reveal to what extent anemia caused postoperative complications before hiatal hernia surgery. Material and Methods: One hundred and ninety-two patients operated for hiatal hernia in our clinic between 2015 and 2019 were analyzed retrospectively. Patients were compared according to demographics, preoperative laboratory values, preoperative Charlson comorbidity index score, hiatal hernia type, postoperative intensive care requirement, presence of postoperative complications, Clavien-Dindo score, blood transfusion need, and length of hospital stay. Results: Of the patients, 109 were female and 83 were male. The mean age was 50.1±9.1 years. Fifty-four (28.2%) of the patients were in the anemic group, and 138 (71.8%) were in the non-anemic group. There was no statistically significant difference between the groups in terms of gender distribution (p=0.663). When the groups were compared in terms of age distribution, it was found that the anemic group was older than the non-anemic group and the difference was statistically significant (p<0.001). There was a significant difference between the groups in terms of the postoperative complications rate and it was more common in the anemic group (p<0.001). There was a significant difference between the groups in terms of the need for intensive care and blood transfusion in the postoperative period (p=0.020, p<0.001, respectively). Conclusion: Preoperative anemia increases postoperative complications in hiatal hernia surgery. Therefore, the presence of anemia should be investigated before hiatal hernia surgery and patients with anemia should be followed up closely postoperatively.

Keywords:

anemia, hiatal hernia, morbidity, mortality,

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