K. TURHAN, H. KARAPOLAT, S. EYİGÖR, A. ÖZDİL, A. ÇAKAN, U. ÇAĞRICI

Akciğer rezeksiyonu öncesi preoperatif değerlendirme

Giriş: Akciğer rezeksiyonu yapılan olgular ameliyat sonrası gelişen komplikasyonlar açısından risk altındadır. Bu nedenle akciğer rezeksiyonu olacak hastalarda preoperatif dönemde kardiyopulmoner ve fonksiyonel kapasite değerlendirimi önemlidir. Bu çalışmada, akciğer rezeksiyonu yapılacak olan hastaların preoperatif kardiyopulmoner fonksiyonlarını, fonksiyonel kapasitelerini değerlendirmek ve bu bulguların postoperatif dönemde oluşan komplikasyonlarla ilişkisini ortaya koymayı amaçladık. Gereç ve Yöntem: Çalışmamıza rezektabl bir akciğer hastalığı olduğu düşünülen 21 hasta alındı. Hastalar preoperatif dönemdeki kardiyopulmoner fonksiyonları; solunum fonksiyon testi, kan gazı, oksijen satürasyonu, akciğer grafisi, elektrokardiyografi, ekokardiyografi ile, fonksiyonel kapasiteleri kardiyopulmoner egzersiz testi (pVO2), 6 dakika yürüme testi ve yaşam kalitesi (KF 36) ile değerlendirildi. Hastaların yoğun bakımda kalış süreleri, postoperatif komplikasyonları ve hastanede kalış süreleri kaydedildi. Bulgular: Hastaların %85.7 (n: 18 hasta) rezektabl bir akciğer malignitesi saptandı. Preoperatif klinik değerlendirme sonrası akciğer rezeksiyonunu takiben % 38.1 (n: 8) hastada komplikasyon görüldü. Komplikasyon gelişen ve komplikasyon gelişmeyen grup arasında hastanede kalış süresi dışında, diğer tüm kardiyopulmoner, fonksiyonel kapasite parametreleri açısından ilişki saptanmadı (p>0.05). Sonuç: Çalışmamızda, komplikasyonların kardiyopulmoner fonksiyonlar ve fonksiyonel kapasite parametreleri ile ilişkisi gösterilememiştir. Komplikasyonlarla kardiyopulmoner fonksiyonların ve fonksiyonel kapasitenin ilişkisini değerlendiren ve daha fazla sayıda hasta içeren çalışmalara ihtiyaç duyulmaktadır.

Preoperative evaluation of lung resection candidate

Introduction: Patients who undergo evaluation for lung resection have increased risk for the development of postoperative complications. Therefore, preoperative cardiopulmonary and functional evaluation are very important in the evaluation of lung resection candidates. We evaluated preoperative cardiopulmonary function and functional capacity of these patients and correlate them with postoperative complications. Material and Methods: 21 resectable lung cancer patients were included into the study. Patients were evaluated for cardiopulmonary functions (spirometry, blood gases, oxygen saturation, lung radiology, electrokardiography, echocardiogarphy) and functional capacity (maximal cardiopulmonary exercise test, siz minute walk test, quality of life questionnaire (SF 36). Postoperative complications, duration of hospital stay and duration of ICU (intensive care unit stay) were recorded. Results: % 85.7 patients had lung cancer. %31.8 (n:8) patients show complications after lung resection. There was no correlation between complications and cardiopulmonary functions, functional capacity (p>0.05). Duration of hospital stay found only significant who had complications (p= 0.008). Conclusion: Postoperative complications show no correlation with cardiopulmonary functions and functional capacity. Studies with more patients are needed to evaluate the relationship among complications and cardiopulmonary functions and functional capacity.

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