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PULMONER REZEKSİYONLARDA TORAKOTOMİ İLE UNİPORTAL VATS YÖNTEMLERİNİN KIYASLANMASI

Amaç: Küçük hücreli dışı akciğer kanserlerinde (KHDAK) hastalara önerilen altın standart tedavi cerrahi yöntemdir. Çalışmadaki amacımız torakotomi veya uniportal video yardımlı torakoskopik cerrahi (U-VATS) yapılan KHDAK hastalarında; cerrahinin sonuçlarının değerlendirilmesidir. Gereç ve yöntem: 2018–2020 yılları süresinde kliniğimizde KHDAK sebebiyle pulmoner rezeksiyon planlanan 30 hasta prospektif incelendi. Uniportal video yardımlı torakoskopik cerrahi (U-VATS) ve kas koruyucu torakotomi (KKT) olarak iki grup oluşturuldu (n=15, n=15). Grupların parametreleri İstatistiksel olarak değerlendirildi. Bulgular: Gruplar operasyon süresi, ameliyat esnasında kaydedilen kanama miktarı, çıkarılan lenf nodu sayısı açısından kıyaslandığında fark görülmedi. İnsizyonun boyu U-VATS’da KKT’ye göre anlamlı olarak düşük bulundu. Göğüs direni kalma süresi U-VATS grubunda, KKT’ye göre anlamlı olarak düşük tespit edildi. U-VATS yapılan grubun yattığı gün sayısı ortalama 5.8; Torakotomi grubunun ise gün sayısı 10.06 olarak kaydedildi. Ortalama göğüs direninin kaldığı günlerinin sayıları istatiksel açıdan U-VATS’da daha az olduğu tespit edildi. Grupların Visuel Analog Skalaları (VAS) skoru anlamlı düzeyde düşük bulundu. Sonuç: U-VATS grubu KKT’ye göre karşılaştırılınca; insizyonun boyu, yattığı gün sayısı, göğüs direnli gün sayısı istatistiksel yönden düşük tespit edildi. Cerrahinin süresi, intraoperatif kanama miktarı, lenf nodlarının diseksiyon/örnekleme sayısı açısından kıyaslandığında istatistiksel olarak anlamlı farklılık bulunmadı. Pulmoner rezeksiyonlarda U-VATS yönteminin açık cerrahi tekniğiyle kıyaslayınca ağrı skorunun daha az olduğu kayda geçildi.

Anahtar Kelimeler:

Akciğer kanseri, Pulmoner rezeksiyon, Torakotomi ve Uniportal VATS yöntemlerinin karşılaştırılması

COMPARİSON OF THORACOTOMY AND UNİPORTAL VATS TECHNİQUES İN PULMONARY RESECTİONS

Objective: In non-small cell lung cancers(NSCLC), surgery is the gold standard treatment recommended for patients. Our aim is to evaluate the results of surgery in NSCLC patients who underwent thoracotomy or uniportal video-assisted thoracoscopic surgery(U-VATS). Method: During 2018–2020, 30 patients planned pulmonary resection NSCLC in our clinic were prospectively analyzed. Two groups were divided into uniportal video-assisted thoracoscopic surgery(U-VATS) and muscle-sparing thoracotomy(KKT)(n=15, n=15). The group’s parameters were evaluated statistically. Results: o differences in the groups were compared in operation time, the amount of bleeding recorded, and the number of lymph nodes removed. The length of the incision was found to be significantly lower in U-VATS compared to KKT. The length of stay of the chest tube was found to be significantly lower in the U-VATS group compared to KKT. The average number of days spent in the hospital U-VATS group was 5.8; The number of days in the thoracotomy group was recorded as 10.06. The number of days of average chest tube stay was statistically less in U-VATS. Visual Analogue Scales(VAS) was found to be significantly lower in U-VATS. Conclusion: When the U-VATS group compared to KKT; the length of the incision, the number of days hospitalized, and the number of days with chest-tube were found to be statistically low. No statistically significant difference when the duration of surgery intraoperative bleeding, the number of lymph nodes dissection/sampling were compared. It was noted that the pain score was lower the U-VATS method was compared with the open surgery technique.

Keywords:

Comparison of Thoracotomy and Uniportal VATS techniques, Lung cancer, Pulmonary resection,

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