Planjon guatrların cerrahi tedavisi

Planjon guatrlar mediastinal bir kitle olarak etki göstererek dispne, disfaji, larengeal sinir hasarı ve vena cava superior sendromu gibi bulgularla seyredebilen bir hastalıktır. Hastalığın tedavisinde servikal yaklaşım, sternotomi, torakotomi ve torakoskopi uygulanmaktadır. Bu çalışmada KTÜ, Tıp Fakültesi Genel Cerrahi Anabilim Dair na 2001 - 2002 yıllarında başvuran 16 planjon guatrlı hastaya uyguladığımız servikal yaklaşımın sonuçlarını ve güvenilirliğini retrospektif değerlendirmeyi amaç-ladık. Servikal yaklaşımda tiroid bezinin damarları bağlanıp servikal tiroid dokusu serbestleştirildikten sonra retrosternal komponenti boyuna doğrultuldu ve rezeksiyon işlemi gerçekleştirildi. Bir hastamızda postoperatif 3. saatte kanama meydana geldi ve bu nedenle revize edildi. Planjon guatrların servikal bir insizyon ile parmak yardımıyla doğrultulması güvenilir ve etkin bir yoldur.

Surgical treatment of plunging goiters

Plunging goitre is a mediastinal mass presented with dyspnea, dysphagia, laryngeal nerve paralysis and superior vena cava syndrome. In the treatment of this condition cervical apporach, sternotomy, thoracotomy and thoracoscopy methods are used. In this study we assessed the results and safety of cervical apporach that we applied to patients with plunging goitre in Department of General Surgery - Faculty of Medicine - Karadeniz Technical University. With cervical apporach the thyroid vessels were ligated and cervical thyroid tissue dissected. Then the substernal component was delivered to the neck with aid of finger dissection and excision of thyroid tissue was performed. One patient was revised because of significant bleeding at third postoperative hour. We conclude that through cervical apporach, delivery of the plunging goitre with finger, is an effective and safe method.

Kaynakça

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10. Arıcı C, Dertsiz L, Altunbaş H, Demircan A, Emek K, Operative Management of substernal goiter. Analysis of 52 patient. Int Surg. 86(4): 220-224, 2001.

11. İşgör A, Tiroid Hastalıkları ve Cerrahisi, Avrupa Tıp kitapçılık, s. 170, 2000.

12. Makeieff M, Marlier F, Khudjadze M, Garrel R, Crampette L, Guerrier B, Substernal Goiter, Report of 212 Cases. Ann Chir. 25(1): 18-25, 2000

13. Rios Zambudio A, Rodriguez Gonzales JM, Carrasco Pratz M, Pinero Madrona A, Soria Cogollos T, Parrilla Paricio P, Superior Vena Cava Syndrome Caused by Multinodular Goiter. Rev Clin Esp. 200(4): 208-211, 2000.

14. Torre G, Borgonovo G, Amato A, Arezzo A, Ansaldo G, De Negri A, Ughe M, Mattioli F, Surgical Management of Substernal Goiter, Analysis of 237 patients. Am Surg. 61: 826-831, 1995.

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