TUĞRA GENÇPINAR, Çağatay BİLEN, Gökmen AKKAYA, SERDAR BAYRAK, Hüdai ÇATALYÜREK

VASKULER RİNG ANOMALİLERİNE CERRAHİ GİRİŞİM YÖNTEMLERİ VE YAKLAŞIMLAR

Giriş: Vasküler ring terimi embriyolojik hayatta, aortik ark ve dallarında gelişen anomalileri içeren geniş bir spektruma sahiptir. Hastalar tanı aldıktan sonra yapılan dekompresyon amaçlı cerrahi girişim, vasküler ring tedavisinde altın standart yöntemidir. Gereç ve Yöntem: Çalışmaya 2005-2017 yılları arasında kliniğimizde vasküler ring nedeni ile opere edilen hastalar dahil edildi. Hastaların hastane kayıtları retrospektif olarak tarandı. Hastaların tanısınının doğrulanması için kullanılan yöntemler çalışmada sunuldu. Operasyon sırasında kullanılan teknik, yoğun bakım takip süresi, entübasyon süresi, hastane kalış süresi ve operasyon sonrası oluşan komplikasyonlar kayıt altına alındı. Bulgular: Vasküler ring anomalisi nedeni ile toplam 16 hasta opere edildi. Hastaların yaş ortalaması 43,50±38,61 ay olarak saptandı. Hastaların altısında çift arkus aorta, yedisinde sol arkus aorta ve sağ aberran subklavian arter, üç hastada sağ arkus aorta ve sol ligamentum arteriozus saptandı. En sık görülen klinik yakınma öksürüktü. Ortalama entübasyon ve yoğun bakım kalış süreleri 9,31±16,79, 32,62±26,33 saat, hastane yatış süreleri, 6,31±2,62 gün olarak saptandı. Sonuç: Erken çocukluk çağında sık tekrarlayan solunumsal ve özefageal semptomlar varlığında vasküler ring tanısı akılda tutulmalıdır. Geri dönüşümsüz hasar oluşmadan konulacak erken tanı ve yapılacak cerrahi tedavi ile hastalarda uzun dönem semptomsuz sağ kalım sağlanabilmektedir.

MANAGEMENT AND SURGICAL INTERVENTION STRATEGIES OF VASCULAR RING ANOMALIES

Introduction: The vascular ring has a broad spectrum of anomalies in the aortic arch and its branches in embryological life. Surgical intervention with decompression purpose after the diagnosis of the patients is the gold standard method in vascular ring treatment. Material and Method: Patients who were operated in our clinic on with vascular ring reasoning were included in our clinic between 2005 and 2017. The methods used to confirm the diagnosis of the patients were presented in the study. The technique used during the operation, the intensive care follow-up period, the duration of intubation, the duration of the hospital stay and the complications that occurred after the operation were recorded. Result: A total of 16 patients were operated with the cause of vascular ring anomaly. The mean age of the patients was 43.50 ± 38.61 months. In six of the patients were double aortic arch anomaly, in seven of the patients were left arcus aorta and right aberran subclavian artery anomaly and in three of the patients were right arcus aorta and left ligamentum arteriosus anomaly revealed. The most common clinical complaint is cough. Mean intubation andintensive care unit stay were 9.31 ± 16.79, 32.62 ± 26.33 hours, hospitalization time, 6.31 ± 2.62 days was founded. Conclusion: In the presence of frequent repetitive respiratory and esophageal symptoms in early childhood, the diagnosis of vascular ring should be kept in mind. Late-term asymptomatic survival can be achieved with early diagnosis and surgical treatment before the occurrence of irreversible damage.

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