KRONİK POSTTORAKOTOMİ AĞRI SENDROMU; DERLEME
Kronik post torakotomi ağrı sendromu (KPAS); torakotomiden 2 ay sonra, devam eden kronikleşmiş ağrı olarak ifade edilmektedir. Minimal invaziv tekniklerin gelişmesiyle son yıllarda insidansında azalma olmakla birlikte, torakotomi geçiren olguların yarıya yakınında görülür. Hastaların günlük yaşamını ve yaşamsal fonksiyonlarını olumsuz yönde etkileyen, etyolojisi tam olarak aydınlatılamamış bir problemidir. Etyolojide en çok torakotomi sırasında ekartör basısı ve kot fraktürü oluşumu suçlanmaktadır. Bu yüzden amaca en uygun ve en az travmatik cerrahi yöntem seçilmelidir. Sendrom klinikte önemli bir hasta populasyonunu etkilemektedir. Tedavi birinci basamak tedavilerden, nöromodülasyon ve sinir bloklarına kadar uzanan geniş bir yelpazede multimodal olarak değerlendirilmelidir ve mutlaka kişiselleştirilmelidir.
CHRONIC POSTTHORACOTOMY PAIN SYNDROME, A REVIEW
Chronic postthoracotomy pain syndrome (CPPS); can explain as persisting chronic pain during two months after thoracotomy. In last years, CPPS is seen in approximately half of patients after thoracotomy although the decrease in incidence with the development of minimally invasive techniques. The pain affects the patient's daily lives and vital functions in a negative way. The exact mechanism for the pathogenesis of CPPS is still not clear. Most common etiological factors are retractor compression during thoracotomy and rib fracture formation. For this reason the most appropriate and least traumatic surgical procedure should be selected. The Syndrome affects a significant patient population in clinical. Therapy should be considered as multimodal which is varies from primary treatment to neuromodulation and nerve blocks in wide range and the treatment should be personalized.
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