Ali YAVUZCAN, Mete ÇAĞLAR, Yusuf ÜSTÜN, Serdar DİLBAZ, Atilla ÖZKARA, Selahattin KUMRU

Laparaskopik Histerektomi’de Traneksamik Asit Kullanımı

Amaç: Bu çalışmanın amacı preoperatif dönemde traneksamik asit TA uygulanmasının laparaskopik histerektomide LH operasyon süresi , preoperatif-postoperatif dönem arasındaki hemoglobin Hb değişimi delta Hb ve hospitalizasyon süresi üzerine etkisini değerlendirmektir.Çalışmanın Yapıldığı Yer: Düzce Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı.Materyal-Metod: Adneksektomi dahil yada hariç olmak üzere LH ile birlikte tanısal sistoskopi CYS işlemi yapılan hastalar çalışmaya dahil edilmiştir. Operasyonların hepsi aynı cerrah tarafından gerçekleştirilmiştir.Bulgular: TA kullanılan hastalar ile kullanılmayan hastalar arasında hasta yaşı ve uterin ağırlık açısından istatistiksel olarak anlamlı farklılık saptanmamıştır p=0,714 ve p=0,955 sırasıyla . Ancak ortalama parite sayısı TA uygulanan grupta istatistiksel olarak anlamlı olacak şekilde düşük tespit edilmiştir p=0,006 . Operasyonda TA uygulanan hastalar ile uygulanmayan hastalar arasında arasında operasyon süresi p=0,962 , delta Hb p=0,870 ve hospitalizasyon süresi p=0,759 açısından istatistiksel olarak anlamlı farklılık saptanmamıştır.Sonuç: Çalışmamızda TA uygulanmasının LH’de operasyon sonuçları üzerine olumlu etkisi gösterilememiştir. Konvansiyonel olarak yapılan açık cerrahi işlemlerde kan kaybını azalttığı ispatlanmış olan TA’nın minimal invaziv yöntemlerle yapılan operasyonlardaki etkinliğinin net olarak ortaya konabilmesi için geniş kapsamlı yeni araştırmalara gerek duyulmaktadır.

Anahtar Kelimeler:

laparaskopik histerektomi, operasyon sonuçları, traneksamik asit

Using Tranexamic Acid In Laparoscopic Hysterectomy

Objective: The aim of this study was to evaluate the effect of using systemic tranexamic acid TA preoperatively on operation time, difference in hemoglobin Hb levels measured before and after surgery delta Hb and duration of hospitalization in laparoscopic hysterectomy LH .Institution: Düzce University School of Medicine, Department of Obstetrics and Gynecology.Materials and Methods: The patients undergo LH with cystoscopy CYS with or without adnexectomy were included in this study. All the operations carried out by the same surgeon.Results: The patients receiving TA and patients not receiving TA were compared in terms of age and uterine weight. There was no statistically significant difference between two groups in terms of age and uterine weight p = 0.714 and p = 0.955 respectively . However, the average number of parity was to be significantly lower in the patients receiving TA p = 0.006 . There was not any statistically significant difference between the patients who received TA and who did not recieve in terms of operative time p =0.962 , delta Hb p = 0.870 and duration of hospitalization p = 0.759 .Conclusion: Our study did not demonstrate a positive effect of tranexamic acid after systemic administration on perioperative outcomes of LH . The effectiveness of TA in conventional open surgical procedures to reduce blood loss has been proven but further investigations to clarify the effectivity of TA on minimally invasive surgical approaches are needed.

Keywords:

laparoscopic hysterectomy, perioperative outcomes, tranexamic acid,

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