Emre GÖNÜLLÜ, Ahmet Tarık HARMANTEPE, Furkan KUCUK, Recayi CAPOGLU, Zulfu BAYHAN, Mehmet ÖZDİN, Gizem FIRTINA

Delta nötrofil indeksi, inkarsere inguinal fıtıklarda barsak rezeksiyonu gereğini öngörmede bir belirteç olarak kullanılabilir mi?

Amaç: Delta nötrofil indeksi, immatür granülositlerin nötrofil sayısına oranını gösteren bir parametredir. Bu çalışma, DNI'nin inkarsere inguinal herni hastalarında strangülasyon varlığını öngörmedeki gücünü belirlemeyi amaçlamaktadır. Yöntem: Mayıs 2021-Mayıs 2022 tarihleri arasında inkarsere kasık fıtığı nedeniyle kliniğimize başvuran ve opere edilen hastaların dosyaları geriye dönük olarak incelendi. Hastaların dosyalarından yaş, cinsiyet, fıtık tipi, lökosit, lenfosit, nötrofil, trombosit, monosit değerleri, delta nötrofil indeksi, uygulanan cerrahi yöntem ve barsak rezeksiyonu yapılıp yapılmadığı öğrenildi. Hastalar barsak iskemisi nedeniyle barsak rezeksiyonu yapılanlar (grup 1) ve yapılmayanlar (grup 2) olarak iki gruba ayrıldı. Bulgular: Seksen bir hasta çalışmaya dahil edildi. 70 (%86,4) hastaya barsak rezeksiyonu yapılmadığı, 11 (%13,6) hastaya barsak rezeksiyonu yapıldığı belirlendi. Grup 1'deki hastaların ortanca DNI değeri 0,30 (0,10 - 1,20), Grup 2'deki hastaların ortanca DNI değeri 0,30 (0,10 - 1,30) idi ve aradaki fark istatistiksel olarak anlamlı değildi (p=0,77). Sonuç: İnkarsere inguinal hernisi olan hastalarda inkarsere barsak segmentinde iskemi varlığını öngörmek için delta nötrofil indeksi güçlü bir prediktif değer olmayabilir.

Anahtar Kelimeler:

Delta nötrofil indeks, İnkarsere inguinal herni, strangülasyon

May the delta neutrophil index be used as a marker to predict the need for bowel resection in incarcerated hernias?

Objective: Delta neutrophil index is a parameter that shows the ratio of immature granulocytes to the neutrophil count. This study aims to determine the power of DNI in predicting the presence of strangulation in incarcerated inguinal hernias. Methods: The files of the patients who were admitted to our clinic and operated due to incarcerated inguinal hernia between May 2021 and May 2022 were reviewed retrospectively. The patients' age, gender, hernia type, leukocyte, lymphocyte, neutrophil, platelet, monocyte values, delta neuthrophil index, the surgical method applied, and whether bowel resection was performed were extracted from the patient files. The patients were divided into two groups patients who underwent bowel resection because of bowel ischemia (group 1) and those who did not (group 2). Results: Eighty-one patients were included in the study. It was determined that 70 (86.4%) patients did not undergo bowel resection, and 11 (13.6%) underwent bowel resection. The median DNI value of the patients in Group 1 was 0.30 (0.10 - 1.20), and the median DNI value of the patients in Group 2 was 0.30 (0.10 - 1.30), and the difference was not statistically significant (p=0.77) Conclusion: Delta neutrophil index may not be an accurate predictive value to predict the presence of ischemia in the incarcerated bowel segment in patients with incarcerated inguinal hernia.

Keywords:

Delta neutrophil index, Incarcerated inguinal hernia, strangulation,

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