Cenk BALTA, İsmail KARACAOĞLU, Duygu MERGAN, Ali Cem YEKDEŞ

Primer spontan pnömotoraks tedavisinde küçük çaplı toraks kateterleri etkili midir?

Amaç: Primer spontan pnömotoraks (PSP) tedavisinde ilk seçenek hala tartışmalıdır. Klinisyenler tarafından genellikle geniş çaplı toraks drenleri tercih edilmektedir. Fakat son yıllarda da küçük boyutlu kateterlerin kullanımı artmıştır. Çalışmamızda PSP tedavisinde kullanılan küçük ve geniş çaplı toraks kateterlerinin tedavi etkinliği, klinik sonuçları ve oluşturdukları ağrı seviyeleri karşılaştırılması amaçlandı. Yöntemler: Ağustos 2017 ve Ağustos 2019 arasında PSP tanısıyla başvuran 18 yaş üstü hastalar çalışmaya dahil edildi. Hastalar küçük ve geniş çalı toraks dreni uygulanmasına göre iki gruba ayrıldı. Grupların demografik bilgileri, klinik sonuçları ve ağrı seviyeleri geriye dönük olarak incelendi. Hastanede yatış süresi, drenaj süresi ve Görsel Analog Skala sonuçları karşılaştırmalı olarak değerlendirildi. Elde edilen veriler istatistiksel olarak incelendi. Bulgular: Ortanca yaşları 26 (22-33) olan 95 erkek ve 10 kadın hasta çalışmaya dahil edildi. Hastaların 47(%44,8)’ine geniş çaplı, 58(%55,2)’sine küçük çaplı drenaj uygulandı. İki grupta da başarısızlıkla sonuçlanan tedavi olmadı. Geniş çaplı drenaj uygulananların 6(%12,8)’sında, küçük çaplı drenaj uygulananların 4(%6,9)’sinde nüks izlendi. Gruplar arasında yaş, cinsiyet, hastalık yönü, sigara durumu, nüks oranı açısından istatistiksel olarak anlamlı fark saptanmadı. Görsel Analog Skala sonuçları, drenaj süresi, hastane yatış süresi küçük boyutlu drenaj uygulanan hastalarda anlamlı olarak daha az bulundu. Sonuç: Daha az ağrı oluşturan, kolay uygulanan, daha kısa drenaj ve hastanede yatış süreleri sahip küçük çaplı toraks kateteri uygulamasının geleneksel toraks drenleri kadar PSP tedavisinde etkilidir.

Anahtar Kelimeler:

pnömotoraks, toraks dreni, küçük çaplı toraks kateterleri, primer spontan pnömotoraks

Are small bore thorax catheters effective in the treatment of primary spontaneous pneumothorax?

Aim: The first option in the treatment of primary spontaneous pneumothorax (PSP) is still controversial. Large bore thoracic drains (LBTD) are generally preferred by clinicians. However, the use of small-bore thorax catheters (SBTC) has increased in recent years. In our study, we aimed to compare the treatment efficacy, clinical outcomes and pain levels of small and large diameter thoracic catheters used in PSP treatment. Methods: Patients over the age of 18 who presented with a diagnosis of PSP between August 2017 and August 2019 were included in the study. The patients were divided into two groups according to the application of small and large bore thorax drain. Demographic information, clinical results and pain levels of the groups were analyzed retrospectively. The duration of hospitalization, duration of drainage and Visual Analogue Scale (VAS) results were evaluated comparatively. Results: 95 male and 10 female patients with a median age of 26 (22-33) were included in the study. LBTD was applied to 47 (44.8%) and SBTC was applied to 58 (55.2%) of the patients. Recurrence was observed in 6 (12.8%) of LBTD group and in 4 (6.9%) SBTC group. VAS scores, drainage time, hospital stay were significantly less in patients with small-sized drainage. Conclusion: SBTC application is easy to apply, causes less pain, has shorter drainage time and duration of hospital stay. It is as effective as traditional thoracic drains in the treatment of PSP.

Keywords:

pneumothorax, thoracic drain, small bore thoracic catheter, primary spontaneous pneumothorax,

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