Muhammet Onur HANEDAN, İlker MATARACI, İzzet EMİR, Murat YÜCEL, Tanıl ÖZER, Ufuk SAYAR

Minimally invasive cardiac surgery experiences in a district branch hospital

Giriş: Teknolojik ve cerrahi alandaki gelişmelerle, minimal invazif cerrahi yaklaşımlar hekimler için daha fazla tercih edilebilir hal almışlardır. Aynı zamanda bu küçük kesiler hastaların postoperatif dönemdeki hayat kalitesini de arttırmıştır. Bu çalışma ile bir bölge dal hastanesi olarak bu alandaki deneyimlerimizi bildirmek istedik. Hastalar ve Metod: Mart 2010 ile Nisan 2014 arası 10 hasta hastanemizde minimal invazif yaklaşımla opere edildi. Altısı (%60) bayan olan hastaların yaş ortalaması 50,5±26 yıl (22-82) idi. Dört hastaya ministernotomi, 5 hastaya sağ bir hastaya sol anteriyor minitorakotomi uygulandı. Bulgular: Ortalama operasyon süresi 6,8±1,8 saat (4-10 saat) (anestezi indüksiyonundan yaranın steril gazlı bez ile kapatılmasına kadar geçen süre). Sadece bir hasta ameliyathanede ekstübe edildi. Erken mortalite (postoperatif ilk 30 gün) sadece bir hastada görüldü. Bir hasta yara yeri komplikasyonu nedeniyle yeniden hospitalize edildi. Sonuç: Kardiyak cerrahi alandaki gelişmeler ile birçok bozukluk konvansiyonel yöntemler kadar iyi görüş sağlayan minimal invazif tekniklerle ameliyat edilebilmektedir. Son yıllarda birçok klinik bu alanda gayet güzel sonuçlarını yayınlamışlardır. Sonuçlar da gösteriyor ki, minimal invazif yaklaşım standart tekniklerden daha kötü sonuçları olmamakla beraber hastaların normal yaşam aktivitelerine dönüşlerini kolaylaştırıp, yara yeri komplikasyonlarını da azaltmaktadır. Artan deneyimlerle beraber özellikle dış görünümüne önem veren uygun hastalarda minimal invazif yaklaşımlar akılda bulundurulmalıdır.

Bir bölge dal hastanesinin minimal invazif kalp cerrahisi deneyimleri

Introduction: With the development of technology and surgical experiences, minimally invasive approaches are getting more preferable by physicians. Also these smaller incisions provide patients to have higher life quality at their postoperative periods. In this study we aimed to report our minimally invasive approach experiences. Patients and Methods: In our clinic 10 patients underwent open heart surgery with minimally invasive approaches between March 2010 and January 2014. The mean age was 50.5±26 years (range, 22-82 years). Six of them were females (60%). Four patients have had previous open heart surgery through standard sternotomy. Mini- sternotomy was performed in 4 patients, 5 patients operations were done via right anterior mini-thoracotomy and one patient was operated via left anterior minithoracotomy. Results: The mean operation duration was 6.8±1.8 hours (range, 4-10 hours) (time elapsed from anesthesia induction to wound closure with sterile sponge). Only one patient was extubated in operating theatre. Early mortality (in postoperative 30 days) was seen in only one patient. One patient was admitted to hospital with wound complication and re-hospitalized for wound care. Conclusion: With developments in cardiac surgery field, many disorders are repaired via minimally invasive techniques providing exposures as good as conventional approaches. In recent years, many clinics reported their experiences at these applications with excellent results. Minimally invasive cardiac surgery does not have worse mortality rates than standard techniques. Also, it enables patients to return to their own normal activities, providing them with less wound complications. With the increasing experiences, minimally invasive cardiac surgery may be considered in those appropriate patients and particularly in patients who care about their own appearances.

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