Rıza DOĞAN, Ahmet Gökhan GÜNDOĞDU, Meral KANBAK, Murat KARA, Alkın YAZICIOĞLU

Pulmoner rezeksiyon yapılan hastalarda doku yapıştırıcısı kullanımı ve hastane maliyetine etkisi

Akciğer rezeksiyonları sonrası ortaya çıkan uzun süreli hava kaçağı, önemli bir morbidite ve hastane maliyeti artış sebebidir. Kliniğimizde akciğer rezeksiyonu sonrası homolog/otolog doku yapıştırıcısı (fibrin glue) uygulanan 19 (FG grubu) olgu ile beriplast uygulanan 12 olgu ve doku yapıştırıcısı uygulanmayan 27 (kontrol grubu) olguyu uzamış hava kaçağı, tüp çekilme zamanları ve hastane maliyeti açısından karşılaştırdık. Olguların yaş ortalaması sırasıyla FG grubu (19 olgu), beriplast (12 olgu) ve kontrol grubu (27 olgu) 48.5 ± 14, 50.5 ± 6.8 ve 55 ± 12.9 idi. Gruplar arasında yaş (p= 0.210), cinsiyet (p= 0.287) ve uygulanan cerrahi işlem (p= 0.289) açısından fark yoktu. Uzamış hava kaçağı insidansı FG grubu, beriplast grubu ve kontrol grubunda sırasıyla %48, %50 ve %63 olarak saptandı (p= 0.533). Ortalama tüp çekilme zamanı FG grubunda 10.7 ± 8.7, beriblast grubunda 9 ± 4.1, kontrol grubunda ise 8 ± 3.1 gün olarak belirlendi (p= 0.282). Ortalama hastane maliyeti FG grubunda 4633 ± 3272 YTL, beriblast grubunda 4611 ± 1583 YTL, kontrol grubunda ise 4015 ± 911 YTL olarak hesaplandı (p= 0.547). Pulmoner rezeksiyon sonrası fibrin glue kullanımının uzamış hava kaçağı insidansı, tüp çekilme süresi ve hastane maliyetine bir etkisi olmadığı saptanmıştır.

The use of tissue glue and its effect on hospital cost in patients undergoing pulmonary surgery

Prolonged air leak following pulmonary resections is an important cause of morbidity and increased hospital costs. We compared 19 homologous/autologous tissue glue (fibrin glue) applied patients (FG group), 12 beriplast-P applied patients (beriplast group) and 27 control patients with respect to prolonged air leak, chest tube removal time and hospital costs. The mean ages for FG group (19 patients), beriplast group (12 patients) and control group (27 patients) were 48.5 ± 14, 50.5 ± 6.8 and 55 ± 12.9 respectively. The groups were comparable with respect to age (p= 0.210), sex (p= 0.287) and the surgical procedure performed (p= 0.289). The incidence of prolonged air leak in FG group, beriplast group and the control group was 48%, 50% and 63%, respectively (p= 0.533). The mean chest tube removal time in FG group, beriplast group and the control group was 10.7 ± 8.7, 9 ± 4.1 and 8 ± 3.1 days, respectively (p= 0.282). Mean hospital costs in FG group, beriplast group and the control group were 4633 ± 3272 YTL, 4611 ± 1583 YTL and 4015 ± 911 YTL, respectively (p= 0.547). Fibrin glue had no effect on the incidence of prolonged air leak, chest tube removal time and hospital costs.

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