Burhan APİLİOĞULLARI, Sami CERAN, Ahmet DUMANLI

Akciğerleri ekspanse olmayan ve uzamış hava kaçağı olan hastalarda otolog kan yaması uygulaması

Amaç: Bu çalışmada, akciğerin ekspanse olması ve akciğer parankim kaçaklarının otolog kan yaması ile tıkanması sağlanarak, plörodez işleminin etkinliği araştırıldı. Çalışma planı: Kasım 2015 - Kasım 2019 tarihleri arasında kliniğimizde otolog kan yama plörodezisi uygulanan toplam 24 hasta (17 erkek, 7 kadın; ort. yaş 59.9±12.2 yıl; dağılım, 30-86 yıl) retrospektif olarak incelendi. Hastalar akciğerin ekspanse olamaması veya kötü genel durum nedeniyle kimyasal plörodez için uygun değildi. Hastaların demografik ve klinik özellikleri ve ameliyat sonrası verileri değerlendirildi. Bulgular: Hastaların yedisinde otolog kan yama plörodezisinden sonraki 48 saat içinde hava kaçağı kesildi. Hava kaçağı 13 hastada anlamlı düzeyde azalır iken, dört hastada herhangi bir değişiklik görülmedi. Hava kaçağı kesilen veya anlamlı düzeyde azalan hastalarda Hemlich valfi takıldı. Takip akciğer grafisinde, bu hastaların akciğerlerinin tamamen ekspanse olduğu görüldü. Sonuç: Çalışma sonuçlarımız, cerrahi kontraendikasyonlar veya ekspanse olmayan akciğerlerin varlığı nedeniyle, konvansiyonel kimyasal plörodez yöntemlerinden çok fayda sağlayamayan hastalarda, otolog kan yaması işleminin uygun bir seçenek olduğunu göstermektedir.

Application of autologous blood patch in patients with non-expanded lungs and persistent air leak

Background: This study aims to evaluate the effectiveness ofpleurodesis procedure by ensuring the expansion of the lung andoccluding lung parenchyma leaks with an autologous blood patch.Methods: A total of 24 patients (17 males, 7 females; mean age59.9±12.2 years; range, 30 to 86 years) who underwent autologousblood patch pleurodesis in our clinic between November 2015and November 2019 were retrospectively analyzed. The patientswere not eligible to undergo chemical pleurodesis due to a nonexpandable lung or poor general condition. Demographic andclinical characteristics of the patients and postoperative datawere evaluated.Results: The air leak stopped within 48 h after autologous bloodpatch pleurodesis in seven patients. The air leak significantlydecreased in 13 patients, while it remained unchanged in fourpatients. A Heimlich valve was placed in the patients in whomthe air leak stopped or significantly decreased. The follow-upchest X-rays showed that the respective lungs of these patientsbecame completely expandable.Conclusion: Our study results suggest that the autologousblood patch procedure is a favorable option for the patientswho are unable to benefit much from the conventional chemicalpleurodesis methods due to contraindications to surgery or thepresence of non-expandable lungs.

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