Yasemin Bilgin BÜYÜKKARABACAK, Ahmet BAŞOĞLU, Tülin YETİM DURGUN, Ayşen ŞENGÜL TASLAK, Birol GÜNDOĞDU

Pnömotoraks ile komplike olmuş büllöz akciğer hastalıklarının cerrahi tedavisi ve politetrafloroetilen greft desteğinin karşılaştırılmalı sonuçları

Amaç: Büllöz akciğer hastalıklarında politetrafloroetilen (PTFE) greft kullanımının komplikasyonları azaltmadaki etkinliği araştırıldı. Çalışma planı: Ocak 2004 - Aralık 2012 tarihleriarasında spontan pnömotoraks ile komplike olmuş büllöz akciğer hastalığı olan 22 hasta çalışmaya alındı.Hastalar iki gruba ayrıldı. Grup 1’de 10 hastada heterojen amfizematöz hastalık, grup 2’de ise 12 hastadahomojen amfizematöz hastalık vardı. Her iki gruba dakas korumalı torakotomi yapıldı. Stapler kullanılarakkama rezeksiyon uygulandı. Grup 1’de altı, grup 2’de beş hastanın rezeksiyon hattı genişleyebilen PTFE greft ile desteklendi. Tedavi sonuçları ve komplikasyonlargruplar arasında karşılaştırıldı.Bulgular: Tedavi sonucunu belirleyen en önemli kriter amfizemin alt tipi idi. Her iki amfizem alt tipi için PTFE greft destek kullanımının komplikasyonlar üzerine etkisi görülmemesine karşılık, bunun göğüs tüpüçekilme süresini ve hastanede kalış süresini kısalttığı görüldü.Sonuç: Tedavi sonucunu belirleyen en önemli kriterin amfizem alt tipi olduğu, her iki amfizem alt tipi için PTFE destek kullanımının komplikasyonlar üzerine etkisi görülmemesine karşılık, göğüs tüpü çekilme süresini ve hastanede kalış süresini kısalttığı görüldü.

Comparative results of surgical treatment of bullous lung diseases complicated with pneumothorax and the use of polytetrafluoroethylene graft support

Background: This study aims to investigate the efficacy of polytetrafluoroethylene (PTFE) graft use in decreasing complications of bullous lung diseases. Methods: Between January 2004 and December 2012, 22 patients with bullous lung disease complicated with spontaneous pneumothorax were included. The patients were divided into two groups. Ten patients in group 1 had heterogeneous emphysematous disease and the 12 patients in group 2 had homogenous emphysematous disease. Both groups underwent muscle-saving thoracotomy. Wedge resection was performed by using stapler. The resection line was supported with an expandable PTFE graft in six patients in group 1 and in five patients in group 2. Treatment results and complications were compared between the groups. Results: Subtype of emphysema was the most important criterion which determined the result of the treatment. Although the use of PTFE graft support had no effect on complications in both emphysema subtypes, it shortened the duration of the chest tube withdrawal and the length of hospital stay. Conclusion: We concluded that the most important criterion which determined the treatment outcome was subtype of emphysema and this led to reduced intubation time and length of hospital stay, although use of PTFE support in both emphysema types had no effect on complications.

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