Sedat ZİYADE, Dilek YILMAZBAYHAN, Şükrü DİLEGE, Göksel KALAYCI, Serhan TANJU, Alper TOKER, Yusuf BAYRAK

Sleeve rezeksiyonları: 77 olgunun değerlendirilmesi

Amaç: Akciğerin iyi veya kötü huylu hastalıklarında, sağlam akciğer parenkimini korumak için pnömonektomiye alternatif olarak sleeve rezeksiyonu uygulanan hastalar endikasyon, teknik, komplikasyon, mortalite ve sağkalım oranları açısından incelendi. Çalışma planı: Çalışmaya, Ocak 1992-Aralık 2004 tarihleri arasında değişik patolojiler nedeniyle sleeve rezeksiyonu uygulanan 77 olgu (19 kadın, 58 erkek; ort. yaş 57.0±15.4; dağılım 7-82) alındı.Bulgular: Sleeve rezeksiyonu endikasyonları 58 olguda primer akciğer kanseri, dört olguda metastatik akciğer kanseri, dokuz olguda karsinoid tümör, beş olguda iyi huylu hastalıklar, bir olguda da başka tümördü. Rezeksiyonların 60’ı bronşiyal sleeve, beşi izole vasküler sleeve, altısı çift sleeve, dördü segmental, ikisi karinal rezeksiyon idi. On altı olguda (%20.7) komplikasyon görüldü. İki olgu (%2.6) adult respiratuar distres sendromu nedeniyle ameliyat sonrası dönemde kaybedildi. Komplikasyon analizinde, seçilen dikiş tekniğinin, primer patolojinin ve uygulanan rezeksiyon tipinin anlamlı etkisi olmadığı görüldü (p>0.05).Sonuç: Sleeve rezeksiyonu uygulanan hastalarda ameliyat mortalitesi ve morbiditesi konvansiyonel rezeksiyonlardan farklı değildir. Ameliyat sonrası dönemde ortaya çıkan komplikasyonların cerrahi teknik, rezeksiyon tipi ve primer patolojiyle ilgili olmadığı görülmektedir.

Sleeve resections: an evaluation of 77 patients

Background: The aim of this study was to evaluate the indications, techniques, postoperative complications, mortality, and survival in primary lung cancer patients who underwent sleeve resection to preserve tumor-free pulmonary parenchyma. Methods: From January 1992 to December 2004, 77 patients (19 females, 58 males; mean age 57.0±15.4 years; range 7 to 82 years) with various pathologies underwent pulmonary sleeve resections.Results: Indications for sleeve resections were primary lung cancer in 58 patients, metastatic lung cancer in four patients, carcinoid tumor in nine patients, benign diseases in five patients, and another tumor in one patient. The type of resections were bronchial sleeve lobectomy (n=60), isolated arterial sleeve resection (n=5), double sleeve resection (n=6), and segmental (n=4) and carinal (n=2) sleeve resections. Postoperative complications occurred in 16 patients (20.7%) and mortality was seen in two patients (2.6%) who died from adult respiratory distress syndrome. Complications were not found to be associated with the suture technique, primary pathology, and the type of resection (p>0.05).Conclusion: Sleeve resections have similar mortality and morbidity rates to those of conventional pulmonary resections. The occurrence of postoperative complications is not correlated with the suture technique, primary pathology, and the type of resection.

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