İkinci basamak devlet hastanesinde laparoskopik adrenalektomi uygulanabilirliği ve deneyimlerimiz

Amaç: Laparoskopi eğitiminin yaygınlaşması, ileri düzey laparoskopik girişimlerin ikinci basamak sağlık kuruluşlarında da yapılabilmesine olanak tanımıştır. Biz laparoskopiye yeni başlayan kliniğimizde transperitoneal laparoskopik adrenalektomi deneyimlerimizi paylaşmayı amaçladık. Gereç ve Yöntemler: Ekim 2012 ve Nisan 2019 arası laparoskopik transperitoneal adrenelektomi yapılan otuz hasta çalışmaya dahil edildi. Retrospektif olarak yapılan değerlendirmede; cinsiyet, yaş, beden kitle endeksi, adrenal kitle karakteristikleri, hormonal aktivitesi,operasyon süresi,kanama durumu, transfüzyon ihtiyacı, final patoloji ve komplikasyon oranları incelendi. Bulgular: Ortalama kitle boyutu 48.5±23 milimetre ve ortalama operasyon süresi 70.2±21.6 dakika olarak bulundu. Peroperatif ortalama kanama miktarı 41±48.8 cc olarak bulunurken sadece 2 hastada transfüzyon ihtiyacı görüldü. Ortalama hastanede yatış süresi ise 1.3±0.88 gün olarak bulundu. Vakaların hiçbirinde açık tekniğe dönüş gerekmedi ve 2 hastada transfüzyon ihtiyacı dışında major komplikasyon yaşanmadı. Sonuç: Transperitoneal laparoskopik adrenelektomi cerrahisi, yeterli eğitim sonrasında uygun hastalarda ikinci basamak hastanelerde de düşük komorbidite ve mortalite oranları ile güvenle uygulanabilir.

Anahtar Kelimeler:

Laparaskopi, Adrenalektomi, Deneyim

The applicability of laparoscopic adrenalectomy and our experience at a secondary health institution

Objective: Since the laparoscopy education had became widespread, the advance laparoscopic procedures can be performed even at secondary public hospitals. In this study, we aimed to present our experience of the first seven years of laparoscopic transperitoneal adrenalectomy. Material And Methods: the study included 30 patients with laparoscopic transperitoneal adrenalectomy (LA) performed from October 2012 to April 2019. The retrospective assessment investigated age, sex, body mass index, adrenal mass characteristics, hormonal activity, operation duration, hemorrhage status, transfusion requirements, final pathology and complication rates. Results: Mean age was 54.3±11.5 years and mean body mass index was 25.6±2.7 kg/m2. Mean mass size was 48.5±23 mm and mean operation duration was 70.2±21.6 minutes. Mean peroperative hemorrhage amount was 41±48.8 cc, while only 2 patients required transfusion. Mean hospitalization duration was 1.3±0.88 days. None of the laparoscopic cases was converted to open surgery, and no major complications such as death recorded. Conclusion: Transperitoneal laparoscopic adrenalectomy (LA) surgery may be performed safely after adequate training for appropriate patients with low morbidity and mortality.

Keywords:

laparoscopy, adrenalectomy, experience,

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