should angiography be routinely employed in high grade liver injuries
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should angiography be routinely employed in high grade liver injuries
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İst Tıp Fak Derg 2016; 79: 4 J Ist Faculty Med 2016; 79: 4 http://dergipark.ulakbim.gov.tr/iuitfd http://www.journals.istanbul.edu.tr/iuitfd
KLİNİK ARAŞTIRMA/ CLINICAL RESEARCH
SHOULD ANGIOGRAPHY BE ROUTINELY EMPLOYED IN HIGH GRADE LIVER INJURIES UNDERGOING DAMAGE CONTROL SURGERY? HASAR KONTROL CERRAHİSİ SONRASI ANJİYOGRAFİ RUTİN OLARAK YAPILMALI MIDIR? Beyza ÖZÇINAR*, Hakan T. YANAR*, Emre SİVRİKOZ, Fatih YANAR*, İnanç S. SARICI*, Adem UÇAR**, Kayıhan GÜNAY*, Recep GÜLOĞLU*, Cemalettin ERTEKİN*, Mehmet KURTOĞLU*
ÖZET Giriş: Karaciğer travmalarına yaklaşım klinik takipten hasar kontrol cerrahisine kadar değişiklik göstermektedir. Bu çalışmanın amacı, hasar kontrol cerrahisi uygulanan hastalara anjiyografi rutin olarak yapılmalı mıdır yoksa depacking sonrası kanama olursa yapılmak üzere beklenilmeli midir sorusuna cevap aramaktır. Method: Ocak 2000 ve Aralık 2010 tarihleri arasında künt veya penetran karaciğer yaralanması tanısı ile kliniğimize başvuran ve hasar kontrol cerrahisi uygulanan hastalar çalışmaya dahil edilmiştir. Hastaların demografik verileri, travma mekanizması, şok durumu, injury severity skoru (ISS), karaciğer yaralanma derecesi, eşlik eden yaralanmalar, anjiyoembolizasyon, hastane yatış süresi, depacking zamanı ve mortalite bilgileri kayıt altına alınmıştır. Sonuçlar: Çalışmaya 513 karaciğer yaralanması olan hasta dahil edilmiştir. Bu hastalardan 60’ına hasar kontrol cerrahisi uygulanmıştır. Yirmibir hastaya anjiyoembolizasyon yapılmıştır. Yüksek ISS ile ilişkili olarak şok durumu (p=0.009) ve eşlik eden organ yaralanmaları (p
