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Perikardiyal Efüzyonun Subksifoid Yaklaşım ile Tedavisi

Subxiphoid Approach for Treatment of Pericardial Effusion

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Abstract (2. Language): 
Objective: Forty-two patients with pericardial effusion admitted to our clinic between January 1996 - June 2002 were treated through subxiphoid pericardiotomy. Methods: 23 of patients were male and 19 were female and their ages were between 11 months to 82 years. The procedure was carried out with local anesthesia and sedation in 38 (90 %) patients and under general anesthesia in 4 patients. These 4 patients were not tolerated local anesthesia. Results: Uremia was most common cause of pericardial effusion. 13 patients with cardiac tamponade were underwent emergency operation. Average drainage volume was 980 ml in patients with uremia, 1040 ml in patients with malignant disease. Two patients were died postoperatively. Thirty-two patients (76.2 %) were followed up to 3 to 20 months, with a mean follow up period of 9±3.8 months. Recurrent pericardial effusion requiring repeated surgical intervention was observed in 4 patients (9.5 %). Conclusion: Subxiphoid drainage is the procedure of choice for patients with pericardial tamponade. Because, it can be performed quickly under local anesthesia, offers sufficient drainage, biopsy for histopathologic examination, associated with minimal mortality and morbidity and prevents recurrent tamponade. ©2004, Fırat Üniversitesi, Tıp Fakültesi
Abstract (Original Language): 
Amaç: Ocak 1996 ile Haziran 2002 tarihleri arasında subksifoid perikardiyotomi tekniği ile tedavi edilen 42 perikardiyal efüzyonlu hasta retrospektif incelendi. Yöntem: Hastaların 19'u bayan, 23'ü erkek olup yaşları 11 ay ile 82 yaş arasındaydı. Prosedür 38 hastada (% 90.0) lokal anestezi ve sedasyon altında gerçekleştirildi. Operasyona lokal anestezi ile başlanılan 4 hastada lokal anesteziyi tolere edememeleri nedeniyle genel anesteziye geçildi. Bulgular: Üremi 11 vaka ile (% 26.2) en sık perikardiyal efüzyon nedeniydi. Hastaların 13'ü, kardiyak tamponad tanısı ile acil operasyona alındı. Ortalama toplam drenaj üremik hastalarda 980 ml, maligniteli hastalarda 1040 ml idi. Postoperatif 2 hasta kaybedildi. Hastaların 32'si 3 ile 20 ay, ortalama 9±3.8 ay takip edildi. Rekürren efüzyon nedeniyle 4 hastada (% 9.5) yeniden subksifoid perikardiyotomi girişimi gerekti. Sonuç: Subksifoid perikardiyotomi, hızlı uygulanabilmesi, genel anestezi gerektirmemesi, yeterli drenaj ve biyopsi imkanı sağlaması, kabül edilebilir morbidite ve mortalite oranları nedeniyle perikardiyal efüzyon ve kardiyak tamponad tedavisinde ilk tercih edilmesi gereken yöntemdir. ©2004, Fırat Üniversitesi, Tıp Fakültesi
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