Yıl: 2020 Cilt: 36 Sayı: 1 Sayfa Aralığı: 72 - 81 Metin Dili: İngilizce DOI: 10.5578/turkjsurg.4535 İndeks Tarihi: 09-11-2020

Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy

Öz:
Objective: Minimal invasive surgery is one of the most popular treatment approaches which is safe and effective in experienced hands in differentclinical practices. In the present study, we aimed to evaluate the risks factors for conversion to open splenectomy and the performance of indirect hilumdissection technique.Material and Methods: A total of 56 patients who underwent laparoscopic or robotic splenectomy for isolated spleen diseases were included into thestudy. Patients were divided into two groups as robotic or laparoscopic splenectomy (Group 1; n= 48) and conversion to open surgery (Group 2; n= 8).Patients were retrospectively evaluated according to clinical, biochemical, hematological and microbiological parameters and morbidity.Results: No statistically significant difference was found between the groups in terms of age, gender, body mass index (BMI), ASA score, co-morbid disease,operation time, hospital stay, follow-up period, accessory spleen, diagnosis, international normalized ratio (INR), red cell distribution width (RDW), plateletdistribution width (PDW), platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), reapplication, splenosis, surgical site infection, vascularthrombus and incisional hernia (p> 0.05). On the other hand, intraoperative splenic hilum hemorrhage and increased spleen size (p< 0.05) were higherin the conversion to open surgery group. In logistic regression analysis, intraoperative splenic hilum hemorrhage (B= 4.127) (OR= 61.974) (95% CI= 3.913-981.454) (p= 0.003) and increased spleen volume (B= 3.114) (OR= 22.509) (95% CI= 1.818-278.714) (p= 0.015) were found as risk factors for conversion toopen surgery.Conclusion: Intraoperative hemorrhage from the splenic hilum and increased spleen volume (> 400 cm3) are risk factors for conversion to open splenectomy in patients undergoing elective robotic or laparoscopic splenectomy. Indirect splenic hilum dissection can decrease intraoperative hemorrhage and conversion to open surgery.
Anahtar Kelime:

İntraoperatif splenik hilus kanaması ve splenomegali robotik ve laparoskopik splenektomiden açık cerrahiye geçişe etki eden risk faktörleridir

Öz:
Giriş ve Amaç: Minimal invaziv cerrahi tüm dünyada farklı klinik pratiklerde etkili ve güvenli popüler tedavi yöntemlerinden biridir. Bu çalışmada amacımız, robotik veya laparoskopik splenektomi (RLS)’den açık cerrahiye geçişe etki eden risk faktörlerini ve indirekt hilum diseksiyonu tekniğinin performansını ortaya koymaktır. Gereç ve Yöntem: Çalışmaya izole dalak hastalıkları nedeniyle RLS splenektomi yapılan 56 hasta kabul edildi. Hastalar iki gruba ayrıldı; RLS yapılan hastalar (grup 1) (n= 48) ve açık cerrahiye geçilen hastalar (grup 2) (n= 8). Hastalar yaş, cinsiyet, beden kütle indeksi (BKİ), yandaş hastalık, tanı, ASA skoru, dalak çapı, biyokimyasal, mikrobiyolojik parametreler ve morbiditeler açısından retrospektif olarak değerlendirildi. Bulgular: Yaş, cinsiyet, BKİ, ASA skoru, yandaş hastalık, operasyon süresi, hastanede kalış süresi, takip süresi, aksesuar dalak, tanı, Uluslararası Normalizasyon Oranı (INR), eritrosit dağılım genişliği (RDW), trombosit dağılım genişliği (PDW), trombosit-lenfosit oranı (PLR), nötrofil-lenfosit oranı (NLR), tekrar başvuru, splenozis, cerrahi alan infeksiyonu, vasküler trombüs ve insizyonel herni açısından gruplar arasında istatistiksel olarak farklılık yoktu (p> 0,05). Diğer taraftan, açık splenektomiye geçilen grupta intraoperatif splenik hilustan kanama ve dalak çapı istatistiksel olarak daha fazlaydı (p< 0,05). Multivaryant analizde açığa geçişe etki eden faktörler; intraoperatif hilustan kanama (B= 4,127) (OR= 61,974) (%95 GA= 3,913-981,454) (p= 0,003) ve artmış dalak çapı (> 400 cm3) (B= 3,114) (OR= 22,509) (%95 GA= 1,818-278,714) (p= 0,015) olarak tespit edilmiştir. Sonuç: İntraoperatif splenik hilustan kanama ve artmış dalak çapı (> 400 cm3 ) elektif RLS’den açık splenektomiye geçişe etki eden risk faktörleridir. İndirekt splenik hilum diseksiyonu intraoperatif kanama ve açık cerrahiye geçişi azaltabilir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Aziret M, KOYUN B, Karaman K, Sunu C, karacan a, Oter V, Çelebi F, Ercan M, Bostanci E (2020). Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy. , 72 - 81. 10.5578/turkjsurg.4535
Chicago Aziret Mehmet,KOYUN BÜLENT,Karaman Kerem,Sunu Cenk,karacan alper,Oter Volkan,Çelebi Fehmi,Ercan Metin,Bostanci Erdal Birol Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy. (2020): 72 - 81. 10.5578/turkjsurg.4535
MLA Aziret Mehmet,KOYUN BÜLENT,Karaman Kerem,Sunu Cenk,karacan alper,Oter Volkan,Çelebi Fehmi,Ercan Metin,Bostanci Erdal Birol Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy. , 2020, ss.72 - 81. 10.5578/turkjsurg.4535
AMA Aziret M,KOYUN B,Karaman K,Sunu C,karacan a,Oter V,Çelebi F,Ercan M,Bostanci E Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy. . 2020; 72 - 81. 10.5578/turkjsurg.4535
Vancouver Aziret M,KOYUN B,Karaman K,Sunu C,karacan a,Oter V,Çelebi F,Ercan M,Bostanci E Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy. . 2020; 72 - 81. 10.5578/turkjsurg.4535
IEEE Aziret M,KOYUN B,Karaman K,Sunu C,karacan a,Oter V,Çelebi F,Ercan M,Bostanci E "Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy." , ss.72 - 81, 2020. 10.5578/turkjsurg.4535
ISNAD Aziret, Mehmet vd. "Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy". (2020), 72-81. https://doi.org/10.5578/turkjsurg.4535
APA Aziret M, KOYUN B, Karaman K, Sunu C, karacan a, Oter V, Çelebi F, Ercan M, Bostanci E (2020). Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy. Turkish Journal of Surgery, 36(1), 72 - 81. 10.5578/turkjsurg.4535
Chicago Aziret Mehmet,KOYUN BÜLENT,Karaman Kerem,Sunu Cenk,karacan alper,Oter Volkan,Çelebi Fehmi,Ercan Metin,Bostanci Erdal Birol Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy. Turkish Journal of Surgery 36, no.1 (2020): 72 - 81. 10.5578/turkjsurg.4535
MLA Aziret Mehmet,KOYUN BÜLENT,Karaman Kerem,Sunu Cenk,karacan alper,Oter Volkan,Çelebi Fehmi,Ercan Metin,Bostanci Erdal Birol Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy. Turkish Journal of Surgery, vol.36, no.1, 2020, ss.72 - 81. 10.5578/turkjsurg.4535
AMA Aziret M,KOYUN B,Karaman K,Sunu C,karacan a,Oter V,Çelebi F,Ercan M,Bostanci E Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy. Turkish Journal of Surgery. 2020; 36(1): 72 - 81. 10.5578/turkjsurg.4535
Vancouver Aziret M,KOYUN B,Karaman K,Sunu C,karacan a,Oter V,Çelebi F,Ercan M,Bostanci E Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy. Turkish Journal of Surgery. 2020; 36(1): 72 - 81. 10.5578/turkjsurg.4535
IEEE Aziret M,KOYUN B,Karaman K,Sunu C,karacan a,Oter V,Çelebi F,Ercan M,Bostanci E "Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy." Turkish Journal of Surgery, 36, ss.72 - 81, 2020. 10.5578/turkjsurg.4535
ISNAD Aziret, Mehmet vd. "Intraoperative hemorrhage and increased spleen volume are risk factors for conversion to open surgery in patients undergoing elective robotic and laparoscopic splenectomy". Turkish Journal of Surgery 36/1 (2020), 72-81. https://doi.org/10.5578/turkjsurg.4535