Kosuyolu Heart J 2013;16(1)
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Kosuyolu Heart J 2013;16(1):42-46 - doi: 10.5578/kkd.4561
Kliniğimizde Kardiyak Problemi Mevcut Olan Hastalarda Laparoskopik Kolesistektomi; Retrospektif Çalışma

Laparoscopic Cholecystectomy of Patients with Cardiac Disease in Our Clinic; Retrospective Study

Ömer Faruk Şavluk1, Füsun Güzelmeriç1, Tülay Kayacan Örki1, Atakan Erkılınç1, Volkan Temel1


1 Department of Anesthesia and Reanimation, Kosuyolu Heart Center, Istanbul, Turkey

ABSTRACT

Introduction: The application of laparoscopic cholecystectomy is investigated to effected on patients with cardiac surgery or examination of patients that were identified with cardiac problem.

Patients and Methods: Between 2008-2010 total of 233 patients with laporoscopiccholecystectomy were retrospectively analyzed follow up papers. Systolic blood pressure, diastolic blood pressure, heart rate, X-rays and ECGs were evaluated in preoperative examination in all patients. ECG, SpO2 monitoring was performed to all patients in the operating room. In all patients systolic blood pressure, diastolic blood pressure, heart rate and SpO2 values before the operation and during the operation were recorded. End-tidal CO2 was monitored during the operation. Additional disease duration of surgery, duration of intubation, preoperative, perioperative and postoperative need to inotropic support were recorded.

Results: One hundred and one (43%) patients were men and 132 (57%) female. Forty five of 233 patients with cardiac problems are sick. Twenty five patients of these patients had coronary bypass surgery and eight patients underwent prosthetic valve surgery. As a result of preoperative transthoracic echocardiography in 12 patients were diagnosed with valve insufficiency. Demographic characteristics were similar than between the two groups. The mean operation time, insuflation time, extubation time, staying hospital time and hemodynamic data were similar than between the two groups.

Conclusion: Laparoscopic cholecystectomy safely and easily can apply for application of the balanced anesthesia, low-pressure pneumoperitoneum after being stable cardiac status in patients with cardiac problem.

Key Words: Cholecystectomy, laparoscopic; anesthesia, general; heart diseases.

Received: 10.10.2012 Accepted: 28.11.2012

Correspondence

Dr. Ömer Faruk Şavluk

Kartal Koşuyolu Yüksek İhtisas

Eğitim ve Araştırma Hastanesi,

Anesteziyoloji ve Reanimasyon Kliniği,

Denizer Caddesi Cevizli Kavşağı No: 2

34846 Cevizli, Kartal, İstanbul-Türkiye

e-posta: dromersavluk@hotmail.com

Kliniğimizde Kardiyak Problemi Mevcut Olan Hastalarda Laparoskopik Kolesistektomi; Retrospektif Çalışma

Kliniğimizde Kardiyak Problemi Mevcut Olan Hastalarda
Laparoskopik Kolesistektomi; Retrospektif Çalışma

Laparoscopic Cholecystectomy of Patients with Cardiac Disease in Our Clinic; Retrospective Study

Ömer Faruk Şavluk1, Füsun Güzelmeriç1, Tülay Kayacan Örki1, Atakan Erkılınç1, Volkan Temel1


1 Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği,

İstanbul, Türkiye

1 Department of Anesthesia and Reanimation, Kosuyolu Heart Center, Istanbul, Turkey

ÖZET

Giriş: Bu çalışmanın amacı, laparoskopik kolesistektomi uygulamasının kardiyak operasyon geçirmiş veya muayenesinde kardiyak problem tespit edilmiş hastalar üzerine etkisini araştırmaktır.

Hastalar ve Yöntem: 2008-2010 tarihleri arasında laparoskopik kolesistektomi uygulanan toplam 233 hastanın izlem kağıtları retrospektif olarak incelendi. Tüm hastaların preoperatif muayenelerinde sistolik arter basıncı, diyastolik arter basıncı, kalp atım hızı, akciğer grafileri ve EKG'leri değerlendirildi. Operasyon odasında tüm hastalara EKG, SpO2 monitörizasyonu yapıldı. Tüm hastalarda sistolik arter basıncı, diyastolik arter basıncı, kalp atım hızı ve SpO2 değerleri operasyon başlamadan önce ve operasyon süresince takip edilerek kaydedildi. Operasyon süresince soluk sonu CO2 takibi yapıldı. Ek hastalıkları, operasyon süresi, entübasyon süresi, preoperatif, perioperatif ve postoperatif inotropik destek ihtiyacı olup olmadığı kaydedildi.

Bulgular: Hastaların 101 (%43)'i  erkek ve 132 (%57)'si kadındı. Toplam 233 hastanın 45'i kardiyak problemi olan hastadır. Bu hastaların 25'i koroner baypas operasyonu, sekizi protez kapak operasyonu geçirmiştir. On iki hasta ise yapılan preoperatif dönemde transtorasik ekokardiyografi sonucunda kapak yetmezliği tanısı almıştır. İki grup arasında demografik özellikler benzer bulunmuştur. Ortalama operasyon süresi, ensüflasyon süresi, ekstübasyon süresi, hastanede kalış süresi ve hemodinami iki grup arasında benzer bulunmuştur.

Sonuç: Laparoskopik kolesistektomi kardiyak problemi olan hastalarda kardiyak durumu stabil hale geldikten sonra dengeli anestezi, düşük basınçlı pnömoperiton uygulaması ile güvenle ve kolayca uygulanabilir.

Anahtar Kelimeler: Kolesistektomi, laparoskopik; anestezi, genel; kalp hastalıkları.

Geliş Tarihi: 10.10.2012 Kabul Tarihi: 28.11.2012

ABSTRACT

Introduction: The application of laparoscopic cholecystectomy is investigated to effected on patients with cardiac surgery or examination of patients that were identified with cardiac problem.

Patients and Methods: Between 2008-2010 total of 233 patients with laporoscopiccholecystectomy were retrospectively analyzed follow up papers. Systolic blood pressure, diastolic blood pressure, heart rate, X-rays and ECGs were evaluated in preoperative examination in all patients. ECG, SpO2 monitoring was performed to all patients in the operating room. In all patients systolic blood pressure, diastolic blood pressure, heart rate and SpO2 values before the operation and during the operation were recorded. End-tidal CO2 was monitored during the operation. Additional disease duration of surgery, duration of intubation, preoperative, perioperative and postoperative need to inotropic support were recorded.

Results: One hundred and one (43%) patients were men and 132 (57%) female. Forty five of 233 patients with cardiac problems are sick. Twenty five patients of these patients had coronary bypass surgery and eight patients underwent prosthetic valve surgery. As a result of preoperative transthoracic echocardiography in 12 patients were diagnosed with valve insufficiency. Demographic characteristics were similar than between the two groups. The mean operation time, insuflation time, extubation time, staying hospital time and hemodynamic data were similar than between the two groups.

Conclusion: Laparoscopic cholecystectomy safely and easily can apply for application of the balanced anesthesia, low-pressure pneumoperitoneum after being stable cardiac status in patients with cardiac problem.

Key Words: Cholecystectomy, laparoscopic; anesthesia, general; heart diseases.

Received: 10.10.2012 Accepted: 28.11.2012

Yazışma Adresi/Correspondence

Dr. Ömer Faruk Şavluk

Kartal Koşuyolu Yüksek İhtisas

Eğitim ve Araştırma Hastanesi,

Anesteziyoloji ve Reanimasyon Kliniği,

Denizer Caddesi Cevizli Kavşağı No: 2

34846 Cevizli, Kartal, İstanbul-Türkiye

e-posta: dromersavluk@hotmail.com

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