Apendektomi yapılan çocuklarda peritoneal sıvı kültürü elde edilecek olguların seçimi
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Tarih
2007
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info:eu-repo/semantics/openAccess
Özet
Amaç: Apendektomi sırasında elde edilen peritoneal sıvı kültürlerinin (PSK) postoperatif takibe olan katkısı tartışmalıdır. Apendektomi yapılan çocuklarda PSK alınacak olguların seçimini belirlemek üzere prospektif bir çalışma planlanmıştır. Gereç ve Yöntem: Son bir yılda kliniğimizde apendektomi yapılan hastalar; yaş, cinsiyet, karın ağrısı süresi, akyuvar sayısı, peritoneal sıvı kültürü ve antibiyogramlan ile postoperatif komplikasyonlar açısından prospektif olarak incelenmiştir. Yaş, cinsiyet, karın ağrısı süresi, akyuvar sayısı ve olguların akut-perfore apendisit olması ile PSK sonuçları karşılaştınlmıştır. Tüm hastalar operasyon sonrası erken (l.ve 3. ay) ve geç (9 aydan sonra) komplikasyonlar açısından takip edilmiştir. Bulgular: Çalışmaya dahil edilen 33 hastanın yaş ortalaması 10 (5-15) yıl olup, kız erkek oranı 111.1'dir. Olguların % 63.6'sı akut (n:21), % 36.4'üperfore (n:12) apendisitdir. PSK'da üreme olmayan ve olan olgularda karın ağrısı süresinin ortancası sırasıyla 1 (1-1,24) gün ve 5 (3-10) gün olup, akyuvar sayısı ortancaları ise 13.350 (12.225-18.200) /mm3 ve 15.600 (15.400-27.800) /mm3'dür. Pozitif PSK olguları ile yanlız perfore apendisit .olguları ve karın ağrısı süresi ile ilişkilidir (p0.05, Mann Whitney-U testi). Perfore apendisit olgularında (n:7), akut apendisitlere (n:0) oranla pozitif PSK daha sıktır. (p0.05, ki-kare testi). Antibiyogramlara göre 3 hastada antibiyotik değişlikliği yapılmıştır. Akut apendisit grubunda postoperatif komplikasyona rastlanmazken, perfore apendisit olan hastaların 4'ünde (% 33.3) yara enfeksiyonu, 2'sinde adezif intestinal tıkanıklık (% 16.7) ve birinde (% 8.3) enterokutanöz fistül tespit edilmiştir. Sonuç: PSK perfore apendisit nedeniyle ameliyat edilen ve başvuru anında karın ağrısı 3 günden uzun süren hastalarda, postoperatif antibiyotik sağaltımını yönlendirmek amacıyla yapılabilir.
Aim: Use of peritoneal fluid cultures (PFC) to postoperative treatment in appendicectomy is controversial. A prospective study was performed to determine the selection of patients to obtain PFC during appendicectomy. Patients and Methods: Patients who went appendicectomy in our department were evaluted for age, sex, white blood cell counts, duration of adbominal pain, acute or perforated appendicitis, peritoneal fluid cultures and postoperative complications. Age, sex, duration of abdominal pain, white blood cell counts and acute or perforated appendicitis were correlated with PFC results. All patients were followed up for early (1st and 3rd months) and late (after 9th months) complications. Results: Thirty-three patients were enrolled in the study. Mean age of the patients were 10 (5-15) year and the male female ratio was 111.1. The diagnosis of patients were acute appendicitis in % 63.6 (n:21) of all cases and % 36.4 (n:12) were perforated. Mean duration of abdominal pain in negative and positive PFC were 1 (1-1,24) day and 5 (3-10) days respectively. Mean white blood cell counts were also 13.350 (12.225-18.200) /mm3 and 15.600 (15.400-27.800) /mm3) in negative and positive PFC. Positive PFC cases were only correlated with perforated appendicitis and duration of abdominal pain (p<0.05, Mann Whitney-U test). In perforated cases (n:7), positive PFC was more common with respect to acute appendicitis cases (n:0) (p<0.05, Chi-Square test). Four patients were developed wound infection (% 33.3), 2 patients had adhesive intestinal obstruction (% 16.7) and one had enterocutenous fistula (% 8.3) in perforated cases. Conclusion: In order to determine the suitable antibiotic treatment, PFC should be obtained in cases of perforation and duration of abdominal pain longer than 3 days.
Aim: Use of peritoneal fluid cultures (PFC) to postoperative treatment in appendicectomy is controversial. A prospective study was performed to determine the selection of patients to obtain PFC during appendicectomy. Patients and Methods: Patients who went appendicectomy in our department were evaluted for age, sex, white blood cell counts, duration of adbominal pain, acute or perforated appendicitis, peritoneal fluid cultures and postoperative complications. Age, sex, duration of abdominal pain, white blood cell counts and acute or perforated appendicitis were correlated with PFC results. All patients were followed up for early (1st and 3rd months) and late (after 9th months) complications. Results: Thirty-three patients were enrolled in the study. Mean age of the patients were 10 (5-15) year and the male female ratio was 111.1. The diagnosis of patients were acute appendicitis in % 63.6 (n:21) of all cases and % 36.4 (n:12) were perforated. Mean duration of abdominal pain in negative and positive PFC were 1 (1-1,24) day and 5 (3-10) days respectively. Mean white blood cell counts were also 13.350 (12.225-18.200) /mm3 and 15.600 (15.400-27.800) /mm3) in negative and positive PFC. Positive PFC cases were only correlated with perforated appendicitis and duration of abdominal pain (p<0.05, Mann Whitney-U test). In perforated cases (n:7), positive PFC was more common with respect to acute appendicitis cases (n:0) (p<0.05, Chi-Square test). Four patients were developed wound infection (% 33.3), 2 patients had adhesive intestinal obstruction (% 16.7) and one had enterocutenous fistula (% 8.3) in perforated cases. Conclusion: In order to determine the suitable antibiotic treatment, PFC should be obtained in cases of perforation and duration of abdominal pain longer than 3 days.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Çocuk Cerrahisi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
21
Sayı
3
Künye
Soyer, T., Türkmen, F., Akman, H., Kaya, M., Hançerlioğulları, Ö., Cesur, Ö., Somuncu, S., Çakmak, M. (2007). Apendektomi yapılan çocuklarda peritoneal sıvı kültürü elde edilecek olguların seçimi. Çocuk Cerrahisi Dergisi, 21(3), 120 - 123.
