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Kronik Subdural Hematom Cerrahisinde Ameliyathanenin Etkin Kullanımı Hakkındaki Görüşler

Year 2019, Volume: 21 Issue: 2, 123 - 126, 30.08.2019
https://doi.org/10.18678/dtfd.560894

Abstract

Amaç: Kronik subdural hematom insan ömrünün artmasıyla birlikte sıklığı daha da artan önemli morbiditelere neden olan ve oldukça sık görülen ekstraserebral kanamalardandır. Literatürde hafif kafa travmaları ile birlikteliğinin %60-80 oranında olduğu bildirilmektedir. Bu çalışmanın amacı kronik subdural hematom hastalarının ameliyatında uygulanan lokal ve genel anestezinin ameliyat süresi, ameliyat maliyeti ve toplam ameliyathane odasını kullanım süreleri açısından bir farklılığa sebep olup olmadığını araştırmaktır.

Gereç ve Yöntemler: Düzce Üniversitesi Tıp Fakültesi Sağlık Araştırma ve Uygulama Hastanesi Nöroşirürji Anabilim Dalında 2016 ve 2018 yılları arasında tek taraflı kronik subdural hematom tanısı ile opere edilmiş olan toplam 27 hastanın kayıtları geriye dönük olarak incelenmiştir. Yaş, cinsiyet, ASA skoru, ameliyat süresi, ameliyat odasına giriş ve çıkış zamanları arasındaki süre, hastanede kalış süresinin uzunluğu ve ameliyat maliyetleri kaydedildi.

Bulgular: Lokal anestezi uygulanan hastalarda ameliyat maliyetinin ve ameliyathane odasına giriş ve çıkış arasındaki toplam sürelerinin daha kısa olduğu ve genel anestezi uygulanan hastalar ile arasındaki farklılığın istatistiksel olarak anlamlı olduğu saptanmıştır (her iki p değeri de <0,001).

Sonuç: Çalışmamızda lokal ve genel anestezi uygulanan hastaların giriş ve çıkış zamanları arasında anlamlı bir fark bulundu. Genel anestezi grubunda, maliyetler anlamlı derecede yüksekti. Kronik subdural hematomlu hastalarda lokal anestezi, hastane ameliyathanesinin etkin kullanımı ve işletme maliyetlerinin azaltılması açısından daha faydalı bir yöntemdir. Bu uygulamanın ülke ekonomisine de katkı sağlayacağına inanıyoruz.

Supporting Institution

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References

  • Ducruet AF, Grobelny BT, Zacharia BE, Hickman ZL, Derosa PL, Anderson K, et al. The surgical management of chronic subdural hematoma. Neurosurg Rev. 2012;35(2):155-69.
  • Ernestus RI, Beldzinski P, Lanfermann H, Klug N. Chronic subdural hematoma: surgical treatment and outcome in 104 patients. Surg Neurol. 1997;48(3):220-5.
  • Ko BS, Lee JK, Seo BR, Moon SJ, Kim JH, Kim SH. Clinical analysis of risk factors related to recurrent chronic subdural hematoma. J Korean Neurosurg Soc. 2008;43(1):11-5.
  • Frati A, Salvati M, Mainireo F, Ippoliti F, Rocchi G, Raco A, et al. Inflammation markers and risk factors for recurrence in 35 patients with a posttraumatic chronic subdural hematoma: a prospective study. J Neurosurg. 2004;100(1):24-32.
  • Okada Y, Akai T, Okamoto K, Iida T, Takata H, Iizuka H. A comparative study of the treatment of chronic subdural hematoma-burr hole drainage versus burr hole irrigation. Surg Neurol. 2002;57(6):405-9.
  • Weigel R, Schmiedek P, Krauss JK. Outcome of contemporary surgery for chronic subdural haematoma: evidence based review. J Neurol Neurosurg Psychiatry. 2003;74(7):937-43.
  • Gelabert-González M, Iglesias-Pais M, García-Allut A, Martínez-Rumbo R. Chronic subdural haematoma: surgical treatment and outcome in 1000 cases. Clin Neurol Neurosurg. 2005;107(3):223-9.
  • Misra M, Salazar JL, Bloom DM. Subdural-peritoneal shunt: treatment for bilateral chronic subdural hematoma. Surg Neurol. 1996;46(4):378-83.
  • McKissock W, Richardson A, Bloom WH. Subdural haematoma: a review of 389 cases. Lancet. 1960;275(7139):1365-9.
  • Çelikoğlu E, İş M, Yılmaz M, Kiraz İ, Ramazanoğlu AF, Alkan B. Surgical management outcomes of our cases with chronic subdural hematoma. J Nervous Sys Surgery. 2014;4(1):36-41.
  • Di Rienzo A, Iacoangeli M, Alvaro L, Colasanti R, Somma LGMD, Nocchi N, et al. Mini-craniotomy under local anesthesia to treat acute subdural hematoma in deteriorating elderly patients. J Neurol Surg A Cent Eur Neurosurg. 2017;78(6):535-40.
  • Mahmood SD, Waqas M, Baig MZ, Darbar A. Mini-craniotomy under local anesthesia for chronic subdural hematoma: an effective choice for elderly patients and for patients in a resource-strained environment. World Neurosurg. 2017;106:676-9.
  • Republic of Turkey Ministry of Health, General Directorate of Health Information Systems. Health Statistics Yearbook. Ankara: Ministry of Health; 2018.
  • Türk O, Yaldız C, Ceylan D. Chronic subdural hematomas: epidemiology, radiology, hematological parameters and surgical results of cases. Mustafa Kemal Üniv Tıp Derg. 2018;9(35):121-7.

Opinions on Using Operating Room Effectively in Chronic Subdural Hematoma Surgery

Year 2019, Volume: 21 Issue: 2, 123 - 126, 30.08.2019
https://doi.org/10.18678/dtfd.560894

Abstract

Aim: Chronic subdural hematoma is one of the most common extracerebral hemorrhages that causes significant morbidity with increasing human life. Associations with mild head trauma are reported in 60-80% of the literature. The aim of this study is to investigate whether local and general anesthesia performed in the operation of chronic subdural hematoma patients make a difference in terms of operative time, operation cost and total times for using the operating room.

Material and Methods: The records of 27 patients who were operated with diagnosis of unilateral chronic subdural hematoma between the years 2016 and 2018 in Duzce University Medical Faculty Training and Research Hospital, Neurosurgery Department were reviewed retrospectively. Age, gender, ASA score, operative time, time between entry and exit to the operating room, length of hospital stay and operating costs were recorded.

Results: It was found that the operating cost and total time between entry and exit to the operating room were shorter in patients undergoing local anesthesia, and the difference between patients undergoing general anesthesia was found statistically significant (both p values are <0.001).

Conclusion: In our study, a significant difference was found between the time of entrance and exit of patients who underwent local and general anesthesia. In the general anesthesia group, the costs were significantly higher. In patients with chronic subdural hematoma, local anesthesia is a more useful method in terms of efficient use of hospital operating room and reduction of operating costs. We believe that this practice will also contribute to the national economy.

References

  • Ducruet AF, Grobelny BT, Zacharia BE, Hickman ZL, Derosa PL, Anderson K, et al. The surgical management of chronic subdural hematoma. Neurosurg Rev. 2012;35(2):155-69.
  • Ernestus RI, Beldzinski P, Lanfermann H, Klug N. Chronic subdural hematoma: surgical treatment and outcome in 104 patients. Surg Neurol. 1997;48(3):220-5.
  • Ko BS, Lee JK, Seo BR, Moon SJ, Kim JH, Kim SH. Clinical analysis of risk factors related to recurrent chronic subdural hematoma. J Korean Neurosurg Soc. 2008;43(1):11-5.
  • Frati A, Salvati M, Mainireo F, Ippoliti F, Rocchi G, Raco A, et al. Inflammation markers and risk factors for recurrence in 35 patients with a posttraumatic chronic subdural hematoma: a prospective study. J Neurosurg. 2004;100(1):24-32.
  • Okada Y, Akai T, Okamoto K, Iida T, Takata H, Iizuka H. A comparative study of the treatment of chronic subdural hematoma-burr hole drainage versus burr hole irrigation. Surg Neurol. 2002;57(6):405-9.
  • Weigel R, Schmiedek P, Krauss JK. Outcome of contemporary surgery for chronic subdural haematoma: evidence based review. J Neurol Neurosurg Psychiatry. 2003;74(7):937-43.
  • Gelabert-González M, Iglesias-Pais M, García-Allut A, Martínez-Rumbo R. Chronic subdural haematoma: surgical treatment and outcome in 1000 cases. Clin Neurol Neurosurg. 2005;107(3):223-9.
  • Misra M, Salazar JL, Bloom DM. Subdural-peritoneal shunt: treatment for bilateral chronic subdural hematoma. Surg Neurol. 1996;46(4):378-83.
  • McKissock W, Richardson A, Bloom WH. Subdural haematoma: a review of 389 cases. Lancet. 1960;275(7139):1365-9.
  • Çelikoğlu E, İş M, Yılmaz M, Kiraz İ, Ramazanoğlu AF, Alkan B. Surgical management outcomes of our cases with chronic subdural hematoma. J Nervous Sys Surgery. 2014;4(1):36-41.
  • Di Rienzo A, Iacoangeli M, Alvaro L, Colasanti R, Somma LGMD, Nocchi N, et al. Mini-craniotomy under local anesthesia to treat acute subdural hematoma in deteriorating elderly patients. J Neurol Surg A Cent Eur Neurosurg. 2017;78(6):535-40.
  • Mahmood SD, Waqas M, Baig MZ, Darbar A. Mini-craniotomy under local anesthesia for chronic subdural hematoma: an effective choice for elderly patients and for patients in a resource-strained environment. World Neurosurg. 2017;106:676-9.
  • Republic of Turkey Ministry of Health, General Directorate of Health Information Systems. Health Statistics Yearbook. Ankara: Ministry of Health; 2018.
  • Türk O, Yaldız C, Ceylan D. Chronic subdural hematomas: epidemiology, radiology, hematological parameters and surgical results of cases. Mustafa Kemal Üniv Tıp Derg. 2018;9(35):121-7.
There are 14 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Cengiz Tuncer 0000-0003-2400-5546

Ömer Polat 0000-0003-4521-4312

Publication Date August 30, 2019
Submission Date May 6, 2019
Published in Issue Year 2019 Volume: 21 Issue: 2

Cite

APA Tuncer, C., & Polat, Ö. (2019). Opinions on Using Operating Room Effectively in Chronic Subdural Hematoma Surgery. Duzce Medical Journal, 21(2), 123-126. https://doi.org/10.18678/dtfd.560894
AMA Tuncer C, Polat Ö. Opinions on Using Operating Room Effectively in Chronic Subdural Hematoma Surgery. Duzce Med J. August 2019;21(2):123-126. doi:10.18678/dtfd.560894
Chicago Tuncer, Cengiz, and Ömer Polat. “Opinions on Using Operating Room Effectively in Chronic Subdural Hematoma Surgery”. Duzce Medical Journal 21, no. 2 (August 2019): 123-26. https://doi.org/10.18678/dtfd.560894.
EndNote Tuncer C, Polat Ö (August 1, 2019) Opinions on Using Operating Room Effectively in Chronic Subdural Hematoma Surgery. Duzce Medical Journal 21 2 123–126.
IEEE C. Tuncer and Ö. Polat, “Opinions on Using Operating Room Effectively in Chronic Subdural Hematoma Surgery”, Duzce Med J, vol. 21, no. 2, pp. 123–126, 2019, doi: 10.18678/dtfd.560894.
ISNAD Tuncer, Cengiz - Polat, Ömer. “Opinions on Using Operating Room Effectively in Chronic Subdural Hematoma Surgery”. Duzce Medical Journal 21/2 (August 2019), 123-126. https://doi.org/10.18678/dtfd.560894.
JAMA Tuncer C, Polat Ö. Opinions on Using Operating Room Effectively in Chronic Subdural Hematoma Surgery. Duzce Med J. 2019;21:123–126.
MLA Tuncer, Cengiz and Ömer Polat. “Opinions on Using Operating Room Effectively in Chronic Subdural Hematoma Surgery”. Duzce Medical Journal, vol. 21, no. 2, 2019, pp. 123-6, doi:10.18678/dtfd.560894.
Vancouver Tuncer C, Polat Ö. Opinions on Using Operating Room Effectively in Chronic Subdural Hematoma Surgery. Duzce Med J. 2019;21(2):123-6.