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  • Küçük Resim Yok
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    Comparison of Implantable Central Venous Ports: Subclavian Versus Juguler Access
    (Derman Medical Publ, 2013) Karamustafaoglu, Yekta Altemur; Yagci, Sevinc; Kocal, Sedat; Yoruk, Yener
    Aim: Today, implantable central venous ports (ICVP) are increasingly used in oncology patients and provide easy vascular access for delivery of chemotherapy, other intravenous treatments, as fluids, blood products and parenteral nutrition solutions. In this study, we present our experience and comparison of efficacy and incidence of complications between subclavian versus jugular access in oncology patients and provide easy vascular access for delivery of chemotherapy. Material and Method: Three hundred ten implantable central venous ports (ICVP) were implanted via the subclavian vein (SV) in 145 patients (66 men, 79 women) with average age of 56.55 (18-86) and were implanted via the external jugular vein (EJV) in 165 patients (75 men, 90 women) with average age of 56.81 (19-81) between November 1.2006 and June 3, 2009. Results: There was no mortality caused by ICVP. As early complications, pneumothorax developed immediately after the procedure in 7 patients and arterial puncture in 34 patients. As late complications, infections developed in 10 patients, breakage of the catheter in one patient, malposition of catheter in one patient, jugular vein thrombosis in one patient. There was significant higher rate total implantation time in SV group (41610 catheter days) comparing with EJV group (23861 catheter days) ( p=0.0001. Discussion: According to experience, there was no difference rates of complication of catheter between the two groups despite a longer stay in SV group (complication numbers 28 in SV group. 28 in EJV group). It should be noted that this study took place at a single centre experience with a limited number of cases included and more research needs to be done to determine new and better ways to long-term vascular access.
  • Küçük Resim Yok
    Öğe
    Entübasyon sonrası erken ve geç trakea patolojileri
    (2011) Reyhan, Gökay; Karamustafaoğlu, Y. Altemur; Kocal, Sedat; Yörük, Yener
    Amaç: Biz bu yazıda, entübasyon sonrası oluşan trakeal rüptür ve stenoz konusundaki deneyimlerimizi sunmak istedik. Gereç ve Yöntem: Çalışmada Aralık 2004-Kasım 2009 tarihleri arasında uzun süre entübasyon sonrası trakea rüptürü ve darlık oluşan dokuz vaka retrospektif olarak incelendi. Olguların dördü rüptür beşi darlık idi. Trakeal rüptürlü olguların üçü erkek, biri kadın ortalama yaşları 37 (25-46) idi. Trakeal darlıklı olguların üçü erkek, ikisi kadın ortalama yaşları 32 (15-43) idi. Trakeal rüptürlü tüm olgularda etyoloji; genel anestezi sırasında zorlu entübasyon ve trakeal darlıklı tüm olgularda ise uzamış mekanik ventilatör kullanımıydı. Bulgular: Trakeal stenozlu üç olguda rezeksiyon ve anastomoz, bir olguda trakeostomi kuadroplejik bir olguda ise stent uygulandı. Trakeoözofageal fistül gelişen bir olgu cerrahi olarak tedavi edildi. Sonuç: Trakeal rüptür ve darlık, entübasyon sonrası herhangi bir hastada ve herhangi bir zamanda görülebilir. Bu nedenle mümkün olan en kısa sürede tanımak için özel bir dikkat gereklidir. Uygun tedavi seçiminin uygun zamanda, klinik bulgular eşliğinde uygulanması gerekir.
  • Küçük Resim Yok
    Öğe
    Post Intubation Early and Late Tracheal Pathologies
    (Bilimsel Tip Publishing House, 2011) Karamustafaoglu, Y. Altemur; Reyhan, Gokay; Kocal, Sedat; Yoruk, Yener
    Objective: Herein, we present our experience in treating the tracheal ruptures and stenoses after endotracheal intubation. Material and Method: Nine patients with tracheal stenosis and rupture after prolonged intubation between December 2004-November 2009 were retrospectively evaluated. Four of these cases were tracheal ruptures and five were tracheal stenoses. Three of the cases with tracheal ruptures were male and one was female, with a mean age of 37 (25-46). Three of the cases with tracheal stenoses were male and two were female, with a mean age of 32 (15-43). The etiology of all cases with tracheal rupture was forced intubation for general anesthesia and prolonged mechanical ventilation in all tracheal stenosis cases. Results: All cases with tracheal rupture were treated conservatively. There was no morbidity or mortality. Resection and anastomosis were performed in three tracheal stenoses cases, tracheostomy was applied in one case for long tracheal stenoses and broncoscopic dilatation and stent in one case quadroplegic case. Tracheoesophageal fistula developed in one case which was treated surgically. Conclusion: Tracheal rupture and stenosis can occur in any patient after intubation of any duration. Therefore, special notice is required to diagnose these cases as soon as possible. Proper treatment should be planned in the light of clinical observation.