SEKONDER SPONTAN PNÖMOTORAKSIN TEDAVÝSÝNDE TÜP TORAKOSTOMÝ YOLU ÝLE TALK PLÖKEDEZ UYGULAMASI: 30 OLGU

Plevral boþluðun yapay olarak adhezyonu, yineleyen efüzyonlarda ve rekürren pnömotoraks ataklarýnýn önlenmesinde uygulanýr ve akciðerin komplet ekspansasyonunun korunmasýný saðlar. Plevral adhezyon yöntemleri olarak plörektomi, plevral abrazyon ve inflamatuar reaksiyonlarý tetikleyen çeþitli kimyasallarýn intraplevral uygulanmasý bulunmaktadýr. Literatürde plöredezin geliþimi aþamasýnda birçok ajanýn kullanýldýðý görülmektedir. Bunlar arasýnda bleomisin, tetra-siklin ve talk en çok tercih edilen ajanlardýr. Kliniðimizde 2001-2002 yýllarý arasýnda nüks pnömotoraks tanýsý almýþ 30 olguya talk plöredez uygulanmýþ ve baþarý oranlarý belirlenmiþtir. Olgularýn 26'sý erkek 4'ü kadýn olup olgular 47-80 yaþ aralýðýnda daðýlmaktadýr. En sýk rastlanan komplikasyon aðrý, dispne ve ateþ idi. Baþarý oranlarý 1-3-6 ve 12 aylýk periyotlarla nüks takibi ile belirlenmiþtir. 1 yýllýk süre sonunda kümülatif olarak %90 oranýnda plöredez baþarýsý saptanmýþtýr.

TALC PLEURODESIS VIA TUBE THORACOSTOMY IN SECONDARY SPONTANEOUS PNEUMOTHORAX: 30 CASES

Adhesion of the pleural space is indicated when recurrent effusion or recurrent episodes of pneumothorax prevent complete expansion of the lung. Methods for creation of the pleural adhesions include pleurectomy, pleural abrasion and intrapleural instillation of various agents capable of stimulating inflammatory reaction. There have been many agents used, during the evolution of the pleurodesis, all of which are cited on the literature. Bleomycin, tetracycline and talc are the most commonly preffered agents. Thirty patients, in whom talc pleurodesis were caried out in our department, between 2001-2002, were analyzed and the rate of success among the patients were documented. Twenty six male and four female patients, of whom ages between 47 and 80, constituted our research group. Chest pain, fever and dyspnea were the most common complications. Success rate was determined according to the presence of the recurrences in the 1st, 3th, 6th and the 12th months. After 12 months, the cumulative success rate of the talc pleurodesis was found as; 90%.