Özofagus Yaralanmaları - Journal of Clinical and Analytical Medicine
Özofagus Yaralanmaları - Journal of Clinical and Analytical Medicine
Özofagus Yaralanmaları - Journal of Clinical and Analytical Medicine
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<strong>Öz<strong>of</strong>agus</strong> <strong>Yaralanmaları</strong> <strong>Öz<strong>of</strong>agus</strong> <strong>Yaralanmaları</strong><br />
İntratorasik öz<strong>of</strong>agus injurilerine tercih edilen yaklaşım üst öz<strong>of</strong>agus yaralanması<br />
için sağ, alt seviyeli öz<strong>of</strong>agus yaralanması içinde sol posterolateral torakotomidir.<br />
• <strong>Öz<strong>of</strong>agus</strong>u mobilize ederek injuriyi tespit et. Primer olarak absobable 3-0 tek kat<br />
sütürle tamir et ve plevra ile yada interkostal kas flebi ile kapat<br />
• Bir apikal, bir posteriora olmak üzere göğüs tüpüyle drenaj önerilir.<br />
• Geniş bir segment kaybı, yoğun kontaminasyon yada geçikmiş injuri nedeniyle primer<br />
tamir mümkün değilse; injurinin alt ve üstüne stapler, üst poşa bir nazogastrik<br />
tüp, mideyede bir gastrostomi tüpü yerleştir. Kompleks eksklüzyon prosedürleri ileri<br />
bir ameliyat için endike değildir.<br />
• <strong>Öz<strong>of</strong>agus</strong> injurisinin primer tamiri çok geçiktiği zaman kontrollü bir fistüle injuriyi<br />
dönüştüren geniş bir T-tüp üzerine injüriyi kapatmak bir alternatiftir.<br />
• Mediastinum daha sonra göğüs tüpleri kullanılarak geniş bir şekilde drene edilir.<br />
Yada injuri yanına yerleştirilen emici drenlerle kapatılır. Fistül matür trakt haline geldikten<br />
sonra yavaş bir şekilde önce T-tüp daha sonraki günlerde göğüs tüpleri kontrollü<br />
olarak geri çekilir.<br />
Kaynaklar<br />
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