Akciğer lobu kama (wedge) rezeksiyonundanon-kontakt diyod lazer uygulamalarının anlık ve postoperatif erken dönem sonuçlarının araştırılması
Date
2022-07-18
Authors
Aslan, Vildan
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Bu çalışmada, akciğer lobu kama (wedge) rezeksiyonunda non-kontakt 980 nm diyod lazerin anlık ve postoperatif erken dönemdeki radyolojik, laboratuvar ve histopatolojik bulgularının araştırılması amaçlandı. Çalışmada Yeni Zelanda ırkı tavşan kullanıldı ve (n=21) 3 gruba (n=7) ayrıldı. Sol torakotomi sonrası cranial akciğer lobunda, grup I'de (GRI) 15 watt/cm2, grup II'de (GRII) 10 watt/cm2 ve grup III'te (GRIII) 5 watt/cm2 güç yoğunluğu kullanılarak kama rezeksiyon yapıldı. Preoperatif ve postoperatif 0, 1, 7 ve 15. günlerde klinik ve radyolojik muayeneler ile preoperatif, 1, 7 ve 15. günlerde hematolojik, biyobelirteç, kan gazı analizleri yapıldı. Tavşanlar 0. gün ve sakrifiye edildikten sonra 15. günde alınan akciğer doku örneklerinin histopatolojisi incelendi. Verilere istatistik uygulandı. Respirasyon'un GRI'de postoperatif süreçte arttığı gözlendi ve 0. günde GRII ile GRI ve GRIII arasında (p=0,009, p<0,001) fark anlamlıydı. WBC, Neu, Eos, Bas, PLT değerleri tüm grup ve zamanlarda referans aralığındaydı. IL-1β, GRI ve GRIII'te 15. günde artarken, istatistiksel olarak anlamlı değildi (p>0,05). IL-8 değeri GRII'de postoperatif süreçte artarken, ölçüm zamanlarına göre preoperatif ile 1. gün (p=0,006) ve 1 ile 7. gün arasındaki (p=0,018) fark anlamlıydı. VEGF değerinin diğer gruplara göre GRII'de 1. günde artarak 15. günde hafif oranda azaldığı görülürken, 15. günde anlamlı farklılık GRI ve GRII arasında saptandı (p=0,013). PCO2, GRI'de 1. gün, PO2, GRI'de 1, 7, 15. gün ve SaO2 GRI'de 1 ve 7. günde referans değer üzerindeydi. GRII'de PO2 için, preoperatif ve 1. gün arasında (p=0,026) fark anlamlıydı. Akciğer deseni yönünden anlamlı farklılık, 1. günde GRI ile GRIII (p=0,03) ve GRII ile GRIII (p=0,018) arasında belirlendi. Karbonizasyon zonu için GRI ile GRIII ve GRII ile GRIII arasında (p=0,011, p=0,004), koagulasyon zonu için GRI ile GRII arasında (p=0,019) anlamlı farklılık saptandı. Fibroplazi miktarı için 15. günde GRI ile GRIII ve GRII ile GRIII (p=0,015, p=0,002) arasındaki fark anlamlıydı. Sonuç olarak; anlık ve erken postoperatif dönemdeki bulgular değerlendirildiğinde, akciğer dokusunun anatomik ve fizyolojik yapısını koruyacak en etkin lazer modunun, 980 nm dalga boyu, 15watt/cm2, non-kontakt mod, ortalama 60 sn süre ve 900 joule olduğu söylenebilir.
In this study, it was aimed to investigate the radiological, laboratory and histopathological findings of the non-contact 980 nm diode laser in the lung lobe wedge resection in the immediate and early postoperative period. New Zealand rabbits were used in the study and (n=21) were divided into 3 groups (n=7). After left thoracotomy, wedge resection was performed in the cranial lung lobe using a power density of 15 watts/cm2 in group I (GRI), 10 watts/cm2 in group II (GRII) and 5 watts/cm2 in group III (GRIII). Clinical and radiological examinations were performed on preoperative and postoperative days 0, 1, 7 and 15, and hematological, biomarker and blood gas analyzes were performed on days preoperative, 1, 7 and 15. The histopathology of the lung tissue samples taken from the rabbits on day 0 and on the 15th day after sacrification was examined. Statistics were applied to the data. Respiration was observed to increase in GRI in the postoperative period, and the difference between GRII and GRI and GRIII (p=0.009, p<0.001) was significant on day 0. WBC, Neu, Eos, Bas, PLT values were within the reference range for all groups and times. While IL-1β increased at day 15 in GRI and GRIII, it was not statistically significant (p>0.05). While IL-8 value increased in GRII in the postoperative period, the difference between preoperative and day 1 (p=0.006) and day 1 and 7 (p=0.018) was significant according to measurement times. It was observed that the VEGF value increased on the 1st day in GRII compared to the other groups and decreased slightly on the 15th day, while a significant difference was found between the GRI and GRII on the 15th day (p=0.013). PCO2 was above baseline on day 1 in GRI, PO2 on day 1, 7, and 15 in GRI, and SaO2 on day 1 and 7 in GRI. For PO2 in GRII, the difference between preoperative and day 1 (p=0.026) was significant. Significant difference in lung pattern was determined between GRI and GRIII (p=0.03), GRII and GRIII (p=0.018) on day 1. There was a significant difference between GRI and GRIII, GRII and GRIII for the carbonization zone (p=0.011, p=0.004), and between GRI and GRII for the coagulation zone (p=0.019). The difference between GRI and GRIII, GRII and GRIII (p=0.015, p=0.002) on day 15 was significant for the amount of fibroplasia. As a result; when the findings in the instant and early postoperative period are evaluated, it can be said that the most effective laser mode that will protect the anatomical and physiological structure of the lung tissue is 980 nm wavelength, 15watt/cm2, non-contact mode, 60 sec duration and 900 joules.
In this study, it was aimed to investigate the radiological, laboratory and histopathological findings of the non-contact 980 nm diode laser in the lung lobe wedge resection in the immediate and early postoperative period. New Zealand rabbits were used in the study and (n=21) were divided into 3 groups (n=7). After left thoracotomy, wedge resection was performed in the cranial lung lobe using a power density of 15 watts/cm2 in group I (GRI), 10 watts/cm2 in group II (GRII) and 5 watts/cm2 in group III (GRIII). Clinical and radiological examinations were performed on preoperative and postoperative days 0, 1, 7 and 15, and hematological, biomarker and blood gas analyzes were performed on days preoperative, 1, 7 and 15. The histopathology of the lung tissue samples taken from the rabbits on day 0 and on the 15th day after sacrification was examined. Statistics were applied to the data. Respiration was observed to increase in GRI in the postoperative period, and the difference between GRII and GRI and GRIII (p=0.009, p<0.001) was significant on day 0. WBC, Neu, Eos, Bas, PLT values were within the reference range for all groups and times. While IL-1β increased at day 15 in GRI and GRIII, it was not statistically significant (p>0.05). While IL-8 value increased in GRII in the postoperative period, the difference between preoperative and day 1 (p=0.006) and day 1 and 7 (p=0.018) was significant according to measurement times. It was observed that the VEGF value increased on the 1st day in GRII compared to the other groups and decreased slightly on the 15th day, while a significant difference was found between the GRI and GRII on the 15th day (p=0.013). PCO2 was above baseline on day 1 in GRI, PO2 on day 1, 7, and 15 in GRI, and SaO2 on day 1 and 7 in GRI. For PO2 in GRII, the difference between preoperative and day 1 (p=0.026) was significant. Significant difference in lung pattern was determined between GRI and GRIII (p=0.03), GRII and GRIII (p=0.018) on day 1. There was a significant difference between GRI and GRIII, GRII and GRIII for the carbonization zone (p=0.011, p=0.004), and between GRI and GRII for the coagulation zone (p=0.019). The difference between GRI and GRIII, GRII and GRIII (p=0.015, p=0.002) on day 15 was significant for the amount of fibroplasia. As a result; when the findings in the instant and early postoperative period are evaluated, it can be said that the most effective laser mode that will protect the anatomical and physiological structure of the lung tissue is 980 nm wavelength, 15watt/cm2, non-contact mode, 60 sec duration and 900 joules.
Description
Keywords
Akciğer lobu, Kama rezeksiyon, Diyod lazer, Lazer cerrahisi, Tavşan, Lung lobe, Wedge resection, Diode laser, Laser surgery, Rabbit
Citation
Aslan, V. (2022). Akciğer lobu kama (wedge) rezeksiyonundanon-kontakt diyod lazer uygulamalarının anlık ve postoperatif erken dönem sonuçlarının araştırılması. Yayınlanmamış doktora tezi. Bursa Uludağ Üniversitesi Sağlık Bilimleri Enstitüsü.