Nisan 2013
Gastroenterolojide yirmi yilda tanisal laparoskopinin rolü degisti mi?
Has the role of diagnostic laparoscopy in a single gastroenterology unit changed over 20 years?
- Ana Sayfa
- Sayılar
- Nisan 2013
- Gastroenterolojide yirmi yilda tanisal laparoskopinin rolü degisti mi?...
Özet
Giris ve Amaç:Girisimsel olmayan görüntüleme metotlarindaki gelismeler sonrasinda tanisal laparoskopinin kullanimi azalmistir. Biz de gastroenteroloji ünitemizde tanisal laparoskopi olgularini inceledik. Gereç ve Yöntem:1989-2010 yillari arasinda Istanbul Tip Fakültesi Gastroenteroloji Bilim Dali’nda laparoskopik isleme giren 1484 hastanin raporlari retrospektif olarak degerlendirildi. Laparoskopi islemi lokal anestezi altinda Storz marka laparoskopi cihazi ile yapildi. Bulgular: Asitli hastalar serum-asit albumin farklarina göre > 1,1 g/dL ve < 1,1 g/dL olacak sekilde iki gruba ayirilarak incelendi. Toplamda 93 (%6,3) hastanin tanisi laparoskopik inceleme sonrasi degisti. Son bes yilda eksuda asit ve peritoneal hastalik için yapilan tanisal laparoskopi sayisi azalmis olsa da bu azalma transuda asitlilerle karsilastirildiginda azalma oraninin daha düsük oldugu görülmektedir. Sonuç:Tanisal laparoskopi halen peritoneal tüberküloz tanisini koymada ve diger malign hastaliklarin ayirici tanisinda tercih edilen bir yöntemdir.
Abstract
Background and Aims:The use of diagnostic laparoscopy seems to have markedly reduced since the advent of major developments in noninvasive imaging modalities. We aimed to investigate the role of diagnostic laparoscopy in our gastroenterology unit. Materials and Methods:Reports of 1484 laparoscopy patients seen in the Gastroenterology Department of Istanbul University, Istanbul Faculty of Medicine between 1989 and 2010 were evaluated retrospectively. Laparoscopy was performed using the Storz laparoscope under local anesthesia. Results:Patients with ascites were evaluated in two different groups according to serum-ascites albumin gradient values as >1.1 g/dL and <1,1 g/dL. Diagnoses of 93 (6,3%) patients were revised after the laparoscopic examination. Although diagnostic laparoscopy for evaluation of exudative ascites and peritoneal disease has decreased in the last quarter, the decrease was relatively less when compared with that for transudative ascites. Conclusions:Diagnostic laparoscopy is still the preferred method both for the diagnosis of peritoneal tuberculosis and to rule out other diseases such as malignancy.
