Pitfalls in penetrating thoracic trauma
نویسندگان
چکیده
261 Correspondence (‹letiflim): Elias Degiannis, M.D. Department of Surgery, University of the Witswatersrand Medical School, 7 York Road, Parktown 2193 Johannesburg, South Africa. Tel: +27 (11) 933-8804 e-mail ( e p o s t a ) : d e g i a n n i s @ y e b o . c o . z a Department of Surgery, University of The Witswatersrand Medical School, Johannesburg, South Africa. Witswatersrand T›p Fakültesi, Cerrahi Bölümü, Johannesburg, Güney Afrika. Penetran toraks travmal› hastalar›n ço¤unlu¤u ameliyats›z tedavi edilmektedir. Cerrahi gerektiren hastalar›n klinik tablosu, genellikle fizyolojik instabiliteyle birlikte seyretmektedir. Bu hastalar›n durumunun kritik oluflu ve birçok Avrupa ülkesinde toraks travmas›n›n seyrek görülmesi, uzmanl›k e¤itimlerini genellikle genel cerrahi alan›nda alm›fl travma cerrahlar›na güçlük ç›karmaktad›r. Ço¤u genel cerrah, temel kardiyotorasik operatif cerrahi konusunda genel bir bilgi ve kendi e¤itim y›llar›ndan kaynaklanan ve muhtemelen cerrahi kitaplar›n› okumak suretiyle artan bir bilgiye sahiptir. Bu kitaplar›n ço¤una dahil edilen ayr›nt›lar, maalesef bu güç olgunun üstesinden gelmek üzere genel cerraha yeterli donat›m sa¤lamaya yetecek kadar kapsaml› de¤ildir. Bu uzmanlar›n bu anatomik bölgede, kardiyotorasik travma kitaplar›ndan edinilmifl beceri ve bilgileri kardiyotorasik cerrah arkadafllar›n›n operatif becerisi ve bilgisi ile karfl›laflt›r›lamaz. Kardiyotorasik cerrahlar taraf›ndan temel ve kolay olarak kabul edilen teknikler, genel cerrahlar için yabanc› ve zor olabilir. Kardiyotorasik travma cerrahisinde karfl›lafl›labilecek tehlikeli noktalar› ve güçlükleri biliyor olmak, bu uzmanlar›n operasyon s›ras›ndaki hatalardan sak›nmalar›na ve kendi hasta sonuçlar›n› gelifltirmelerine olanak sa¤layacakt›r. Bu yaz›da, gö¤üs bölgesine nafiz penetran travmalar› ameliyat eden cerrahlar›n yayg›n flekilde karfl›laflt›klar› tehlikeler vurguland›.
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