Gastro\u00f6zofageal Refl\u00fc (G\u00d6RH) veya mide f\u0131t\u0131\u011f\u0131nda mide i\u00e7erisindeki asit veya g\u0131da art\u0131klar\u0131 yemek borusuna geri gelmekte ve tahri\u015fe neden olmaktad\u0131r. Hastalar\u0131n %9′ unda g\u00f6\u011f\u00fcs arka k\u0131s\u0131mda yanma, ses k\u0131s\u0131kl\u0131\u011f\u0131 (%78), ast\u0131m (%82), kalp krizini taklit edebilen g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131 (%50) ve a\u011fza ac\u0131 su gelmesi \u015fikayetleri vard\u0131r.<\/p>\n
Refl\u00fcde tedavi:<\/strong> Refl\u00fcde Ameliyat: <\/strong> Refl\u00fcde Ameliyat Sonras\u0131:<\/strong> Refl\u00fc ameliyat\u0131 Olmal\u0131 m\u0131y\u0131m?<\/strong> Gastro\u00f6zofageal Refl\u00fc (G\u00d6RH) veya mide f\u0131t\u0131\u011f\u0131nda mide i\u00e7erisindeki asit veya g\u0131da art\u0131klar\u0131 yemek borusuna geri gelmekte ve tahri\u015fe neden olmaktad\u0131r. Hastalar\u0131n %9′ unda g\u00f6\u011f\u00fcs arka k\u0131s\u0131mda yanma, ses k\u0131s\u0131kl\u0131\u011f\u0131 (%78), ast\u0131m (%82), kalp krizini taklit edebilen g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131 (%50) ve a\u011fza ac\u0131 su gelmesi \u015fikayetleri vard\u0131r. Refl\u00fcde tedavi: G\u00fcnl\u00fck hayatta k\u0131sa s\u00fcreli olu\u015fan \u015fikayetleri genelde …<\/p>\n","protected":false},"author":1,"featured_media":161,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,20],"tags":[],"class_list":["post-160","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-cerrahi","category-d-cerrahi"],"_links":{"self":[{"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/posts\/160","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=160"}],"version-history":[{"count":1,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/posts\/160\/revisions"}],"predecessor-version":[{"id":162,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/posts\/160\/revisions\/162"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/media\/161"}],"wp:attachment":[{"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=160"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=160"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=160"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\nG\u00fcnl\u00fck hayatta k\u0131sa s\u00fcreli olu\u015fan \u015fikayetleri genelde ya\u015fam kalitesini \u00e7ok etkilemez. Ancak refl\u00fc hastal\u0131\u011f\u0131 \u00e7o\u011funlukla uzun s\u00fcre ila\u00e7 kullan\u0131lmas\u0131n\u0131 gerektiren, ya\u015fam kalitesini bozan, gen\u00e7 populasyonu da ilgilendiren kronik bir hastal\u0131kt\u0131r. Tedavisinde proton pompa inhibit\u00f6rleri (PP\u0130), H2 resept\u00f6r blokerleri, prokinetik ajanlar ve antiasitler kullan\u0131lmaktad\u0131r. \u00c7o\u011fu hastada medikal tedaviyle \u015fikayetlerin kontrol alt\u0131na al\u0131nmas\u0131 sa\u011flan\u0131r. Medikal tedavinin hayat boyu devam ettirilecek olmas\u0131 \u00f6zellikle ya\u015fam beklentisi fazla olan gen\u00e7 hasta grubunda hem tedaviye uyumu zorla\u015ft\u0131rmakta hem de maliyeti olduk\u00e7a art\u0131rmaktad\u0131r. Ayr\u0131ca uzun s\u00fcreli \u015fikayetlerde yemek borusunda darl\u0131k (strikt\u00fcr) ve kanser geli\u015fimi (Barrett \u00f6zofagus) olabilece\u011finden ameliyat edilmelidirler.<\/p>\n
\nModern teknolojik geli\u015fmelerle art\u0131k kapal\u0131 (laparoskopik) ameliyatlar\u0131 daha s\u0131k uyguluyoruz. Ameliyat sonras\u0131 kapal\u0131 (laparoskopik) y\u00f6ntem uygulanan hastalarda daha k\u0131sa hastanede yat\u0131\u015f s\u00fcresi, daha az ameliyat a\u011fr\u0131s\u0131, daha y\u00fcksek ya\u015fam kalitesi ve erken d\u00f6nemde i\u015fe ba\u015flama sa\u011flanabilmektedir. Cerrahi komplikasyonlar ve ba\u015far\u0131s\u0131z cerrahi giri\u015fimler g\u00f6z ard\u0131 edildi\u011finde uzun vadede antirefl\u00fc cerrahi G\u00d6RH tedavisinde medikal tedaviye oranla maliyet a\u00e7\u0131s\u0131ndan daha uygundur. Ameliyat sonras\u0131 d\u00f6nemde mideye y\u00f6nelik ila\u00e7 kullan\u0131lma ihtiyac\u0131 azalmaktad\u0131r. \u0130lk refl\u00fc ameliyat\u0131 Nissen taraf\u0131ndan 1956 y\u0131l\u0131nda yap\u0131lm\u0131\u015f, 1991 y\u0131l\u0131ndan beri de laparoskopik y\u00f6ntemle ameliyatlar devam etmi\u015ftir. Toupet tekni\u011fi, Dor tekni\u011fi gibi parsiyel (k\u0131smi) fundoplikasyonlarda yap\u0131lsa da asit refl\u00fcs\u00fcn\u00fcn \u00f6nlenmesinde en ba\u015far\u0131l\u0131 nissen fundoplikasyonu ve hiatusun onar\u0131lmas\u0131 bulunmu\u015ftur. Mutlaka ameliyatta hiatusun onar\u0131lmas\u0131 \u00f6nerilmekte, %80 n\u00fcks\u00fcn \u00f6nlenebilece\u011fi belirtilmektedir. N\u00fcks olgularda bu b\u00f6lgede greft kullan\u0131labilmektedir. Ameliyattan sonra yutma g\u00fc\u00e7l\u00fc\u011f\u00fcn\u00fcn \u00f6nlenmesi i\u00e7in geni\u015f \u00e7apl\u0131 buji kullan\u0131lmas\u0131 yararl\u0131 olmaktad\u0131r.<\/p>\n
\nAmeliyat ba\u015far\u0131s\u0131 ortalama %90 lar seviyesindedir. Uzun d\u00f6nem sonunda da laparoskopik refl\u00fc ameliyatlar\u0131n\u0131n medikal tedaviyle ya\u015fam kalitesi ve semptomlar a\u00e7\u0131s\u0131ndan kar\u015f\u0131la\u015ft\u0131rd\u0131klar\u0131nda daha \u00fcst\u00fcn oldu\u011funu bulmu\u015flard\u0131r. Ameliyat sonras\u0131 d\u00f6nemde en s\u0131k yutkunmada tak\u0131lma hissi (%6) g\u00f6r\u00fclmektedir. Ancak bu durum ameliyat yerinde \u00f6deme ba\u011fl\u0131 olur, k\u0131sa s\u00fcrede ge\u00e7mektedir. Ameliyat sonras\u0131 ishal, ge\u011firememe, kar\u0131nda \u015fi\u015fkinlik g\u00f6r\u00fclebilir.<\/p>\n
\nRefl\u00fc hastalar\u0131nda ameliyat \u00f6ncesi uygun de\u011ferlendirme ve haz\u0131rl\u0131k yap\u0131ld\u0131ktan sonra t\u0131bbi gereklilik varsa tecr\u00fcbeli ellerde, uygun cerrahi donan\u0131m kullan\u0131larak, kapal\u0131 ameliyatlar ile etkin tedavi sa\u011flanaca\u011f\u0131 unutulmamal\u0131d\u0131r.<\/p>\n","protected":false},"excerpt":{"rendered":"