{"id":6173,"date":"2023-02-01T15:29:00","date_gmt":"2023-02-01T12:29:00","guid":{"rendered":"https:\/\/zulfikarpolat.com\/?page_id=6173"},"modified":"2023-02-02T02:50:07","modified_gmt":"2023-02-01T23:50:07","slug":"eus","status":"publish","type":"page","link":"https:\/\/zulfikarpolat.com\/en\/eus\/","title":{"rendered":"EUS"},"content":{"rendered":"\t\t
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EUS (Endoskopik Ultrasonografi)<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Endoskopik Ultrasonografi (EUS)\u00a0Nedir ?\u00a0<\/strong>\u00a0\u00a0\u00a0<\/strong><\/span><\/h2>

Endoskoplar\u0131n u\u00e7 k\u0131smana \u00a0minik bir kamera ve ultrason probu \u00a0yerle\u015ftirilmesi ile \u00a0\u00a0yemek borusu, mide, oniki parmak ba\u011f\u0131rsa\u011f\u0131, rektum gibi sindirim sistemi organlar\u0131n\u0131n \u00a0ve \u00e7evresindeki organlar\u0131n incelenmesi i\u015flemidir.<\/span><\/p>

Endoskopun ucundaki kamera ile organlar\u0131n i\u00e7 y\u00fcz\u00fcn\u00fcn g\u00f6r\u00fcnt\u00fcs\u00fc bir ekrana yans\u0131t\u0131lmakta ve e\u015f zamanl\u0131 olarak endoskop ucundaki ultrason probu ile incelenen organ ve \u00e7evresi sayesindeki yap\u0131lar incelenebilmektedir.<\/em>\u00a0Bu i\u015flem ile organlar\u0131n duvar katlar\u0131 derinlemesine incelenebilmekte, organ duvarlar\u0131n\u0131n derin katlar\u0131nda yerle\u015fen lezyonlar tan\u0131mlanabilmekte, gastrointestinal t\u00fcm\u00f6rlerin evrelemesi-takibi yap\u0131labilmekte ve lezyonlar\u0131n endoskopik olarak \u00e7\u0131kar\u0131labilirli\u011fi de de\u011ferlendirilebilmektedir.<\/span><\/p>

Ayr\u0131ca safra kesesi, safra yollar\u0131, pankreas ve lenf nodlar\u0131 gibi kom\u015fu organlar\u0131n ve ili\u015fkili lezyonlar\u0131n m\u00fckemmel sonografik g\u00f6r\u00fcnt\u00fcleri elde edilebilmektedir. Bu i\u015flemde duvar katlar\u0131ndaki veya kom\u015fu organlardaki kitle lezyonlar\u0131ndan, lenf nodlar\u0131ndan, i\u00e7i s\u0131v\u0131 dolu (kistik) lezyonlardan biyopsiler (k\u00fc\u00e7\u00fck par\u00e7alar) al\u0131nabilmekte ve s\u0131v\u0131 \u00f6rneklemesi yap\u0131labilmektedir.<\/strong><\/span><\/p>

Endoskopik ultrasonografi; yayg\u0131n olarak yap\u0131lan kar\u0131n ultrasonografisinde kullan\u0131lan ultrason cihaz\u0131n\u0131n k\u00fc\u00e7\u00fclt\u00fcl\u00fcp minyaturize edilerek endoskop ucuna konulmu\u015f halidir.<\/em>\u00a0Bu sayede ilgilenilen organa en yak\u0131n mesafeye kadar gidilmekte ve g\u00f6r\u00fcnt\u00fcleme \u00e7ok yak\u0131ndan detayl\u0131 olarak yap\u0131lmaktad\u0131r. \u00d6rnekleme yap\u0131lmas\u0131 gereken durumlarda problemli alan\u0131n \u00f6rnek al\u0131nacak b\u00f6lgesinin net olarak belirlenmesini sa\u011flamaktad\u0131r.\u00a0En \u00f6nemli avantajlar\u0131ndan bir tanesi, \u00e7evre damarlar\u0131 \u00e7ok iyi \u015fekilde g\u00f6stermesi dolay\u0131s\u0131yla \u00f6rnek al\u0131nacak sahaya g\u00fcvenle ve damars\u0131z bir b\u00f6lgeden giri\u015f yap\u0131lmas\u0131n\u0131 sa\u011flamaktad\u0131r. Bu teknoloji detayl\u0131 g\u00f6r\u00fcnt\u00fc sa\u011flaman\u0131n yan\u0131 s\u0131ra g\u00fcvenle \u00f6rnek al\u0131nmas\u0131na olanak vermektedir.<\/em>\u00a0<\/strong>Bu teknoloji ile (di\u011fer y\u00f6ntemler ba\u015far\u0131s\u0131z kald\u0131\u011f\u0131nda) safra yollar\u0131nda darl\u0131k veya t\u00fcm\u00f6rlerin rahatlat\u0131labilmesi i\u00e7in ince t\u00fcpler (stent) konulabilir veya kistik alanlar barsa\u011fa a\u011f\u0131zla\u015ft\u0131rlabilir.<\/span><\/p>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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EUS Nas\u0131l Uygulan\u0131r ?<\/strong><\/span><\/h3>\n
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  • \u0130\u015flem i\u00e7in mide ve oniki parmak ba\u011f\u0131rsa\u011f\u0131n\u0131n bo\u015f olmas\u0131 gerekti\u011finden hastalar\u0131n i\u015flem\u00a0\u00f6ncesi en az 8 saat a\u00e7 olmalar\u0131 gerekmektedir.<\/em><\/span><\/li>\n \t
  • Kanama artt\u0131r\u0131c\u0131, kan suland\u0131r\u0131c\u0131 ve a\u011fr\u0131 kesici ila\u00e7lar m\u00fcmk\u00fcnse, i\u015flemden bir hafta \u00f6nce kesilmelidir. Bu gruptaki ila\u00e7lar; bebek aspirini (coraspin, ecopirin, babyprin), plavix, coumadin, eliquis, pradaxa, xarelto ad\u0131 ile sat\u0131lan ila\u00e7lar olup de\u011fi\u015fik firmalar\u0131n farkl\u0131 isimlerde \u00fcr\u00fcnleri oldu\u011fu bilinmelidir.<\/span><\/li>\n \t
  • \u0130\u015flem ortalama olarak 20 ila 45 dakika aras\u0131nda s\u00fcrmektedir. \u0130\u015flem s\u0131ras\u0131nda rahats\u0131zl\u0131k\u00a0hissedilmemesi i\u00e7in anestezi hekimi taraf\u0131ndan damardan uyku yap\u0131c\u0131 ila\u00e7lar<\/em>\u00a0Bu sayede hasta uyumakta ve i\u015flem ile ilgili olumsuz bir his\u00a0ya\u015famamaktad\u0131r.<\/em>\u00a0Anestezi hekimi ve i\u015flem yapan hekiminizin uygun g\u00f6rd\u00fc\u011f\u00fc durumlarda gerek i\u015flem \u00f6zellikleri gerekse de ek hastal\u0131klar\u0131n\u0131za ba\u011fl\u0131 olarak genel anestezi ile tam bir anestezi yap\u0131lmas\u0131 s\u00f6z konusu olabilir.<\/span><\/li>\n \t
  • \u0130\u015flem sonras\u0131 hastalar en az 30 dk derlenme odas\u0131nda m\u00fc\u015fahade alt\u0131nda tutulur.<\/span><\/li>\n<\/ul>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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    Endoskopik Ultrasonografi kullan\u0131m alanlar\u0131:<\/strong><\/span><\/h4>
    • Yemek borusu t\u00fcm\u00f6rleri (derinli\u011fin saptanmas\u0131, evreleme, lenf bezi yay\u0131l\u0131m\u0131n\u0131n ara\u015ft\u0131r\u0131lmas\u0131 ve \u00f6rnekleme)<\/span><\/li>
    • Akci\u011fer t\u00fcm\u00f6rlerinin evrelemesi, lenf nodu yay\u0131l\u0131m\u0131n\u0131n saptanmas\u0131 ve \u00f6rneklemesi<\/span><\/li>
    • Akci\u011fer \u00e7evresinde (mediasten) bulunan len fnodlar\u0131nda t\u00fcberk\u00fcloz, sarkoidoz gibi hastal\u0131klar\u0131n ara\u015ft\u0131r\u0131lmas\u0131 ve \u00f6rneklemesinde<\/span><\/li>
    • Mide t\u00fcm\u00f6rleri (derinli\u011fin saptanmas\u0131, evreleme, lenf bezi yay\u0131l\u0131m\u0131n\u0131n ara\u015ft\u0131r\u0131lmas\u0131 ve \u00f6rnekleme)<\/span><\/li>
    • Yemek borusu, mide, on iki parmak barsak duvar\u0131nda bulunan lezyonlar\u0131n derinli\u011finin saptanmas\u0131 ve \u00f6rneklemesi<\/span><\/li>
    • Safra yolu ta\u015flar\u0131n\u0131n ara\u015ft\u0131r\u0131lmas\u0131<\/span><\/li>
    • Sebebi a\u00e7\u0131klanamam\u0131\u015f safra ve pankreas yollar\u0131 geni\u015flemesinin ayd\u0131nlat\u0131lmas\u0131<\/span><\/li>
    • Safra kesesi ta\u015flar\u0131n\u0131n varl\u0131\u011f\u0131n\u0131n ara\u015ft\u0131r\u0131lmas\u0131<\/span><\/li>
    • Safra ve pankreas yollar\u0131nda darl\u0131k ve nedenlerinin ara\u015ft\u0131r\u0131lmas\u0131<\/span><\/li>
    • Safra yollar\u0131 t\u00fcm\u00f6rleri tan\u0131s\u0131, \u00f6rneklemesi ve evrelemesi<\/span><\/li>
    • Pankreas t\u00fcm\u00f6rleri ve kitlelerinin ara\u015ft\u0131r\u0131lmas\u0131 ve \u00f6rneklenmesi<\/span><\/li>
    • Pankreas kistlerinin ara\u015ft\u0131r\u0131lmas\u0131 ve \u00f6rneklenmesi<\/span><\/li>
    • Kronik pankreatit<\/span><\/li>
    • Otoimm\u00fcn pankreatit<\/span><\/li>
    • Akut pankreatit (se\u00e7ilmi\u015f durumlarda)<\/span><\/li>
    • Tekrarlayan pankreatit ataklar\u0131 olan hastalar\u0131n ara\u015ft\u0131r\u0131lmas\u0131<\/span><\/li>
    • Pankreas anomalileri (pancreas divisum, annuler pancreas)<\/span><\/li>
    • Barsak t\u00fcm\u00f6rleri, derinli\u011fi ve \u00f6rneklemesi<\/span><\/li>
    • Kar\u0131n i\u00e7indeki lenf bezlerinin \u00f6rneklenmesi<\/span><\/li>
    • Sol adrenal (s\u00fcrrenal) bez de\u011ferlendirilmesi ve \u00f6rneklemesi<\/span><\/li>
    • Kar\u0131n i\u00e7indeki vask\u00fcler yap\u0131lar\u0131n de\u011ferlendirilmesi (se\u00e7ilmi\u015f hastalarda)<\/span><\/li>
    • Rektum t\u00fcm\u00f6rlerinin evrelemesi ve \u00f6rneklenmesi<\/span><\/li><\/ul>

      \u00a0<\/p>

      EUS Sonras\u0131 Dikkat Edilmesi Gereken Noktalar Nelerdir ?<\/strong><\/span><\/h4>

      \u0130\u015flemden yakla\u015f\u0131k 45 dakika sonra a\u011f\u0131zdan beslenme ba\u015flayabilir. Ancak yeme\u011fe ne zaman ba\u015flanaca\u011f\u0131 hastan\u0131n durumuna, yap\u0131lan i\u015fleme ve hekim karar\u0131na g\u00f6re de\u011fi\u015febilmektedir. \u0130\u015flem esnas\u0131nda sakinle\u015ftirici ila\u00e7 uygulanm\u0131\u015f olan bireylerin mutlaka bir refakat\u00e7i e\u015fli\u011finde evine g\u00f6t\u00fcr\u00fclmesi gerekmektedir. \u0130la\u00e7lar\u0131n etkisinin ge\u00e7ece\u011fi ertesi g\u00fcne kadar motorlu ara\u00e7lar kesinlikle kullan\u0131lmamal\u0131d\u0131r.<\/span><\/p>

      Uygulanacak \u0130\u015flemlerin Riskleri:<\/strong><\/span><\/h5>

      Endoskopik ultrasonografide istenmeyen yan etkiler \u00e7ok nadiren g\u00f6r\u00fclmekte olup oran her 1000 ki\u015fide 1 (bir) d\u00fczeyindedir. Bu olas\u0131 riskler ve koruyucu tedbirler a\u015fa\u011f\u0131da a\u00e7\u0131klanm\u0131\u015ft\u0131r.<\/span><\/p>

      -Kist s\u0131v\u0131s\u0131 \u00f6rneklemesi yap\u0131lan ki\u015filerde i\u015flemden sonra kist s\u0131v\u0131s\u0131 i\u00e7erisinde infeksiyon geli\u015fmesi riski s\u00f6z konusu olabilmektedir. Bu riski azaltmak i\u00e7in i\u015flem \u00f6ncesi antibiyotik tedavisi verilmekte ve yakla\u015f\u0131k 3-5 g\u00fcn antibiyotik tedavisine devam edilmektedir. Ayr\u0131ca kist s\u0131v\u0131s\u0131 tama yak\u0131n bo\u015falt\u0131larak infeksiyon riski azalt\u0131lmaktad\u0131r. Kistik olmayan alanlardan \u00f6rnek al\u0131nmas\u0131nda infeksiyon riski yok denecek d\u00fczeyde oldu\u011fu i\u00e7in bu gibi hastalar\u0131m\u0131zda antibiyotik verilmemektedir.<\/span><\/p>

      -Di\u011fer \u00e7ok nadir rastlan\u0131lan durumlar aras\u0131nda pankreas hastal\u0131\u011f\u0131 nedeni ile pankreasdan \u00f6rnek al\u0131nan ki\u015filerde g\u00f6r\u00fclebilen pankreas bezi iltihab\u0131 (pankreatit) ve \u00e7ok nadiren barsak delinmesidir. Bu gibi \u00e7ok nadir durumlara \u00f6zellikle kanser hastalar\u0131 ve ileri boyutta hastal\u0131\u011f\u0131 olanlarda rastlan\u0131lmaktad\u0131r. Endoskopik ultrasonografi, v\u00fccut d\u0131\u015f\u0131ndan i\u011fne yard\u0131m\u0131 ile \u00f6rnek al\u0131nmas\u0131na g\u00f6re \u00e7ok daha g\u00fcvenilir olmas\u0131 ve istenmeyen yan etki oran\u0131n\u0131n d\u00fc\u015f\u00fck olmas\u0131 nedeni ile di\u011fer y\u00f6ntemlerle kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda yine de en g\u00fcvenilir yol olarak kabul edilmektedir.<\/span><\/p>

      -Mide \u00e7\u0131k\u0131\u015f\u0131nda t\u00fcm\u00f6r varl\u0131\u011f\u0131 nedeniyle darl\u0131\u011f\u0131 olan hastalarda endoskopik ultrasonografi ile stent (t\u00fcp) yerle\u015ftirilerek mide ve barsak aras\u0131nda \u00e7al\u0131\u015fan yeni bir yol olu\u015fturulmaktad\u0131r. Ek olarak safra yolu t\u0131kanmas\u0131 olan hastalarda safran\u0131n ak\u0131\u015f\u0131n\u0131n sa\u011flanabilmesi i\u00e7in safra yolu ile mide veya barsak aras\u0131na stent konulabilmektedir. Bu gibi teknik olarak ileri d\u00fczey zorluk g\u00f6steren vakalarda nadiren barsak delinmesi gibi istenmeyen olaylar g\u00f6r\u00fclebilmektedir. Ancak bu gibi hastal\u0131klarda, se\u00e7ilecek di\u011fer tedavi y\u00f6ntemlerinin yan etki riski genellikle endoskopik ultrasonografiden \u00e7ok daha fazlad\u0131r.<\/span><\/p>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

      EUS (Endoskopik Ultrasonografi) Endoskopik Ultrasonografi (EUS)\u00a0Nedir ?\u00a0\u00a0\u00a0\u00a0 Endoskoplar\u0131n u\u00e7 k\u0131smana \u00a0minik bir kamera ve ultrason probu \u00a0yerle\u015ftirilmesi ile \u00a0\u00a0yemek borusu, mide, oniki parmak ba\u011f\u0131rsa\u011f\u0131, rektum gibi sindirim sistemi organlar\u0131n\u0131n \u00a0ve \u00e7evresindeki organlar\u0131n incelenmesi i\u015flemidir. Endoskopun ucundaki kamera ile organlar\u0131n i\u00e7 y\u00fcz\u00fcn\u00fcn g\u00f6r\u00fcnt\u00fcs\u00fc bir ekrana yans\u0131t\u0131lmakta ve e\u015f zamanl\u0131 olarak endoskop ucundaki ultrason probu ile incelenen […]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"yoast_head":"\nEUS - Endoskopik Ultrasonografi - Prof Dr Z\u00fclfikar Polat<\/title>\n<meta name=\"description\" content=\"Endoskopik Ultrasonografi (EUS) Nedir ? EUS Nas\u0131l Uygulan\u0131r ? 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