Benign pelvik kitle nedeniyle opere edilen hastaların preoperatif ve postoperatif sonuçlarının değerlendirilmesi
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Dosyalar
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Benign pelvik kitleler her yaş grubundaki kadınları ilgilendiren asemptomatikten acil patolojiye geniş semptom yelpazesi olan patolojilerdir. Yaptığımız çalışmada Ocak 2006-Aralık 2016 tarihleri arasında Trakya Üniversitesi Tıp Fakültesi Kadın Hastalıklar Servisi'nde benign pelvik kitle nedeniyle opere olmuş hastaların preoperatif, peroperatif ve postoperatif sonuçları retrospektif olarak incelendi. Pelvik kitlelerin tedavisi takip, medikal ve cerrahi tedaviyi içermekle birlikte; cerrahi tedavi çoğunlukla kesin tedaviyi sağlar. Cerrahi tedavi kararı alırken hastanın semptomları, yaşı ve risk faktörleri dikkate alınmalıdır. Pelvik kitlenin tedavisi hastanın semptomlarına, yaşına ve risk faktörlerine göre değişir. Olgu serimize 18 yaş ve üzeri, intrauterin gebeliği olmayan, jinekolojik malignitesi olmayan, benign pelvik kitle nedeniyle laparatomi yada laparoskopi yapılmış hastalar dahil edildi. Çalışmaya katılan tüm hastaların yaş ortalaması 42,9±11,6 yaş idi. 50 yaş altı 1117 hasta, 50 yaş ve üzeri 346 hasta vardı. Tüm yaş gruplarında en sık histopatoloji myomdu (%50,3) .Yaşa göre histopatolojik sınıflama yapıldığında ileri yaşta myomdan sonra endometrioma sıklıkla görülmüşken; erken yaşlarda yerini ektopik gebeliğe bırakmaktadır. Tüm yaş gruplarında overin en sık benign neoplastik tümörü seröz (kistadenom, kistadenofibrom) kist idi. Profilaktik antitrombotik (%52,2) ve profilaktik antibiyotik (%100) kullanımı oldukça yüksek orandaydı. Diyabet veya kardiyovasküler sistem hastalığı olan hasta grubunda yara yeri enfeksiyonu oranı, hastanede toplam yatış süresi ve postoperatif yoğun bakım ihtiyacı belirgin olarak yüksek bulundu. Yara yeri enfeksiyonu ile laparotominin insizyon şekli arasında anlamlı bir ilişki görülmedi . Peropertif komplikasyonların ovaryan kitlenin boyutu ile ilişkisi saptanmadı. Seçilmiş vakalarda laparoskopik yöntem tercih ettiğimiz; bu nedenle laparoskopi oranımızın düşük olduğu görüldü. Laparoskopik vakalarada laparatomi ile kıyaslandığında trasfüzyon ihtiyacı, hastanede toplam yatış süresi, iyileşme süresi, peroperatif ve postoperatif komplikasyonların belirgin olarak az olduğu görüldü.
Benign pelvic masses are pathologies with wide symptom spectrum from asymptomatic to urgent pathologies of all age groups. In our study, the preoperative, peroperative and postoperative results of the patients who underwent surgery due to a benign pelvic mass at the Trakya University Medical Faculty Department of Obstetrics and Gynecology between January 2006 and December 2016 were retrospectively analyzed. The treatment of pelvic masses includes follow-up, medical and surgical treatment; surgical treatment often provides definitive treatment. The patient's symptoms, age and risk factors should be taken into consideration when deciding on surgical treatment. The treatment of pelvic mass depends on the patient's symptoms, age and risk factors. Our patients were 18 years old and older, had no intrauterine pregnancy, had no gynecological malignancy and underwent laparotomy or laparoscopy for benign pelvic mass. The mean age of all patients was 42,9 ±11,6 years. There were 1117 patients under the age of 50, and 346 patients aged 50 and over. The most common histopathology in all age groups was myoma uteri (%50,3). It leaves its place to ectopic pregnancy at an early age. The most common benign neoplastic tumor of the ovary in all age groups was serous (cystadenoma, cystadenofibroma) cyst. Prophylactic antithrombotic (%52,2) and prophylactic antibiotic (%100) use was very high. The wound infection rate, total length of hospital stay and postoperative intensive care requirement were significantly higher in the patients with diabetes or cardiovascular system disease. There was no significant relationship between wound site infection and laparotomy incision. Peropertive complications were not associated with the size of the ovarian mass. We preferred laparoscopic method in selected cases; therefore, our laparoscopy rate was low. In laparoscopic cases, compared to laparotomy, the need for trasfusion, length of hospital stay, recovery time, and peroperative and postoperative complications were significantly lower.
Benign pelvic masses are pathologies with wide symptom spectrum from asymptomatic to urgent pathologies of all age groups. In our study, the preoperative, peroperative and postoperative results of the patients who underwent surgery due to a benign pelvic mass at the Trakya University Medical Faculty Department of Obstetrics and Gynecology between January 2006 and December 2016 were retrospectively analyzed. The treatment of pelvic masses includes follow-up, medical and surgical treatment; surgical treatment often provides definitive treatment. The patient's symptoms, age and risk factors should be taken into consideration when deciding on surgical treatment. The treatment of pelvic mass depends on the patient's symptoms, age and risk factors. Our patients were 18 years old and older, had no intrauterine pregnancy, had no gynecological malignancy and underwent laparotomy or laparoscopy for benign pelvic mass. The mean age of all patients was 42,9 ±11,6 years. There were 1117 patients under the age of 50, and 346 patients aged 50 and over. The most common histopathology in all age groups was myoma uteri (%50,3). It leaves its place to ectopic pregnancy at an early age. The most common benign neoplastic tumor of the ovary in all age groups was serous (cystadenoma, cystadenofibroma) cyst. Prophylactic antithrombotic (%52,2) and prophylactic antibiotic (%100) use was very high. The wound infection rate, total length of hospital stay and postoperative intensive care requirement were significantly higher in the patients with diabetes or cardiovascular system disease. There was no significant relationship between wound site infection and laparotomy incision. Peropertive complications were not associated with the size of the ovarian mass. We preferred laparoscopic method in selected cases; therefore, our laparoscopy rate was low. In laparoscopic cases, compared to laparotomy, the need for trasfusion, length of hospital stay, recovery time, and peroperative and postoperative complications were significantly lower.
Açıklama
Anahtar Kelimeler
Benign Pelvik Tümörler, Laparoskopi, Laparotomi, Benign Pelvic Tumors, Laparoscopy, Laparotomy.
