ISSN: 2148-8274 / E-ISSN: 2587-0084
, Türk Üreme Tıbbı ve Cerrahisi
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Turkish Journal of Reproductive Medicine and Surgery

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ORİJİNAL ARAŞTIRMALAR

Dermoid Kistlerde Beş Yıllık Tek Merkez Laparoskopik ve Laparotomik Cerrahi Deneyimi
Five Years of Single Central Laparoscopic and Laparotomic Surgery Experience in Dermoid Cysts
Received Date : 18 Dec 2020
Accepted Date : 26 Jan 2021
Available Online : 03 Feb 2021
Doi: 10.24074/tjrms.2020-80687 - Makale Dili: TR
TJRMS. 2020;4(3):90-3
ÖZET
Amaç: Ovaryan dermoid kist nedeniyle cerrahi yapılan hastaların laparoskopi ve laparotomi tekniklerine göre hastanede kalış süresi, postoperatif komplikasyonlar, hastaların yaşı, intraoperatif replasman ihtiyacı açısından retrospektif karşılaştırılmasıdır. Gereç ve Yöntemler: 2014-2019 yılları arasında Erciyes Üniversitesi Tıp Fakültesi Jinekoloji kliniğinde cerrahi uygulanan 147 dermoid kist hastası retrospektif olarak incelendi ve cerrahi tekniğine göre iki gruba ayrıldı. Bulgular: Her iki grup arasında kist çapı, bilateralite açısından anlamlı fark saptanmadı. Hastaların ortalama hastanedeki yatış süreleri laparoskopik cerrahide 2,5±1.2 gün, Total Abdominal Histerektomi (TAH) + Bilateral Salpingooferektomi (BSO)’de 3,89±2.3 gün ve laparotomik cerrahide 2,7±1.4 gün olarak saptandı. Her iki grup arasında, postoperatif komplikasyonlar açısından anlamlı farklılık saptanmamıştır (p<0,05). Laparoskopik cerrahi başlanan 1 hastada ise pnömoperitoneum nedeniyle laparotomik cerrahiye geçilmiş. Laparoskopi cerrahisi yapılan hastaların 74’ine (50% ) kistektomi, 18’ine (12%) Unilateral Salpingooferektomi (USO) yapılmış. Laparotomik cerrahi yapılan hastaların; 16’sına (11%) kistektomi, 18’ine (13%) USO, 1’i (0,68%) BSO, 19 (13%) hastaya TAH+BSO uygulanmış. Laparoskopik cerrahi yapılan 2 ve laparotomi yapılan 1 hastanın intraoperatif eritrosit replasmanı ihtiyacı olmuştur. Cerrahi yapılan kistlerin ortalama çapı 7,53±2,16 olarak belirlendi. TAH+BSO yapılan bir hastanın (0,68%) gönderilen frozen malignite şüphesi gelmesi üzerine; tamamlayıcı cerrahisi yapıldı. Sonuç: Minimal invaziv yöntemlerin dermoid kist cerrahinde kullanımı günümüzde laparotominin yerini almış durumdadır. Laparotomi ile karşılaştırıldığında; minimal invaziv cerrahi intraoperatif ve postoperatif komplikasyonların azlığı, hastanede kalış süresinin kısalığı ve az adezyon gelişimi nedeniyle daha sık tercih edilmektedir.
ABSTRACT
Objective: The aim of this study is to determine retrospective comparison of patients who underwent surgery for ovarian dermoid cysts in terms of hospital stay, postoperative complications, age of patients, and need for intraoperative replacement according to laparoscopy and laparotomy techniques. Material and Methods: 147 patients with dermoid cysts who underwent surgery in the Erciyes University Faculty of Medicine Gynecology clinic between 2014 and 2019 were retrospectively analyzed and divided into two groups according to the surgical technique. Results: There was no significant difference between the two groups in terms of cyst diameter and bilaterality. The average length of stay in the hospital was 2,5±1.2 days in laparoscopic surgery, 3,89±2.3 days in Total Abdominal Hysterectomy (TAH) and Bilateral salpingoopherectomy (BSO), and 2,7±1.4 days in laparotomic surgery. There was no significant difference between the two groups in terms of postoperative complications (p <0.05). In 1 patient who started laparoscopic surgery, there was a transition to laparotomic surgery due to pneumoperitoneum. Cystectomy was performed in 74 (50%) of the patients who underwent laparoscopic surgery, and uso was performed in 18 (12%). Patients who underwent laparotomic surgery; 16 (11%) had cystectomy, 18 (13%) Unilateral Salpingoopherectomy (USO), 1 (0.68%) BSO, 19 (13%) patients had TAH+BSO surgery. Laparotomic surgeries; Six of them were performed with the sub-umbilical midline incision, one with the midline incision above the umbilical, and the others with a phannelstiel incision. Two patients who underwent laparoscopic surgery required intraoperative erythrocyte replacement One patient who underwent laparotomy surgery needed intraoperative replacement. The mean diameter of the surgically performed cysts was determined to be 7.53 ± 2.16. When a patient (0.68%) who underwent TAH + BSO was suspected of frozen malignancy; Lymph node dissection, omentectomy and peritoneal sampling surgery were also performed. Conclusion: The use of minimally invasive methods in dermoid cyst surgery has replaced laparotomy today. Compared with laparotomy; minimally invasive surgery is preferred more frequently because of the low intraoperative and postoperative complications, short hospital stay and less adhesion development. When the patients are evaluated together with their average length of hospital stay and complications, it is recommended to use minimally invasive surgical method in benign ovarian dermoid cyst surgery.
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