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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Kliniğimizde Yapılan Laparoskopik ve Laparotomik Myomektomilerin Değerlendirilmesi
Evaluation of Laparoscopic and Laparotomic Myomectomies in Our Clinic
Received Date : 09 Dec 2020
Accepted Date : 26 Jan 2021
Available Online : 03 Feb 2021
Doi: 10.24074/tjrms.2020-80467 - Makale Dili: TR
TJRMS. 2020;4(1):24-8
ÖZET
Amaç: Çalışmamızın amacı kliniğimizde laparoskopik ve laparotomik yöntemle myomektomi yaptığımız toplam 102 hastanın sonuçlarını retrospektif olarak literatür eşliğinde incelemektir. Gereç ve Yöntemler: Koşuyolu Medipol Hastanesi Kadın Hastalıkları ve Doğum Kliniği’nde Ocak 2013-Ocak 2019 tarihleri arasında laparoskopik myomektomi yapılan 56 hasta ve laparotomik myomektomi yapılan 46 hasta ameliyat endikasyonları, komplikasyonlar, preoperatif ve postoperatif hemoglobin değerleri, transfüzyon ihtiyacı, ameliyat süresi ve hastanede kalış süresi açısından retrospektif olarak değerlendirildi. Bulgular: Laparoskopik ve laparotomik myomektomi yapılan hastaların yaş ortalaması sırasıyla 36.85 ± 6.39 ve 38.91 ± 5.29 idi (p: 0.08). Operasyon süresi sırasıyla 108.68 ± 42.67 ve 84.4 ± 26.6 dakikaydı (p:0.003). Hastanede yatış süresi laparoskopik myomektomi grubunda anlamlı olarak düşüktü (p<0.05). Preoperatif hemoglobin değerleri gruplar arası benzer iken, postoperatif hemoglobin değerleri laparoskopik ve laparotomik myomektomi yapılan hastalarda sırasıyla 10.5 ± 1.51 ve 9.7 ±1.14 olduğu gözlendi (p: 0.03). Trasfüzyon ihtiyacı gruplar arası benzerdi (p: 0.28). Sonuç: Laparoskopik miyomektomi birçok açıdan laparotomik miyomektomiye tercih edilebilecek bir yöntemdir. Daha erken taburcu olma ve rutin hayatına erken dönme gibi üstünlükleri vardır. Laparoskopi cerrahi ekipman çeşitlerinin artması, animasyon, kadavra ve video eğitim imkanlarının yaygınlaşması sayesinde gün geçtikçe artan sıklıkla yapılacak cerrahilerdendir. Pratik uygulamaların sıklaşması ve yetkin bireylerden kurulu cerrahi ekiplerin elinde, şimdilik handikap gibi görülen uzun ameliyat sürelerinin de kısalacağını düşünmekteyiz.
ABSTRACT
Objective: The aim of this study is to evaluate the results of laparoscopic and abdominal myomectomy procedures with respect to preoperative and postoperative hemoglobin/hematocrite values, operation time, size of leimyomas, transfusion need, hospital stay time and complications. Material and Methods: In this study, we retrospectively evaluated 102 cases who were performed myomectomy operation at Obstetrics and Gynecology Clinic of Istanbul Koşuyolu Medipol Hospital between 2013-2019. All cases were divided into two groups with respect to the surgical procedure performed. 46 patients were in the abdominal myomectomy group, 55 patients were in the laparoscopic myomectomy group and the both groups were compared. Results: There is no significant difference in age, postoperative need for transfusion between the groups. The mean number of parity was higher in the laparoscopic myomectomy group. In abdominal myomectomy group, number of cases, in which myoma was greater than 5cm in diameter, were almost equal to laparoscopic myomectomy group, however mean size of leimyomas of laparotomies 83mm was greater than the mean size of leimyomas of laparoscopies 61mm. The duration of hospital stay was longer (p <0.05), and operation time was shorter ( p:0,003) and while postoperative hemoglobin levels were lower in laparotomic myomectomy group when compared with laparoscopic myomectomy group (p:0.03). Conclusion: The laparoscopy was more advantageous than abdominal surgery with hospital stay time, postoperative hemoglobin levels.
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