Üçüncü Basamak Bir Merkezde Orta ve Geç Adölesan Yaş Grubundaki Adneksiyel Kitleli Hastaların Değerlendirilmesi

Abstract

Amaç: Adneksiyel kitleler, adölesanlardaki jinekolojik cerrahilerin önemli bir sebebi olmakla birlikte erken tanı ve tedavi fertilitenin korunması açısından önemlidir. Bu çalışmanın amacı, üçüncü basamak bir merkezdeki orta ve geç adölesan adneksiyel kitleli hastaların klinik özelliklerini ve sonuçlarını analiz etmektir. Gereç ve Yöntem: Ocak 2015 ile Aralık 2019 tarihleri arasında adneksiyel kitle nedeniyle takip edilen adölesan hastalar retrospektif olarak değerlendirildi. Hastaların şikayetleri, tanıları, kitle çapları ve yerleşimleri, tedavi yöntemleri, operasyonların özellikleri ve histopatolojik sonuçlar karşılaştırıldı. Bulgular: Orta adölesan (n=20) ve geç adölesan grupta (n=121) toplam 141 hasta çalışmaya dahil edildi. Tüm popülasyonda karın ağrısı (%70,9), karında şişlik (%11,3) ve menstrüel bozukluklar (%7,1) en sık semptomlar idi. Kitlelerin %51,9’unun benign neoplastik tümör ve %1,9’unun malign tümör olduğu saptandı. Hastaların %24,8’inde operasyon düşünülmedi. Opere edilen adölesanların %65’ine laparoskopi, %95,3’üne (n=101) over koruyucu cerrahi uygulandı. En sık histopatalojik tanılar benign seröz kist (%18,9) ve matür kistik teratom (%18,9) ve hemorajik kist (%17) idi. Geç adölesan grupta laparoskopik cerrahi oranı anlamlı olarak yüksek saptandı (p=0,024). Opere edilen hastaların kitle boyutları anlamlı olarak yüksek saptandı (p<0,001). Sonuç: Erken ve geç dönem adölesan adneksiyel kitleli hastalarda malignite oranı düşüktür. Adölesan adneksiyel kitleli hastaların yönetiminde minimal invazif yöntemler ve over koruyucu müdahaleler fertilitenin korunmasında önemlidir. Anahtar Kelimeler: Adneksiyel neoplasm, adölesan, fertilite, laparoskopi, over kanseri

Keywords

• Adneksiyel neoplasm
• adölesan
• fertilite
• laparoskopi
• over kanseri

Evaluation of Patients with Adnexal Masses in the Middle and Late Adolescent Age Group in a Tertiary Care Center

Abstract

Objectives: Although adnexal masses are an essential reason for gynecological surgeries in adolescents, early diagnosis and treatment are essential for preserving fertility. This study aimed to analyze the clinical features, treatment management, and histopathological results of patients with adnexal masses in a tertiary care center in the middle and late adolescent age group. Materials and Methods: Adolescent patients with adnexal masses were evaluated retrospectively between January 2015 and December 2019. Patients were classified as middle (15-17 years) and late (18-21 years) adolescents. Patients’ complaints, diagnoses, mass diameters and locations, treatment methods, surgery characteristics, and histopathological results were compared. Results: A total of 141 patients in the middle adolescence (n=20) and late adolescence groups (n=121) were included in the study. Abdominal pain (70.9%), abdominal distension (11.3%), and menstrual disorders (7.1%) were the most common symptoms in the entire population. It was determined that 51.9% of the masses were benign neoplastic tumors, and 1.9% were malignant tumors. Surgery was not considered in 24.8% of the patients. Of the operated adolescents, 65% underwent laparoscopy, and 95.3% (n=101) underwent ovarian-preserving surgery. The most common histopathological diagnoses were benign serous cysts (18.9%), mature cystic teratoma (18.9%), and hemorrhagic cysts (17%). The laparoscopic surgery rate was significantly higher in the late adolescent group (p=0.024). The operated patients’ average mass size was significantly higher (p<0.001). Conclusion: The malignancy rate is low in patients with early and late adolescent adnexal masses. In the management of these patients, minimally invasive methods and ovarian protective interventions are essential in preserving fertility. Keywords: Adnexal neoplasm, adolescent, fertility, laparoscopy, ovarian cancer

Keywords

• Adnexal neoplasm
• adolescent
• fertility
• laparoscopy
• ovarian cancer

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