Türkiye'de Tersiyer Bir Hastanede Üreme Çağı Grubunda Adneksiyal Torsiyon Tedavisinde Laparotomi ve Laparoskopik Cerrahinin Karşılaştırılması

Öz

Amaç: Kliniğimizde son 10 yıl içinde adneksal torsiyon nedeniyle cerrahi müdahale geçiren hastaların sosyodemografik ve klinik özelliklerini, laboratuvar ve patoloji sonuçlarını geriye dönük olarak değerlendirmek. Gereç ve Yöntem: Ocak 2014 ile Aralık 2024 arasında adneksal torsiyon nedeniyle cerrahi işlemler geçiren 176 hasta çalışmaya geriye dönük ve ardışık olarak dahil edilmiştir; bunlardan 146'sı laparoskopi (L/S) ile (Grup 1) ve 30'u laparotomi ile (Grup 2) tedavi edilmiştir. Katılımcıların sosyodemografik ve klinik özellikleri ile laboratuvar ve histopatoloji sonuçları geriye dönük olarak kaydedilmiş ve karşılaştırılmıştır. Bulgular: Gruplar arasında yaş, vücut kitle indeksi, sigara durumu, alkol kullanımı, gravidisite, kitle boyutu, başvuru sırasında semptomlar, torsiyone tur sayısı, torsiyone taraf, nekroz varlığı, pre- ve postoperatif hemoglobin seviyeleri, lökosit, nötrofil, lenfosit, monosit ve trombosit sayıları, kırmızı hücre dağılım genişliği, nötrofil-lenfosit oranı, trombosit-lenfosit oranı, C-reaktif protein veya eritrosit sedimentasyon hızı değerleri açısından herhangi bir fark gözlemlenmemiştir; ancak operasyon süresinde (40.81±18.09 vs 82.33±18.03, p<0.001) ve hastanede yatış gününde (3.12±1.15 vs 4.33±1.54, p=0.002) anlamlı farklılıklar belirlenmiştir. Detorsiyon + kistektomi en sık gerçekleştirilen cerrahi prosedür olurken, olgun kistik teratom en sık gözlemlenen histopatolojik bulgudur. Sonuç: Bu çalışma, L/S'nin üreme çağındaki adnexial torsiyonu olan kadınlarda sıkça gerçekleştirilen bir cerrahi prosedür haline geldiğini göstermiştir. Bu çalışmanın sonuçları, daha fazla katılımcı içeren araştırmalarla doğrulanmalıdır.

Anahtar Kelimeler

• Adneksiyal torsiyon
• klinik özellik
• laparoskopi
• laparatomi

Etik Beyan

Çalışma için 23/05/2024 tarihinde Antalya Eğitim ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu’ndan onay alınmıştır. Karar no: 7/15

A Comparison of Laparotomy and Laparoscopic Surgery in the Treatment of Adnexal Torsion in the Reproductive Age Group at a Tertiary Care Hospital in Türkiye

Öz

Objective: To retrospectively evaluate the sociodemographic and clinical characteristics, and laboratory and pathology results of patients who underwent surgical intervention due to adnexal torsion in our clinic over the previous 10 years. Materials and methods: A hundred and seventy six patients who underwent surgical procedures due to adnexal torsion, 146 of whom were treated with laparoscopy (L/S) (Group 1) and 30 with laparotomy (Group 2), between January 2014 and December 2024, were retrospectively and consecutively included in the study. The participants' sociodemographic and clinical characteristics, and laboratory and histopathology results were retrospectively recorded and compared. Results: While no difference was observed between the groups in terms of age, body mass index, smoking status, alcohol use, gravidity, mass size, symptoms on admission, torsion turn number, the torsioned site, presence of necrosis, pre- and postoperative hemoglobin levels, white blood cell count, neutrophil, lymphocyte, monocyte, and platelet counts, red cell distribution width, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, C-reactive protein, or erythrocyte sedimentation rate values, significant differences were determined in operative times (40.81±18.09 in Group 1 vs 82.33±18.03 in Group 2, p<0.001) and hospitalization days (3.12±1.15 vs 4.33±1.54, p=0.002). Detorsion + cystectomy was the most commonly performed surgical procedure, while mature cystic teratoma was the most frequently observed histopathological finding. Conclusion: This study showed that L/S has established itself as a frequently performed surgical procedure in women of reproductive age with adnexal torsion. The results of this study should now be confirmed by research involving larger numbers of participants.

Anahtar Kelimeler

• adnexial torsiyon
• clinical feature
• laparoscopy
• laparatomy

Etik Beyan

Approval for the study was obtained from the Antalya Training and Research Hospital Clinical Research Ethics Committee on 23/05/2024. Decision no: 7/15

Kaynakça

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