The Effect Of Salphingectomy On Ovarian Function Via Laparotomy Vs Laparoscopy In Patients With Ectopic Pregnancy

Öz

Aim: The aim of this study is to compare the changes of ovarian function in patients underwent laparoscopic or laparotomic salpingectomy for the treatment of ectopic pregnancy.Material and Methods: In this prospective study, the changes of ovarian function in patients administrated to our hospital within the period of March 2013 to June 2015 with ectopic pregnancy treated by laparoscopic and laparotomic salpingectomy tecniques were observed. On 2-4. day of menstruation the antral follicle counts, ovarian volumes and ovarian stromal blood flow characteristics including Peak Systolic Velocity, End Diastolic Velocity, Resistance Index and Systolic/Diastolic ratio in both ovaries of the patients were evaluated by transvaginal ultrasound and Doppler ultrasound by a single person in gynecology outpatient clinic. All these patients met the following criteria: unilateral salpingectomy at least 3 months ago, no history of ovarian or other tubal surgery, no extensive pelvic adhesion found during the operation, no ovarian cyst on pelvic ultrasound scan examinations, and no hormonal treatment for the preceding 3 months.Patients were divided into two groups examining laparotomic and laparoscopic tecniques. This study was included 32 patients with ectopic pregnancy treated by laparoscopic salpingectomy and 25 patients with ectopic pregnancy treated by laparotomic salpingectomy. For all patients included in this study, demographic data, obstetric history and the measurements of ovaries were recorded.Results: Demographic features of the patients in both groups were similar. There is no statistical significant difference between two groups in the manner of antral follicle counts of the ovaries, ovarian volume and ovarian stromal blood flow at the operated side. Similarly, there is no statistical significant difference between two groups in the manner of antral follicle counts of the ovaries, ovarian volume and ovarian stromal blood flow at the non operated side.Conclusion: When our study is analyzed, there is no statistical significant difference between the laparoscopic and laparotomic salpingectomy tecniques in the manner of changes of ovarian function tests after the surgery.

Anahtar Kelimeler

• Ectopic pregnancy,laparoscopy,laparotomy,salpingectomy,ovarian function

Ektopik Gebelikte Salpenjektominin Laparatomik veya Laparoskopik Yöntemle Yapılmasının Over Fonksiyonu Üzerine Etkisi

Öz

Giriş: Ektopik gebelik nedeniyle salpenjektomi olan hastalarda operasyonun laparotomik veya laparoskopik teknikle yapılmasının over fonksiyon testleri üzerine etkisinin olup olmadığının karşılaştırılması amaçlanmıştır.Gereç ve Yöntemler: Prospektif dizayn ile tasarlanmış olan çalışmamızda, ektopik gebelik nedeniyle salpenjektomi olan hastaların over fonksiyon testlerini incelemek amacıyla, jinekoloji polikliniğinde adetlerinin 2-4. günü arasında tek kişi tarafından ultrasound yapılarak hastaların opere olan ve olmayan taraftaki overlerine bakılmıştır. Her iki overdeki antral folliküller sayılmış, her iki overin volümleri ölçülmüş, her iki overin stromal kan akımları Doppler ultrasonografi uygulanarak Peak Sistolik Velosite PSV , End Diyastolik Velosite EDV , Rezistans Index RI ve Sistolik/Diyastolik S/D oranları ölçülmüştür. En az 3 ay önce unilateral salpenjektomi operasyonu geçiren, daha önce over veya tubal bir cerrahi geçirmemiş olan, ameliyatında yaygın pelvik yapışıklık olmayan, ultrasonografide kist izlenmeyen ve son 3 aydır hormonal tedavi almayan hastalar çalışmaya dahil edilmiştir. Hastalar laparotomik ve laparoskopik cerrahi yöntemlerinin değerlendirildiği iki grupta incelenmiştir. Gruplar 32 olgunun incelendiği laparoskopik yaklaşımla salpenjektomi ve 25 olgunun incelendiği laparotomik yaklaşımla salpenjektomi grubu olarak oluşturulmuştur. Çalışmaya dahil edilen tüm hastaların demografik verileri, obstetrik öyküleri ve overlerin ultrasonografik ölçümleri kaydedilmiştir.Bulgular: Her iki gruptaki hastaların demografik özellikleri birbirine benzer saptandı. Her iki grup arasında opere olan taraftaki overlerin antral follikül sayıları, overlerin volümleri ve overlerin stromal kan akımları açısından istatistiksel açıdan anlamlı fark izlenmedi. Aynı şekilde her iki grup arasında opere olmayan taraftaki overlerin follikül sayıları, overlerin volümleri ve overlerin stromal kan akımları açısından istatistiksel açıdan anlamlı fark izlenmedi.Sonuç: Çalışmamız incelendiğinde, laparoskopi veya laparotomi ile salpenjektomi yöntemlerinde cerrahi uygulama sonrası her iki overin fonksiyonlarının etkilenmesi açısından, teknik yaklaşım olarak anlamlı bir fark saptanmamıştır.

Anahtar Kelimeler

• Ektopik gebelik,laparoskopi,laparotomi,salpenjektomi,over fonksiyonu

Kaynakça

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