ELECTIVE GYNECOLOGICAL SURGERY DURING COVID-19 PANDEMIC: A SINGLE CENTER EXPERIENCE

Yıl 2025, Cilt: 26 Sayı: 1, 69 - 75, 27.01.2025

Rıza Dur , Fatih Çelik , Betül Ahat , Mariam Chkhikvadze , Ayşe Yalçınkaya Yılmaz , Mine Kanat Pektaş

https://doi.org/10.18229/kocatepetip.1471868

Öz

OBJECTIVE: This study aims to assess the experience of a tertiary health center about the elective gynecological operations between the two peaks of COVID-19 pandemic.
MATERIAL AND METHODS: This is a retrospective review of 609 patients who underwent elective gynecological surgery at Afyonkarahisar Health Sciences University Hospital from 15 March 2020 to 30 April 2021.
RESULTS: All patients tested negative for COVID-19 preoperatively and 17 patients (2.8%) contracted COVID-19 during the 8-week-long period after the hospital discharge. The averagetime to test positivity was calculated as 4.0±1.3 weeks (range:2-7 weeks). The most common indications for elective gynecological surgeries were abnormal bleeding (30.9%), adnexal mass (19.2%) and uterine leiomyoma (16.9%). Operative hysteroscopy was the most performed gynecological operation (26%),followed by abdominal hysterectomy (17.6%) and laparoscopic hysterectomy (16.2%). The concurrence of hypertension and diabetes mellitus, incompetent cervix and cervical cerclage wassignificantly more prevalent in the patients who tested positive for COVID-19 after surgery (p=0.001 for all). The patients whotested positive for COVID-19 following hospital discharge andthose who did not contract COVID-19 were statistically similarwith respect to postoperative complications and duration ofhospitalization. Four patients (0.65%) who underwent electivegynecological surgery died within 8 weeks following the hospital discharge. None of the deaths were related to COVID-19infection.
CONCLUSIONS: Performing elective gynecological surgery appears as a safe approach during COVID-19 pandemic. Concurrent existence of hypertension and diabetes mellitus and cervical cerclage might be associated with postoperative contagion of COVID-19.

Anahtar Kelimeler

COVID-19, Gynecology, Surgery

COVİD-19 PANDEMİSİ SIRASINDA ELEKTİF JİNEKOLOJİK CERRAHİ: TEK MERKEZ DENEYİMİ

Öz

AMAÇ: Bu çalışma, tersiyer bir sağlık merkezinin, COVID-19 salgınının iki pik dönemi arasındaki elektif jinekolojik operasyonlarla ilgili deneyimini değerlendirmeyi amaçlamaktadır.
GEREÇ VE YÖNTEM: 15 Mart 2020 ile 30 Nisan 2021 tarihleri arasında Afyonkarahisar Sağlık Bilimleri Üniversitesi Hastanesi'nde elektif jinekolojik cerrahi uygulanan 609 hasta retrospektif olarak incelenmiştir.
BULGULAR: Tüm hastaların ameliyat öncesinde yapılan covid-19 testleri negatif çıkmış ve 17 hasta (%2,8) hastaneden taburcu olduktan sonraki 8 haftalık süreçte COVİD-19'a yakalandı. Pozitif test sonucunun elde edilmesi için geçen ortalama süre 4,0±1,3 hafta (aralık: 2-7 hafta) olarak hesaplandı. Elektif jinekolojik ameliyatların en sık endikasyonları anormal kanama (%30,9), adneksiyal kitle (%19,2) ve uterin leiomyoma (%16,9) idi. Operatif histeroskopi en çok uygulanan jinekolojik operasyon (%26) olurken, bunu abdominal histerektomi (%17,6) ve laparoskopik histerektomi (%16,2) izledi. Hipertansiyon ve diyabet birlikteliği, servikal yetmezlik ve servikal serklaj, ameliyat sonrası COVİD-19 testi pozitif çıkan hastalarda anlamlı olarak daha fazla görüldü (tümü için p=0,001). Hastaneden taburcu olduktan sonra COVİD-19 testi pozitif çıkan hastalar ile covid-19'a yakalanmayanlar, ameliyat sonrası komplikasyon ve hastanede kalış süresi açısından istatistiksel olarak benzerdi. Elektif jinekolojik cerrahi uygulanan 4 hasta (%0,65) hastaneden taburcu olduktan sonraki 8 hafta içinde hayatını kaybetti. Ölümlerin hiçbiri COVİD-19 enfeksiyonuyla ilgili değildi.
SONUÇ: Elektif jinekolojik cerrahinin uygulanması COVID-19 salgını sırasında güvenli bir yaklaşım olarak karşımıza çıkmaktadır. Hipertansiyon ve diyabetin eş zamanlı varlığı ve servikal serklaj, COVİD-19'un postoperatif bulaşmasıyla ilişkili olabilir.

Anahtar Kelimeler

covid-19, jinekoloji, cerrahi

Kaynakça

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