21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
www.minimalinvazivjinekolojikcerrahi.org
Demographic and clinical characteristics of the study group
Age (Mean±SD)
47.36±2.16
Gravidity Median (Min-Max)
3 (2-6)
BMI (kg/m2) (Mean±SD)
28.80± 4.49
Amenorrhea n(%)
3 (10%)
Intermenstruel spotting n(%)
6 (21%)
Requirement of hysterectomy n(%)
2(6%)
BMI: Body Mass Index
Power Doppler flow, ultrasonographic, and clinical characteristics
Variables
n (%)
Study group(n=28)
Baseline
6 months
P
Uterine volume (cm3)
830±328
781±316
0.654
Leiomyoma size (mm)
39.8±10.5
38.6±13.9
0.509
Endometrial thickness (mm)
6.7±0.9
3.6±0.8
<0.001*
Hemoglobin
11.13±1.27
12.51±1.21
<0.001*
Uterine artery PI
2.04±0.51
2.30±0.61
0.07
Uterine
artery RI
0.84±0.13
0.86±0.15
0.757
PBAC score
153 (72-225)
35 (0-105)
<0.001*
*P<0.05, statistically significant. PI: Pulsatility Indıces, RI:Resistance indices, PBAC: Pictorial Blood
Loss Assessment Chart
www.minimalinvazivjinekolojikcerrahi.org
21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
SS-05
Comparison of cost-effectivenes and clinical outcomes of abdominal, vaginal and total
laparoscopic hysterectomy in a selected group
Evrim Bostancı
Zeynep Kamil Maternity and Children’s Training and Research Hospital,
Department of
Obstetrics and Gynecology, Istanbul, Turkey
OBJECTIVE: The aim was to compare the perioperative and postoperative outcomes of
total laparoscopic hysterectomy(TLH), total abdominal hysterectomy(TAH), and vaginal
hysterectomy(VH) in a selected group of patients.
MATERIALS-METHODS: Two hundred twenty-three hysterectomies were included in this study.
The patients were separated into three groups. Group1 included patients with TLH(n=63); TAH
patients were placed in Group 2(n=133), and Group 3 was made up of patients who underwent
VH(n=37). All
three groups had similar ages, parities, and uterine sizes. The main outcome
measures were operation time, fever, need for analgesia, duration of hospital survellience,
return
to work time, perioperative and postoperative complications, the number of blood transfusions,
and costs of the surgery.
RESULTS: The total operation time was the shortest in the VH group. There was no significant
difference in the hospital survellience duration between the three groups. The VH was found to
be the cheapest type of hysterectomy. When the VH group was compared with the TLH group,
there was no difference in the use of analgesics for postoperative pain or the time return to work.
The VH group patients required more blood transfusions in contrast with the TAH(p=0.001) and
TLH groups(p<0.001).
CONCLUSION: VH had similar operative and postoperative outcomes but the shortest duration
of operation and the lowest surgical cost compared with the other two techniques.
Keywords: total laparoscopic hysterectomy,
total abdominal hysterectomy, vaginal
hysterectomy, cost-effectiveness, complication
clinical variables of the study participants.
VH
TLH
TAH
p
Operation time(min)
82.2±22.4
109.7±32.1
89.1±20.8
<0.0001
To return to work time(days)
6.8±1.7
7.3±1.9
7.3±1.9
<0.0001
Analgesia for postoperative
pain(amp)
4.2±1.6
4.6±1.4
4.7±1.4
0.206
Cost of surgery(TL)
893.4±178.6
1695.7±630.1 1052.0±114.4 <0.0001
21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
www.minimalinvazivjinekolojikcerrahi.org
SS-06
Laparoscopic ovarian transposition before pelvic irradiation: results of a tertiary center
experience
Oguzhan Kuru,
Gokhan Boyraz, Coskun Salman, Kunter Yuce, Nejat Ozgul
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology,
Faculty of
Medicine, Hacettepe University, Ankara, Turkey
AIM: To report the experience of a tertiary center with laparoscopic ovarian transposition in
patients who require pelvic irradiation as part of their cancer therapy.
Design: Cohort study
Setting: The gynecological oncology clinic in a referral center in Turkey.
Patients: 8 premenopausal patients treated with radiotherapy for a pelvic malignancy.
Intervention: Laparoscopic ovarian transposition to paracolic peritoneum with tubes preserved.
RESULTS: Procedure was performed in 8 patients to be unilateral in 2 patients. The indication
was Ewing sarcoma in 1 patient, rectum ca in 3
patients, Hodgkin lymphoma in 2 patients, vulva
ca in 1 patient, and rhabdomyosarcoma in 1 patient. In 1 patient, 3 months after surgery, torsion
occurred in the transposed ovary and metastatic disease was detected after ooferectomy was
performed. After exclusion of one pre-menarchal girl, ovarian preservation was achieved in 71%
(5/7) of the patients.
CONCLUSION: Laparoscopic ovarian transposition is a safe and feasible procedure in terms of
ovarian preservation. The procedure should be considered as an option
for patients who want to
preserve their fertility/hormonal function before the radiation treatment of pelvic malignancy.
Keywords: Ovarian transposition, laparoscopy, pelvic irradiation