PubMed Kapalı Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10764
Browse
Item Accuracy of intra-operative frozen section in guiding surgical staging of endometrial cancer(2021) Dogan Durdag, Gulsen; Alemdaroglu, Songul; Aka Bolat, Filiz; Yilmaz Baran, Safak; Yuksel Simsek, Seda; Celik, Husnu; 0000-0002-5064-5267; 0000-0003-4335-6659; 0000-0001-5874-7324; 0000-0003-3191-9776; 0000-0003-1185-9227; 33608802; AAI-9594-2021; AAI-8400-2021; AAK-7016-2021Purpose Surgery consists the main treatment of endometrial cancer; however, decision of lypmhadenectomy is controversial. Intra-operative frozen section (FS) is commonly used in guiding surgical staging; nevertheless, there are different reports regarding its adequacy and reliability. Aim of this study is to assess accuracy of FS in predicting paraffin section (PS) results in patients with endometrium cancer. Methods Data of 223 cases, who were operated for endometrial cancer at a tertiary hospital in 2012-2019, were analyzed retrospectively. Histological type, grade, tumor diameter, depth of myometrial invasion, and cervical and adnexal involvement in frozen and paraffin section were evaluated. Positive and negative predictive values and accuracy of frozen results in predicting paraffin results for each parameter was assessed. Statistical significance was taken as 0.05 in all tests. Results Accuracy of FS in predicting PS results were 76.23% for histology, 75.45% for grade, 85.31% for depth of myometrial invasion, and 95.45% for tumor diameter. Surgery, based on FS results, caused undertreatment in 4 patients, while metastatic lymph node ratios were found in only 35.3-50.0% of cases who had high risk parameters at FS. Conclusion Our FS results have reasonable accuracy rates in predicting PS results, in comparison with the previous literature. However, even if the high risk parameters detected in FS predict PS accurately, absence of lymph node involvement in all cases with high risk parameters indicates that FS-based triage cannot prevent unnecessary lymphadenectomies.Item Does abnormal ductus venosus pulsatility index at the first-trimester effect on adverse pregnancy outcomes?(2020) Baran, Safak Yilmaz; Kalayci, Hakan; Durdag, Gulsen Dogan; Yetkinel, Selcuk; Arslan, Alev; Kilicdag, Esra Bulgan; 0000-0002-2165-9168; 0000-0002-5064-5267; 0000-0002-0942-9108; 0000-0003-4444-0027; 0000-0001-5874-7324; 32623067; AAL-1530-2021; AAI-9594-2021; AAK-8872-2021; V-1112-2019Aim: The ductus venosus pulsatility index for veins (DV PIV) has become a popular marker of the first-trimester scan. The aim of this study is to search for any difference between groups with normal and abnormal DV PIV values in terms of adverse pregnancy outcomes. Methods: We retrospectively evaluated 556 women whose first-trimester scan was performed. The ductus venosus pulsatility indices were examined at singleton pregnancies between 11 and 14 weeks of gestation. Patients were categorized as Group-I with normal DV PIV (DV PIV >= 0.73, <= 1.22) and as Group-II with abnormal DV PIV. Group-II was subgrouped as Group-IIA which composed of patients with DV PIV < 0.73 and as Group-IIB with DV PIV > 1.22. Results: There were 451 subjects in Group-I and 105 subjects in Group-II (Group-IIA = 32 and Group-IIB 73). The comparisons between major groups revealed a statistically significant increase about miscarriage (p = 0.002), stillbirth (p < 0.001), small for gestational age (p = 0.033), low birth weight (p < 0.001), fetal growth restriction (p = 0.048), and major congenital heart defect (p=<0.001) in Group-II. This difference is mainly due to Group-IIB. There is no difference in preterm delivery, preeclampsia and gestational diabetes between Group I and II. Conclusion: Routinely monitoring DIV PIV as a first-trimester screening should provide valuable information regarding adverse pregnancy outcomes such as miscarriage, stillbirth, small for gestational age, low birth weight, fetal growth restriction and major congenital heart defect. (C) 2020 Elsevier Masson SAS. All rights reserved.Item Is fetal magnetic resonance imaging indicated in patients with isolated ventriculomegaly?(2019) Durdag, Gulsen Dogan; Baran, Safak Yilmaz; Kalayci, Hakan; Alkan, Ozlem; 0000-0001-5874-7324; 31228676; ABF-6439-2020Objective: Ventriculomegaly is one of the most common anomalies encountered at obstetric ultrasound and it necessitates follow up. Fetal magnetic resonance imaging (MRI) can be used to confirm the ultrasound diagnose or to detect additional anomalies. Aim of this study is to assess follow up and management of fetal ventriculomegaly shown by ultrasound, and to evaluate additional diagnostic contribution of MRI. Study Design: This study was conducted retrospectively including 89 patients who had fetal MRI subsequent to ultrasound diagnose of ventriculomegaly in between 2011-2017. Medical records of patients were investigated and accompanying anomalies, congenital infection. chromosomal examination, degree and progression of ventriculomegaly, neonatal imaging and diagnose, and neurodevelopmental findings on follow up were evaluated. Patients were classified in two groups as isolated and nonisolated ventriculomegaly, and subgroups mild, moderate, severe were formed according to their findings. SPSS 23.0 programme was used for statistical analysis. Results: Ultrasound and following MRI was performed in a range of 18-35 th gestational weeks, diagnoses were isolated ventriculomegaly for 56 patients and nonisolated ventriculomegaly for 33 patients. Progression and neurodevelopmental delay was higher in severe nonisolated ventriculomegaly group. There was not significant contribution of MRI in the follow up of isolated ventriculomegaly (p < 0.001), and diagnostic imaging findings declined in neonatal period with proceeding normal neurodevelopment in 92.7% of patients followed with diagnosis of isolated ventriculomegaly. Conclusion: When isolated ventriculomegaly is detected, ultrasound performed by an experienced team is mostly sufficient. MRI can be used in suspicious cases or when ventriculomegaly progresses. (C) 2019 Elsevier B.V. All rights reserved.Item Laparoscopic para-aortic lymphadenectomy: Technique and surgical outcomes(2021) Durda, Gulsen Dogan; Alemdaroglu, Songul; Baran, Safak Yilmaz; Yaginc, Didem Alkas; Simsek, Seda Yuksel; Celik, Husnu; 0000-0003-4335-6659; 0000-0001-5874-7324; 0000-0001-8309-3537; 0000-0003-1185-9227; 32961327; AAI-8400-2021; AAK-2461-2021; AAL-1923-2021Objective: Pelvic and para-aortic lymph node dissection is an important part of staging surgery. Aim of this study is to evaluate perioperative outcomes of patients, who underwent laparoscopic para-aortic lymphadenectomy for gynecological cancer in a single center over a period of 7 years, based on body mass index (BMI), and to present the surgical technique in steps. Methods: Data of patients who underwent para-aortic lymphadenectomy at gynecological oncology department of a tertiary center in between March 2013 and July 2020 were analyzed retrospectively. Patients were evaluated in two groups according to their BMI (< 30 kg/m(2) as non-obese and >= 30 kg/m(2) as obese groups). Surgical technique is described in steps. Perioperative outcomes of the two groups were evaluated. Results: A total of 230 patients were included in the study. BMI was >= 30 at 58.46 % of the patients. Perioperative features were not significantly affected by the patient's BMI with the presented surgical technique, however, collected para-aortic lymph node numbers were higher in the group with BMI <30, though sufficient number of lymph nodes were achieved in both groups. Conclusion: Although some technical difficulties may be encountered, laparoscopic para-aortic lymphadenectomy is feasable in gynecologic oncological surgery independent of BMI. However, surgical experience is important. (C) 2020 Elsevier Masson SAS. All rights reserved.Item Role of prophylactic and therapeutic red blood cell exchange in pregnancy with sickle cell disease: Maternal and perinatal outcomes(2020) Baran, Safak Yilmaz; Kozanoglu, Ilknur; Korur, Asli; Durdag, Gulsen Dogan; Kalayaci, Hakan; Alemdaroglu, Songul; Asma, Suheyl; Kilicdag, Esra Bulgan; Boga, Can; 0000-0002-0942-9108; 0000-0002-5086-5593; 0000-0002-5268-1210; 0000-0003-4335-6659; 0000-0001-5335-7976; 0000-0002-5064-5267; 0000-0002-8902-1283; 0000-0001-5874-7324; 0000-0002-9680-1958; 32797735; ABF-6439-2020; AAK-8872-2021; AAD-5616-2021; AAD-6222-2021; AAE-1241-2021; AAI-8400-2021; AAI-7831-2021; AAI-9594-2021; AAD-5542-2021Background and Aim The incidence of fetomaternal complications during pregnancy is high for women with sickle cell disease (SCD), which is the most common hematologic genetic disorder worldwide. Prophylactic red blood cell exchange (pRBCX) has been shown to be efficient, safe, and feasible for preventing complications. The aim of this study was to observe maternal, perinatal, and neonatal outcomes of pregnancies in which pRBCX was. Method This was a single-center, retrospective, cross-sectional study, which recruited 46 consecutive adult pregnant women with SCD between January 2012 and June 2019. Obstetric features, SCD-related complications, and fetomaternal outcomes were compared between the 27 patients who received prophylactic exchange and the 19 who did not (therapeutic exchange was performed in 7 and was not performed in 12 cases). Results Painful crises, preeclampsia, and preterm birth rates were significantly higher in the group that did not receive prophylactic exchange (control group;P= .001,P= .024, andP= .027, respectively). There was one maternal mortality in the control group (P= .41). Incidence of adverse fetal or maternal complications was significantly higher in the control group (P= .044 andP= .007, respectively). Conclusions Our center's experience over a 7.5-year period, as described above, demonstrates that pRBCX in SCD affects the course of pregnancy positively by ameliorating negative fetomaternal outcomes.Item Single- or double-layer uterine closure techniques following cesarean: A randomized trial(2020) Yilmaz Baran, Safak; Kalayci, Hakan; Dogan Durdag, Gulsen; Yetkinel, Selcuk; Alemdaroglu, Songul; Cok, Tayfun; Bulgan Kilicdag, Esra; 0000-0002-5064-5267; 0000-0002-2165-9168; 0000-0003-4335-6659; 0000-0002-0942-9108; 0000-0002-7854-2921; 0000-0001-5874-7324; 33029804; AAI-9594-2021; AAL-1530-2021; AAI-8400-2021; AAK-8872-2021; A-8208-2008; ABF-6439-2020Introduction Cesarean deliveries are commonly performed throughout the world. Although the uterine closure technique following this procedure may influence how the uterine scar heals, there is insufficient evidence for choosing the appropriate technique and so preventing long-term negative consequences. This prospective, randomized study examined the effects of single- and double-layer uterine closure techniques on uterine scar healing following cesarean delivery. Material and methods This study assessed a total of 282 women aged 18-45 years who were in gestational weeks 24-41 of singleton pregnancies. None had previously undergone uterine surgeries. These participants completed their first cesarean deliveries at the time of study and were randomized into the following two treatment groups: single-layer closure with locking and double-layer closure with locking in the first layer, but not in the second layer (NCT03629028). However, the decidua was not included for treatment in either group. Participants were evaluated at 6-9 months after cesarean section by saline infusion sonohysterography to assess cesarean delivery scar defects. These procedures were conducted by experienced sonographers who were not aware of the uterine closure technique. Results Of the 225 final participants, 109 received the single-layer closure technique, whereas 116 received the double-layer technique. The niche rates were 37% (n = 40) for the single-layer group and 45.7% (n = 53) for the double-layer group (P = .22, relative risk 1.4, 95% CI = 0.8-4.4). Conclusions The single- and double-layer closure techniques did not produce different impacts on uterine scar niche development.