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Dağdelen C, Erdemoğlu E. Determination of the Readability Level of Consent Forms Used in the Gynecology and Obstetrics Clinic at Suleyman Demirel University. Cureus 2023; 15:e37147. [PMID: 37026110 PMCID: PMC10074016 DOI: 10.7759/cureus.37147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 04/08/2023] Open
Abstract
Background This study aimed to evaluate the readability level of consent forms used for interventional procedures in the obstetrics and gynecology clinic and to determine the readability of the texts according to the education level of the patient. Methodology This study determined the readability of patient consent forms used before interventional procedures in the gynecology and obstetrics clinic at the Suleyman Demirel University Hospital, Isparta. The consent forms were divided into two main groups according to their use in obstetrics and gynecology procedures. The readability level of consent forms was assessed using two readability formulas developed by Ateşman and Bezirci-Yılmaz, which determine the readability level of Turkish texts in the literature. Results When the consent forms were analyzed according to Atesman's readability formula, they were found to be readable with more than 15 years of education at the undergraduate level, while according to Bezirci-Yılmaz's readability formula, they were found to be readable with 17 years of education at the postgraduate level. Conclusions Easy-to-read consent forms will ensure that patients are more informed about interventional procedures and participate more effectively in the treatment process. There is a need to develop readable consent forms suitable for the general education level.
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Affiliation(s)
- Cem Dağdelen
- Clinic of Obstetrics and Gynecology, Isparta Private Meddem Hospital, Isparta, TUR
| | - Evrim Erdemoğlu
- Department of Gynecologic Oncology, Suleyman Demirel University, Isparta, TUR
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Erkılınç G, Yüceer RO, Erdemoğlu E, Kaymak ZA, Darbaş ŞM, Bozkurt KK, Çiriş İM. The expression of stanniocalcin-1, estrogen receptor and progesterone receptor in endometrioid endometrial cancer. Turk J Obstet Gynecol 2023; 20:8-15. [PMID: 36908008 PMCID: PMC10013080 DOI: 10.4274/tjod.galenos.2023.93646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
Objective To evaluate the expression of stanniocalcin-1 (STC-1) and to investigate the correlation of STC-1 with expression of estrogen receptor (ER), progesterone receptor (PR) and clinical parameters, histopathological findings and prognostic factors in endometrioid endometrial cancer (EEC). Materials and Methods In this retrospective study, STC-1 (cytoplasmic), ER (nuclear), and PR (nuclear) stainings were applied to tissue microarray sections of 89 EEC, 27 endometrial intraepithelial neoplasia (EIN), and 21 normal endometrium (NE). Prognostic factors such as age, tumor size, depth of myometrial invasion, lymphovascular invasion, perineural invasion, and lymph node metastasis were compared with the expression of these markers. Results ER showed significantly higher positivity in grade 1 EEC. PR expression was also higher in grade 1 EEC, but these findings were not statistically significant. Strong expression of STC-1 was observed in EIN and EECs compared with NE. STC-1 showed low staining in the NE, and high staining was also noted in the EIN foci adjacent to the NE. STC-1 expression was positively correlated with grade 1 EECs. Conclusion STC-1 expression was positively correlated with low histologic grade in EECs. STC-1 can be used for distinguishing low-grade endometrioid tumors and high -grade endometrioid tumors in curretage specimens. Since STC-1 is related to well differentiated tumors, it can also be regarded as a good prognostic factor in EECs.
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Affiliation(s)
- Gamze Erkılınç
- İzmir Urla State Hospital, Medical Pathology Laboratory, İzmir, Turkey
| | | | - Evrim Erdemoğlu
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology/Gynecological Oncology, Isparta, Turkey
| | - Zümrüt Arda Kaymak
- Süleyman Demirel University Faculty of Medicine, Department of Radiation Oncology, Isparta, Turkey
| | - Şerife Mehtap Darbaş
- Bartın State Hospital, Clinic of Internal Medicine/Department Endocrinology and Metabolic Disease, Bartın, Turkey
| | - Kemal Kürşat Bozkurt
- Süleyman Demirel University Faculty of Medicine, Department of Medical Pathology, Isparta, Turkey
| | - İbrahim Metin Çiriş
- Süleyman Demirel University Faculty of Medicine, Department of Medical Pathology, Isparta, Turkey
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Tezcan AY, Can Iscan S, Erdemoğlu E, Güney M. 2022-RA-1316-ESGO Do other high risk HPV types positive cases deserve colposcopy? Diagnostics (Basel) 2022. [DOI: 10.1136/ijgc-2022-esgo.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Bozkurt KK, Çiriş İM, Başpınar Ş, Çetin B, Erdemoğlu E, Bircan S, Ertunç O. The Prognostic Effect of HER2 Gene Amplification in High-Grade Endometrial Carcinomas and its Correlation with Protein Overexpression. Int J Surg Pathol 2022; 31:365-374. [PMID: 35611517 DOI: 10.1177/10668969221102529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction. New therapeutic agents and biomarkers are needed for the treatment of aggressive endometrial cancer subtypes. Recently, HER2 has been recommended to be tested routinely in serous endometrial cancers. The aim of this study is to investigate the correlation between HER2 (ERBB2) protein overexpression and HER2 gene amplification and the relationship of HER2 gene amplification with prognosis in cancers with serous morphology. In addition, the concordance of HER2 testing in paired curettage and hysterectomy specimens is also investigated. Methods. Twenty five serous carcinomas and 8 carcinosarcomas with a serous morphology were included in the study. HER2 staining was performed on whole tissue sections by immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH). The system, which was proposed by Fader et al was used to evaluate the stainings. Results. Protein overexpression was detected in 27.3% (n = 9) of the cases, and gene amplification in 30.3% (n = 10). A significant positive correlation was found between the two methods (P < .0001). HER2 IHC revealed a heterogeneous staining pattern, such as intense complete membranous in solid areas, and basolateral in papillary and glandular areas. HER2 gene amplification was significantly associated with shorter overall (P = .005) and disease-free (P = .014) survival. The concordence of the results in curettage and hysterectomy specimens was also significantly high. Conclusion. HER2 is an important prognostic and predictive marker for endometrial cancers with serous morphology. HER2 IHC/ISH testing can be performed by using diagnostic curettage specimens which contain enough viable tumor cells. However, pathologists should be aware of the intratumoral heterogeneity for HER2 staining.
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Affiliation(s)
- Kemal Kürşat Bozkurt
- Department of Pathology, Faculty of Medicine, 64076Süleyman Demirel University, Isparta, Turkey
| | - İbrahim Metin Çiriş
- Department of Pathology, Faculty of Medicine, 64076Süleyman Demirel University, Isparta, Turkey
| | - Şirin Başpınar
- Department of Pathology, Faculty of Medicine, 64076Süleyman Demirel University, Isparta, Turkey
| | - Bülent Çetin
- Department of Medical Oncology, Faculty of Medicine, 64076Süleyman Demirel University, Isparta, Turkey
| | - Evrim Erdemoğlu
- Department of Gynecologic Oncology, Faculty of Medicine, 64076Süleyman Demirel University, Isparta, Turkey
| | - Sema Bircan
- Department of Pathology, Faculty of Medicine, 64076Süleyman Demirel University, Isparta, Turkey
| | - Onur Ertunç
- Department of Pathology, Faculty of Medicine, 64076Süleyman Demirel University, Isparta, Turkey
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Kaymak ZA, Karahan N, Erdoğan M, Erdemoğlu E, Zihni İ, Şengül SS. Correlation of 18F-FDG/PET SUV max, SUV mean, MTV, and TLG with HIF-1α in Patients with Colorectal Cancer. Mol Imaging Radionucl Ther 2021; 30:93-100. [PMID: 34082509 PMCID: PMC8185477 DOI: 10.4274/mirt.galenos.2021.04934] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objectives: Post-hypoxia hypoxia-inducible factor (HIF)-1α activation plays a vital role in colorectal cancer (CRC) angiogenesis. Although glucose metabolism is induced in some cancer types via HIF-1α, the prognostic significance of HIF-1α in CRC and its correlation with 18fluorinefluorodeoxyglucose (18F-FDG) uptake in positron emission tomography (PET) remain controversial. This study aims to investigate the association between 18F-FDG/PET parameters and HIF-1α expression in CRC. Methods: Thirty-six histopathologically confirmed patients with CRC who had 18F-FDG/PET scans before surgery were enrolled in the study. The correlations between the maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV), total lesion glycolysis, HIF-1α overexpression, and histopathological features were evaluated. Results: The tumor location, tumor diameter, perineural invasion, lymphovascular invasion, T and N stage were not significantly correlated with HIF-1α overexpression. In contrast, the tumor differentiation was negatively correlated with HIF-1α expression (r=-0.332, p=0.048). None of the 18F-FDG/PET parameters was significantly correlated with HIF-1α overexpression. A significant relationship was found between tumor differentiation, tumor necrosis percentage, and MTV (p=0.030, p=0.020). Conclusion: The expected association between HIF-1α overexpression and 18F-FDG/PET parameters was not found in this study. However, there was a relationship between MTV, tumor differentiation, and tumor necrosis percentage. Hence, further studies are required to predict the pathological and prognostic courses of CRC using a diagnostic 18F-FDG/PET evaluation.
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Affiliation(s)
- Zümrüt Arda Kaymak
- Süleyman Demirel University Faculty of Medicine, Department of Radiaiton Oncology, Isparta, Turkey
| | - Nermin Karahan
- Süleyman Demirel University Faculty of Medicine, Department of Pathology, Isparta, Turkey
| | - Mehmet Erdoğan
- Süleyman Demirel University Faculty of Medicine, Department of Nuclear Medicine, Isparta, Turkey
| | - Evrim Erdemoğlu
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey
| | - İsmail Zihni
- Süleyman Demirel University Faculty of Medicine, Department of Surgical Oncology, Isparta, Turkey
| | - Sevim Süreyya Şengül
- Süleyman Demirel University Faculty of Medicine, Department of Nuclear Medicine, Isparta, Turkey
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Selçuk İ, Doğan O, Barut C, Çalışkan E, Zalewski K, Erdemoğlu E, van der Zee A. Radical vulvectomy with right gluteal and left medial thigh V-Y advancement flap reconstruction. J Turk Ger Gynecol Assoc 2020; 22:339-342. [PMID: 32500682 PMCID: PMC8667004 DOI: 10.4274/jtgga.galenos.2020.2020.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Vulvar cancer is rare. The vulva constitutes the external female genitalia and it is associated with the perineum with the intersection of urinary, sexual and anal systems. The deep anatomy of the perineum in the urogenital and anogenital triangle should be well-known to gynecological oncologists. Radical vulvectomy is the surgical treatment of choice in gross tumors expanding over the vulvar skin. After this type of excision, reconstruction is critically important because it is not always feasible to suture the vulvar defect in a primary manner. Thus, the reconstruction options should also be known to gynecological oncologists. Here, we present a video of radical vulvar cancer surgery, which was performed on a cadaver with gluteal and medial thigh V-Y advancement flap reconstruction.
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Affiliation(s)
- İlker Selçuk
- Department of Gynecologic Oncology, University of Health Sciences, Ankara City Hospital Maternity Hospital, Ankara, Turkey
| | | | - Cağatay Barut
- Department of Anatomy, Bahçeşehir University Faculty of Medicine, İstanbul, Turkey
| | - Eray Çalışkan
- Department of Obstetrics and Gynecology, Okan University Faculty of Medicine, İstanbul, Turkey
| | - Kamil Zalewski
- Department of Gynecologic Oncology, Holycross Cancer Center, Kielce, Poland
| | - Evrim Erdemoğlu
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Agj van der Zee
- Department of Gynecologic Oncology, University of Groningen, Groningen, The Netherlands
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Selçuk İ, Doğan O, Barut C, Çalışkan E, Zalewski K, Erdemoğlu E, van der Zee AGJ. Radical vulvectomy with right gluteal and left medial thigh V-Y advancement flap reconstruction. J Turk Ger Gynecol Assoc 2020. [DOI: 10.4274/jtgga.galenos.2020.2020-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Akkuş F, İşcan SC, Raoufi J, Güney M, Erdemoğlu E. Effect of using magnifying loupe glasses on lymphocele formation and surgical outcomes in gynecologic oncology. Turk J Obstet Gynecol 2020; 16:255-259. [PMID: 32231857 PMCID: PMC7090268 DOI: 10.4274/tjod.galenos.2019.93467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 10/12/2019] [Indexed: 12/01/2022] Open
Abstract
Objective: To investigate the effect of using magnifying loupes during surgery on surgical outcomes and lymphocele formation. Materials and Methods: We prospectively enrolled 36 patients with gynecologic cancer who underwent pelvic and para-aortic lymphadenectomy. Age, body mass index, menopausal status, type of cancer, comorbid diseases, preoperative albumin and albumin replacement therapy, performance status, serum CA125, hemoglobin, platelets and white blood cells, surgical procedure, blood loss, blood transfusion, the count of removed lymph nodes, presence of metastatic lymph nodes, total amount of drainage, postoperative complications, operation length, and count of used hemoclips were recorded. Patients were randomized into two groups: group 1 operated using loupe glasses, and group 2, without loupes. Results: In the loupe-negative group, total drainage volume was 6698 mL, whereas in the loupe-positive group, it was only 1049 mL (p<0.01). Postoperatively, the mean drainage duration was 10.6±5.1 days in loupe-negative group and 4.8±2.4 days in the loupe-positive group (p=0.0001). There were no differences between the two groups in terms of surgical site infections, fascial defects, and pulmonary thromboembolism (p=0.39, 0.33, 0.59, respectively). There was no significant difference in the number of harvested lymph nodes in patients who underwent surgery with or without loupes being used. The count of used hemoclips were 50.22±8.05 and 41.38±9.7 for the loupe-negative and positive groups, respectively (p<0.01). There was no lymphocele in the loupe-positive group, but we detected 5 (27.8%) lymphocele in the loupe-negative group (p=0.05). Conclusion: Gynecologic oncologic surgeons can add magnifying loupe glasses to their armament and benefit from this technical device; lymphocele development, total drainage volume, length of drainage time, and clip counts can be decreased by using loupe glasses in gynecologic cancer surgery.
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Affiliation(s)
- Fatih Akkuş
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Isparta, Turkey
| | - Serhan Can İşcan
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Isparta, Turkey
| | - Jalal Raoufi
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Isparta, Turkey
| | - Mehmet Güney
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Isparta, Turkey
| | - Evrim Erdemoğlu
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Isparta, Turkey
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Özkan EE, Erdemoğlu E, Raoufi J. Impact of diabetes on gastrointestinal and urinary toxicity after radiotherapy for gynecologic malignancy. Turk J Obstet Gynecol 2020; 16:260-265. [PMID: 32231858 PMCID: PMC7090259 DOI: 10.4274/tjod.galenos.2019.56957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 10/12/2019] [Indexed: 12/31/2022] Open
Abstract
Objective Although diabetes is a common co-morbidity in patients with gynecologic cancer, information about its impact on radiation toxicity in patients with gynecologic cancer treated with external pelvic irradiation is scarce. We aimed to investigate the relation of diabetes with acute toxicity in patients with gynecologic tumors who underwent pelvic +/- paraaortic radiotherapy. Materials and Methods One hundred twenty-nine patients with endometrium or cervix carcinoma were enrolled in the study. Demographic features, presence of diabetes, incidence and severity of upper gastrointestinal (UGIS), lower gastrointestinal (LGIS), and urinary symptoms were recorded from files. Correlation and logistic regression analysis was used to determine the impact of diabetes, age, chemotherapy, paraaortic irradiation on toxicities, and a prediction model was developed. Results The median age of 77 patients with endometrium cancer and 52 cervix cancer was 61 (range, 25-92) years, and 28 (21.7%) of them had diabetes. The median pelvic and tumor/tumor bed dose was 5040+247.65 cGy and 5040+222.91 cGy, respectively. Age and Gr 0 UGIS toxicity were significantly related (p=0.047). LGIS Gr 0 toxicity was found to be significantly higher in patients with diabetes (p=0.045). Gr 0 and 2 UGIS toxicities were both found to be significantly correlated with paraaortic irradiation (both p<0.001). Diabetes is also an important determinant on UGIS toxicity in patients who underwent paraaortic irradiation. Conclusion The correlation we found between toxicity and diabetes, concurrent chemotherapy or paraaortic radiation necessitates special care and risk stratification for patients with diabetes. Further prospective studies with long follow-up and larger patient groups are warranted.
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Affiliation(s)
- Emine Elif Özkan
- Süleyman Demirel University Faculty of Medicine, Department of Radiation Oncology, Isparta, Turkey
| | - Evrim Erdemoğlu
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey
| | - Jalal Raoufi
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey
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Biçer Ç, Raoufi J, İşcan SC, Güney M, Erdemoğlu E. Surgical risk assessment for gynecological oncologic patients. Turk J Obstet Gynecol 2019; 16:158-163. [PMID: 31673467 PMCID: PMC6792055 DOI: 10.4274/tjod.galenos.2019.93584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 06/09/2019] [Indexed: 12/01/2022] Open
Abstract
Objective Preoperative surgical risk assessment is important in terms of postoperative morbidity and mortality. Therefore, it is necessary to evaluate the efficacy and safety of these surgeries via an ideal risk assessment model, and reduce risks via applying some findings (for instance, perioperative beta-blockers). There are some risk assessment systems, but these have generally not been verified for patients with gynecologic cancer. The aim of this study was to assess the risk of surgery for gynecological oncologic patients and suggest an easy risk assessment model and risk reduction by applying our findings. Materials and Methods We retrospectively analyzed 258 gynecologic patients with cancer. Age, diagnosis, staging, performance scale, metoprolol use, heart, renal diabetes, Chronic Obstructive Pulmonary disease, diabetes, operation type and length, carcinoma antigen 125, ascites, albumin, surgical procedure, hospitalization length, and complications were recorded. Results Of the 258 patients, 173 patients (67.1%) had no complications, 43 patients (16.7%) had one and 42 patients (16.3%) had two or more complications. The most common complication was the acid-base imbalance (14%), followed by urinary tract infection (9.7%). Parameters associated with complications were performance status, ascites, operating length, metoprolol use, and upper abdominal surgery. In our proposed scoring model with a total score range 0-23, cut-off value points for both the presence and rate of complications was found as >5. Conclusion In gynecological patients with cancer, the addition of metoprolol use and upper abdominal surgery within preoperative risk assessment evaluation parameters are significantly effective in predicting the rate and severity of complications. Moreover, we have suggested a simple, practical, and convenient scoring model for this evaluation.
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Affiliation(s)
- Çağlayan Biçer
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Isparta, Turkey
| | - Jalal Raoufi
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Isparta, Turkey
| | - Serhan Can İşcan
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Isparta, Turkey
| | - Mehmet Güney
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Isparta, Turkey
| | - Evrim Erdemoğlu
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Isparta, Turkey
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Çivici H, İşcan SC, Raoufi J, Erdemoğlu E. Acute Genital Ulcers in a Virgin Adolescent Girl: A Case Report and Literature Review. Ankara Medical Journal 2019. [DOI: 10.17098/amj.575532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Tatar B, Yalçın Y, Erdemoğlu E. Palliative pelvic exenteration using iliofemoral bypass with synthetic grafts for advanced cervical carcinoma. Turk J Obstet Gynecol 2019; 16:80-83. [PMID: 31019845 PMCID: PMC6463427 DOI: 10.4274/tjod.galenos.2018.66743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 11/24/2018] [Indexed: 12/01/2022] Open
Abstract
Objective Recurrent cervical cancer can cause severe morbidity. Despite the severe morbidity after surgery, pelvic exenteration is still used today for mainly curative intent. This intention is neither based on randomized controlled trials (RCTs) nor high quality non-RCTs with adequate patient numbers comparing medical management with surgery. The same is true for exenteration for palliative intent, so the patient selection for either curative or palliative intent must be considered on a patient-by-patient basis. Materials and Methods A 35-year-old patient who had undergone primary chemo-radiotherapy for advanced cervical cancer presented with intractable pain on the swollen left leg and pelvis 8 months later. Left lower extremity Doppler ultrasound revealed echogenic thrombus in the external iliac, femoral, and popliteal veins, consistent with acute deep vein thrombus. She underwent total exenteration, end colostomy, ileal urinary conduit, pelvic lymphadenectomy, paraortic lymph node sampling, and ilio-femoral arterial and venous bypass. Results The procedure relieved her pain, the leg diameter dramatically decreased from 75 cm to 44 cm, and circulation of the leg was reestablished. The procedure deferred leg amputation for about five months. Conclusion To the best of our knowledge, this is the first report of a palliative pelvic exenteration for cervical cancer with combined iliofemoral arterial and venous bypasses. These procedures, with high morbidity and mortality, are also more controversial when undertaken for just palliation of symptoms. They must be considered in the basis of each patient, and the benefits and risks must be discussed thoroughly in a realistic perspective with the patient.
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Affiliation(s)
- Burak Tatar
- University of Health Sciences, Samsun Training and Research Hospital, Clinic of Gynecologic Oncology, Samsun, Turkey
| | - Yakup Yalçın
- Isparta State Hospital, Clinic of Gynecologic Oncology, Isparta, Turkey
| | - Evrim Erdemoğlu
- Suleyman Demirel University Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey
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Raoufi J, İşcan SC, Hanedan C, Özkan EE, Çerçi SS, Erdemoğlu E, Erdemoğlu E. Incidence of suspicious axillary lymph node involvement in fluorine-18 fluoro-D-glucose positron emission tomography/computed tomography in gynecologic cancers. Turk J Obstet Gynecol 2018; 15:99-104. [PMID: 29971187 PMCID: PMC6022426 DOI: 10.4274/tjod.12144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 04/26/2018] [Indexed: 12/01/2022] Open
Abstract
Objective: There is scarce information about axillary lymph node involvement in gynecologic cancers. We analyzed the incidence of suspicious axillary lymph nodes in gynecologic cancers. Materials and Methods: We retrospectively analyzed the positron emission tomography/computed tomography findings of 251 patients with endometrial, cervical, and ovarian cancer. There is no cut-off value documented for axillary metastases from gynecologic cancers; therefore we adopted the cut-off standardized uptake values (SUVs) proclaimed in breast cancer. Results: A total of 251 patients records were available for analysis; 40 patients (15.9%) with suspicious axillary lymph nodes were included in the study. Twenty-one and a half percent (n=20/93) of patients with endometrium cancer, 14.1% (n=14/99) of patients with ovarian cancer, and 10% (n=6/59) of those with cervical cancer had suspicious axillary lymph nodes. Patients with an maximum SUV (SUVmax) uptake higher than 3 underwent axillary lymph node biopsy. None of them was found to have axillary metastases of gynecologic cancers in the pathologic evaluation. In one patient with endometrial cancer, an obscure breast ductal carcinoma was diagnosed, another patient with endometrial cancer was found to have follicular lymphoma. The third patient with endometrial cancer had no malignancy in axillary lymph node biopsy, but had Hurthle cell neoplasia in a thyroid biopsy; the patient did not accept any surgical or medical treatment for endometrial cancer and died 23 months later. There were three (7.5%) metachronous cancers out of 40 gynecologic cancers; two patients were explained above, the third patient with endometrium cancer, who was not histopathologically evaluated although the axillary SUVmax was <3, had rectosigmoid cancer and glioblastoma metachronously. Conclusion: Our study shows that an important ratio (14-21%) of patients with gynecologic cancer has suspicious axillary lymph nodes. Increased SUVmax, particularly above 3, might be used as an indication for axillary biopsy and may help to identify secondary metastatic cancer.
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Affiliation(s)
- Jalal Raoufi
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Isparta, Turkey
| | - Serhan Can İşcan
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Isparta, Turkey
| | - Candost Hanedan
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Isparta, Turkey
| | - Emine Elif Özkan
- Süleyman Demirel University Faculty of Medicine, Department of Radiation Oncology, Isparta, Turkey
| | - Sevim Süreyya Çerçi
- Süleyman Demirel University Faculty of Medicine, Department of Nuclear Medicine, Isparta, Turkey
| | - Ebru Erdemoğlu
- Isparta Maternity and Children's Diseases Hospital, Clinic of Obstetrics and Gynecology, Isparta, Turkey
| | - Evrim Erdemoğlu
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Isparta, Turkey
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Erdemoğlu E, Çerçi SS, Erdemoğlu E, Yalçın Y, Tatar B. Role of positron emission tomography-computed tomography in endometrial cancer. Turk J Obstet Gynecol 2017; 14:203-209. [PMID: 29379661 PMCID: PMC5780562 DOI: 10.4274/tjod.24572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 10/14/2017] [Indexed: 12/01/2022] Open
Abstract
Objective: The efficacy of preoperative 18F-fluoro-D-glucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) in endometrium cancer is controversial. We examined the efficacy of PET-CT and the association between maximum standardized uptake value (SUVmax) and prognostic factors in endometrial cancer. Materials and Methods: Thirty patients with endometrial cancer underwent preoperative 18F-FDG/PET-CT. The patients were treated with abdominal hysterectomy with bilateral salpingo-oophorectomy, and bilateral systemic pelvic lymphadenectomy was planned for all patients; paraaortic lymphadenectomy was performed in patients with intermediate and high risk. Tumor histology, grade, depth of myometrial invasion, maximum tumor diameter, lymphovascular invasion, nodal status, and ovarian/adnexal metastases were recorded. Results: The mean primary tumor diameter was reported smaller in PET-CT and the effect size of PET-CT was -0.60. The kappa value was 0.06 for myometrial invasion. Pelvic lymph node metastasis was reported in 22.2% of patients in PET-CT. However, 3.7% of patients had pelvic lymph node metastasis. The kappa value for pelvic lymph node metastasis was 0.23, and sensitivity, specificity, and positive and negative predictive values were 100%, 80.7%, 16.6%, and 100%, respectively. Paraaortic lymph node metastasis in PET-CT was suspected in 10%. However, paraaortic lymph node metastasis was found in 6.7% in histopathologic analyses. The kappa value was 0.15. The sensitivity, specificity, and positive and negative predictive values of PET-CT for detecting paraaortic lymph node metastases were 100%, 93.7%, 66.6%, and 100%, respectively. Myometrial invasion and tumor diameter were the only important prognostic factors affecting SUVmax. Conclusion: According to our results, PET-CT has a limited role and diagnostic efficacy in endometrial cancer. The indications of FDG/PET-CT in endometrium cancer should be studied further and revised.
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Affiliation(s)
- Evrim Erdemoğlu
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey
| | - Sevim Süreyya Çerçi
- Süleyman Demirel University Faculty of Medicine, Department of Nuclear Medicine, Isparta, Turkey
| | - Ebru Erdemoğlu
- Maternity Hospital, Clinic of Obstetrics and Gynecology, Isparta, Turkey
| | - Yakup Yalçın
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey
| | - Burak Tatar
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey
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15
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Tatar B, Oksay T, Selcen Cebe F, Soyupek S, Erdemoğlu E. Management of vesicovaginal fistulas after gynecologic surgery. Turk J Obstet Gynecol 2017; 14:45-51. [PMID: 28913134 PMCID: PMC5558317 DOI: 10.4274/tjod.46656] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 02/14/2017] [Indexed: 12/01/2022] Open
Abstract
Objective: In developed nations, surgery, especially gynecologic procedures, is the major cause of vesicovaginal fistulas (VVFs). We retrospectively evaluated our treatment modalities for VVF repair caused by a gynecologic surgery, and discussed the reasons of selecting certain surgical techniques and their outcomes. Materials and Methods: We compared the surgical procedure preferences of surgeons and their results with patient and surgeon characteristics for the management of VVFs after an inciting gynecologic surgery in Süleyman Demirel University Hospital, Isparta over a 10-year period. The surgical procedures were undertaken in departments of urology and obstetrics and gynecology. Results: Abdominal repair was chosen for 65%, vaginal repair for 25%, and laparoscopic repair for 10% of patients. For the 75% of the patients that urologists operated, they chose the abdominal route. The mean parity number of patients who underwent abdominal repair was lower than that for vaginal repairs (p<0.05). For the patients managed with the vaginal route, 20% had a Martius flap, and 80% had a simple excision and repair. For patients operated via the abdominal route, 18% needed omental flap; no tissue interposition was used for the rest. The mean hospitalization time was less in patients managed with transvaginal repair (3.4 days) compared with transabdominal repair (9.2 days) (p<0.05). Conclusion: The choice of repair method depends on surgeon’s training (gynecology vs. urology). The vaginal route should be the first choice because it does not compromise the success rate and the mean hospitalization time is less. For the transvaginal approach, access to the lesion is the most important factor for the success of the procedure. No flap is needed for tissues that appear well vascularized.
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Affiliation(s)
- Burak Tatar
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey
| | - Taylan Oksay
- Süleyman Demirel University Faculty of Medicine, Department of Urology, Isparta, Turkey
| | - Fatma Selcen Cebe
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Isparta, Turkey
| | - Sedat Soyupek
- Süleyman Demirel University Faculty of Medicine, Department of Urology, Isparta, Turkey
| | - Evrim Erdemoğlu
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey
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16
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Tola EN, Erdemoğlu E, Yalçın Y, Alkaya Solmaz F, Erdemoğlu E. A 27-kg mucinous cystadenoma of the ovary presenting with deep vein thrombosis. Turk J Obstet Gynecol 2016; 13:53-55. [PMID: 28913091 PMCID: PMC5558358 DOI: 10.4274/tjod.93206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 12/29/2015] [Indexed: 12/01/2022] Open
Abstract
Giant ovarian adenomas are rarely observed today because of early diagnosis and treatment. Mucinous cystadenomas is a kind of tumor that mostly causes the ovary to enlarge. Theu can present with various and non-specific clinical manifestations such as deep vein thrombosis. The primary symptoms of giant ovarian tumors are abdominal enlargement and distension. Therefore, making the correct preoperative diagnosis is sometimes difficult. The appropriate treatment must include oncologic procedures and a multidisciplinary approach to minimalize complications and save the patient’s life. Herein, we report a woman aged 53 years with a 27-kg ovarian mucinous cystadenoma that presented as a left popliteal vein thrombosis.
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Affiliation(s)
- Esra Nur Tola
- Süleyman Demirel University Faculty of Medicine, Department of Gynecology and Obstetrics, Isparta, Turkey
| | - Evrim Erdemoğlu
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey
| | - Yakup Yalçın
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey
| | - Filiz Alkaya Solmaz
- Süleyman Demirel University Faculty of Medicine, Department of Anestesiology and Reanimation, Isparta, Turkey
| | - Ebru Erdemoğlu
- Şifa Hospital, Clinic of Gynecology and Obstetrics, Isparta, Turkey
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17
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Tatar B, Erdemoğlu E, Soyupek S, Yalçın Y, Erdemoğlu E. Vesicocutaneus fistula after cesarean section-a curious complication: Case report and review. Turk J Obstet Gynecol 2016; 13:46-49. [PMID: 28913089 PMCID: PMC5558356 DOI: 10.4274/tjod.71135] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 12/25/2015] [Indexed: 12/01/2022] Open
Abstract
Vesicocutaneous fistulas are very rare pathologies in the urinary tract. We present the second case of a vesicocutaneus fistula after cesarean section, and discuss strategies for prevention, diagnosis, and treatment of this exceptional complication. A woman with a vesicocutaneous fistula after cesarean delivery was admitted and diagnostic tests including fluoroscopy, magnetic resonance imaging (MRI), and reconstructed MRI revealed the fistula tract and an urachal anomaly. The patient was treated through excision of the fistula tract. Laparotomy should be performed carefully, and the surgeon should be aware of the urachus. Inadvertent trauma to the urachus during laparotomy might cause serious unexpected complications. Possible etiologic factors for vesicocutaneous fistulae, prevention, and treatment methods are discussed.
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Affiliation(s)
- Burak Tatar
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic and Oncology, Isparta, Turkey
| | - Ebru Erdemoğlu
- Isparta Maternity Hospital, Clinic of Obstetrics and Gynecology, Isparta, Turkey
| | - Sedat Soyupek
- Süleyman Demirel University Faculty of Medicine, Department of Urology, Isparta, Turkey
| | - Yakup Yalçın
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic and Oncology, Isparta, Turkey
| | - Evrim Erdemoğlu
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic and Oncology, Isparta, Turkey
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18
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Bozkurt KK, Yalçın Y, Erdemoğlu E, Tatar B, Erdemoğlu E, Çerçi SS, Çiriş İM, Başpınar Ş, Uğuz A, Kapucuoğlu N. The role of immunohistochemical adrenomedullin and Bcl-2 expression in development of type-1 endometrial adenocarcinoma: Adrenomedullin expression in endometrium. Pathol Res Pract 2016; 212:450-5. [PMID: 26972419 DOI: 10.1016/j.prp.2016.02.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 02/02/2016] [Accepted: 02/24/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Adrenomedullin (AM) is a pluripotent peptide first discovered from human pheochromocytoma. AM expression has been shown in various cancer types including endometrium cancer. Bcl-2 is an antiapoptotic protein which might be regulated by AM in hypoxic conditions. The aim of the present study was to investigate the role of AM and Bcl-2 expressions in carcinogenesis of type-1 endometrium cancer. MATERIALS AND METHOD Study group consisted of 10 proliferative endometrium, 22 simple endometrial hyperplasia, 23 endometrial intraepithelial neoplasia (EIN) and 30 Grade 1 endometrioid adenocarcinoma patients. AM and Bcl-2 expressions were investigated by immunohistochemistry. RESULTS Mean AM Allred score was 3±2.6, 5.6±1.6 and 5.7±2.5 in benign, EIN and adenocarcinoma groups, respectively. AM expression was significantly higher in EIN and adenocarcinoma groups than in benign endometrium group (p<0.05). Mean Bcl-2 Allred score was 6.4±2.1, 5.2±2.6, 2.3±2 in benign endometrium, EIN and adenocarcinoma groups, respectively. Mean Bcl-2 Allred score was similar between benign endometrium and EIN groups (p>0.05). However, it was significantly lower in adenocarcinoma group (p<0.05). An inverse correlation between AM and Bcl-2 expressions was found (r: -0.4, p<0.001). CONCLUSIONS Our findings showed that AM expression increased in progression from benign endometrium to EIN and type-1 adenocarcinoma while expression of Bcl-2 decreased in transition from EIN to carcinoma.
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Affiliation(s)
- Kemal Kürşat Bozkurt
- Süleyman Demirel University, Faculty of Medicine, Department of Pathology, Isparta, Turkey.
| | - Yakup Yalçın
- Suleyman Demirel University, Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey.
| | - Ebru Erdemoğlu
- Isparta Maternity Hospital, Department of Obstetrics and Gynecology, Isparta, Turkey.
| | - Burak Tatar
- Suleyman Demirel University, Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey.
| | - Evrim Erdemoğlu
- Suleyman Demirel University, Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey.
| | - Sevim Süreyya Çerçi
- Suleyman Demirel University, Faculty of Medicine, Department of Nuclear Medicine, Isparta, Turkey.
| | - İbrahim Metin Çiriş
- Süleyman Demirel University, Faculty of Medicine, Department of Pathology, Isparta, Turkey.
| | - Şirin Başpınar
- Süleyman Demirel University, Faculty of Medicine, Department of Pathology, Isparta, Turkey.
| | - Afife Uğuz
- Süleyman Demirel University, Faculty of Medicine, Department of Pathology, Isparta, Turkey.
| | - Nilgün Kapucuoğlu
- Acıbadem Maslak Hospital, Department of Pathology, Istanbul, Turkey.
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19
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Yalçın Y, Tatar B, Erdemoğlu E, Akkurt MÖ, Yavuz A, Erdemoğlu E. Laparoscopic systemic devascularization of uterine cornu for cornual resection in interstitial pregnancy. Turk J Obstet Gynecol 2015; 12:182-184. [PMID: 28913065 PMCID: PMC5558394 DOI: 10.4274/tjod.23500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 08/06/2015] [Indexed: 12/01/2022] Open
Abstract
Cornual pregnancies carry a greater maternal mortality risk than ampullary ectopic pregnancies and they may cause significant hemorrhage. A woman aged 36 years with a six-week history of amenorrhea, slight vaginal bleeding, and low abdominal pain of three days duration presented to our clinic. A diagnosis of right cornual ectopic pregnancy was made using ultrasonographic findings. Laparoscopic exploration confirmed the diagnosis. We occluded the uterine artery at its origin and also transected vessels within the mesosalpinx and uteroovarian ligament to successfully accomplish avascularization of a cornual pregnancy. Occlusion of the uterine arteries is reported to be a safe and blood-sparing technique. Severe hemorragia may occur during the operation; therefore, techniques to minimize blood loss are reported. In our case, occlusion of the uterine artery and transection of the mesosalpinx and uteroovarian vessels provided a bloodless operation and there was no need to bilaterally occlude vessels.
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Affiliation(s)
- Yakup Yalçın
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey
| | - Burak Tatar
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey
| | - Ebru Erdemoğlu
- Şifa Hospital, Clinic of Obstetrics and Gynecology, Isparta, Turkey
| | - Mehmet Özgür Akkurt
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Isparta, Turkey
| | - And Yavuz
- Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Isparta, Turkey
| | - Evrim Erdemoğlu
- Süleyman Demirel University Faculty of Medicine, Department of Gynecologic Oncology, Isparta, Turkey
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20
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Tola EN, Erdemoğlu E, Erdemoğlu E. Uterine sparing surgical methods in pelvic organ prolapse. Turk J Obstet Gynecol 2015; 12:168-172. [PMID: 28913063 PMCID: PMC5558392 DOI: 10.4274/tjod.43179] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 08/06/2015] [Indexed: 12/01/2022] Open
Abstract
Pelvic organ prolapse (POP) is defined as the protrusion of pelvic organs to the vagen and is an important health problem in patients of older age. Today, most women with POP prefer uterine sparing surgery due to the changes in lifestyle, beliefs, pregnancy desire, and understanding the role of the uterus and cervix in sexual function. Therefore, the need for newer surgical procedures that involve less invasive surgery, reduced intraoperative and postoperative risks, and a faster healing time in POP surgery have gained importance. Vaginal, abdominal, laparoscopic, and robotic methods are defined in uterine preserving surgery but there is not yet a consensus on which of them should be chosen. In choosing the proper technique, the patient's general status, accompanying disease, correct indication, and the surgeon's experience are all important. In our practice we prefer laparoscopic mesh sacrohysteropexy in patients who prefer to preserve their uterus because of the lower costs and high success rates compared with abdominal and robotic techniques.
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Affiliation(s)
- Esra Nur Tola
- Süleyman Demirel Univercity Faculty of Medicine, Department of Gyneacology and Obstetrics, Isparta, Turkey
| | - Evrim Erdemoğlu
- Süleyman Demirel Univercity Faculty of Medicine, Department of Gyneacologic Oncology, Isparta, Turkey
| | - Ebru Erdemoğlu
- Şifa Hospital, Clinic of Gyneacology and Obstetrics, Isparta, Turkey
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21
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Günyeli I, Bozkurt KK, Yalçın Y, Tatar B, Cerçi SS, Erdemoğlu E. Granulosa cell tumor and concurrent endometrial cancer with (18)F-FDG uptake. Hell J Nucl Med 2014; 17:153-155. [PMID: 25097899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 07/14/2014] [Indexed: 06/03/2023]
Abstract
The findings and the role of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) for the diagnosis of ovarian granulosa cell tumor (OG) are described. We present the pre-operative findings of (18)F-FDG PET/CT scan of a case of OG concurrent with endometrium cancer and endometrial hyperplasia, which revealed a 48mm mass demonstrating mild increased metabolic activity on the right ovary. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. Frozen and paraffin-enbeded sections showed an encapsulated OG. There were few mitoses. There was concurrent atypical endometrial hyperplasia. In conclusion, we reported a case of an encapsulated OG, which showed mild uptake of the (18)F-FDG with concurrent endometrial cancer. There has been only one report of (18)F-FDG findings in primary ovarian granulosa cell tumor, similar to ours.
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Affiliation(s)
- Ilker Günyeli
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suleyman Demirel University, Isparta, 32000,Turkey.
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22
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Günyeli I, Erdemoğlu E, Ceylaner S, Zergeroğlu S, Mungan T. Histopathological analysis of the placental lesions in pregnancies complicated with IUGR and stillbirths in comparison with noncomplicated pregnancies. J Turk Ger Gynecol Assoc 2011; 12:75-9. [PMID: 24591966 DOI: 10.5152/jtgga.2011.19] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2011] [Accepted: 04/22/2011] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Placental factors and hypoxemia are the keys to intrauterine growth restriction (IUGR) and stillbirth. The aim of the study is to analyze histological changes in placentas of IUGR fetuses in pregnancies with no apparent etiologic factor and unexplained intrauterine fetal deaths. MATERIAL AND METHODS A total of 110 placentas were collected; 26 placentas of IUGR fetuses with no apparent cause, 58 placentas from unexplained intrauterine deaths over 20 weeks of gestation, and 26 placentas from uncomplicated pregnancies who delivered a healthy live baby. Microscopic examinations of placentas were performed for histopathological analyzes. RESULTS Gestational age at delivery was 33.67±4.37 weeks, 29.15±8.36 weeks, and 39.0±1.52 weeks in women in group I, group II and group III, respectively (p<0.01). Infarction and intervillous thrombosis are significantly more frequent in placentas of Group I and group II. Chronic villitis occurred in 69%, 63% and 30% of group I, group II, and group III, respectively. Placental intravascular thrombi (Group I, 31% and group II, 26%), perivillous fibrin deposition and fibrinoid necrosis (65% in Group I and 53% in group II), infarction, intervillous thrombosis, chronic villitis, hemorrhagic endovasculitis, placental intravascular thrombi, perivillous fibrin deposition, fibrinoid necrosis, erythroblastosis and villous edema were found in the study group. CONCLUSION The results reported here indicate that a relationship exists between morphological changes in the placentas of IUGR and intrauterine fetal deaths.
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Affiliation(s)
- Ilker Günyeli
- Department of Obstetric and Gynecology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Evrim Erdemoğlu
- Department of Obstetric and Gynecology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Serdar Ceylaner
- Department of Genetics, Zekai Tahir Burak Women Health Education and Research Hospital, Ankara, Turkey
| | - Sema Zergeroğlu
- Department of Pathology, Zekai Tahir Burak Women Health Education and Research Hospital, Ankara, Turkey
| | - Tamer Mungan
- Department of Obstetric and Gynecology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
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23
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Güler A, Sahin HG, Küçükaydın Z, Erdemoğlu E. Comparison of the efficacy of intrauterine lidocaine, paracervical block and oral etodolac for decreasing pain in endometrial biopsy. J Turk Ger Gynecol Assoc 2010; 11:178-81. [PMID: 24591932 DOI: 10.5152/jtgga.2010.33] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2010] [Accepted: 11/14/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To compare the effectiveness of paracervical block, intrauterine lidocaine and oral etodolac in decreasing the pain caused by pipelle endometrial sampling. A secondary goal of this study was to determine the adverse effects and compare possible effects of these methods on pulse and blood pressure. MATERIAL AND METHODS The study was performed between April 2006 and October 2006 in the Obstetrics and Gynecology Department of Van Yüzüncü Yıl University Research Hospital. One-hundred twenty patients were randomized into four groups: 1. Group: Paracervical block was performed with 3 ml 2% prilocaine solution. 2. Group: Five ml of 2% lidocaine solution was instilled through the endocervix into the uterine cavity. 3. Group: Subjects received 400 mg oral etodolac tablet 1-1.5 hour before the procedure. 4. Group: No method of anesthesia was used in the control group. Endometrial sampling was performed with pipelle. Severity of pain during the procedure was scored by the subjects according to the "6-point Verbal Rating Scale (VRS)". Blood pressure and pulse rate were measured before, during and 30 minutes after the procedure. RESULTS Pain scores in intrauterine lidocaine group (2(nd) group) were found statistically significantly lower than the other three groups (p<0.05). CONCLUSION Intrauterine lidocaine anesthesia technique decreases pain in endometrial sampling with pipelle more efficiently than paracervical block or oral etodolac. While indication of menorrhagia and endometrial thickness more than 5 mm increased pain scores, intrauterine lidocaine application or paracervical block decreased the scores significantly (p<0.05).
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Affiliation(s)
- Ayşe Güler
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - H Güler Sahin
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Zehra Küçükaydın
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Evrim Erdemoğlu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
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Şengül ÖB, Mungan T, Erdemoğlu E, İslamoğlu G, Kıyak N. Investigation of the correlation between 100 gram oral glucose tolerance test results and maternal leptin levels during pregnancy. J Turk Ger Gynecol Assoc 2009; 10:158-161. [PMID: 24591860 PMCID: PMC3939120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2009] [Accepted: 08/14/2009] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE To investigate the correlation between maternal leptin levels and 100 gram oral glucose test (OGTT) results as well as the correlation between leptin levels and the development of gestational diabetes mellitus (GDM) and glucose intolerance during pregnancy. MATERIAL AND METHOD 104 subjects with gestational weeks ranging from 24 to 32 weeks who had increased 50 gr OGTT values (>140) were included in this study. After the screening test, 100 gr OGTT was administered to the subjects. Sixty cases were selected from these subjects; twenty patients with one abnormal test result were identified as "glucose intolerant" group (Group 1), 20 patients with two abnormal test values were diagnosed with GDM (Group 2) and 20 patients with normal test results constituted the control group. The serum leptin levels of the groups were measured with enzyme linked immunosorbent assay (ELISA). RESULTS The serum leptin level was 8.4±5.1 ng/ml for group 1, 9.1±5.3 ng/ml for group 2 and 6.3±4.6 ng/ml for the control group. Although serum leptin levels for group 1 and 2 was observed to be higher than the control group, the result was not statistically significant (p>0.05). This result did not change after adjusting for body mass index (BMI). CONCLUSION There is no statistically significant difference between leptin levels among three groups.
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Affiliation(s)
- Özlem Baykara Şengül
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Womens Health Hospital, Ankara, Turkey
| | - Tamer Mungan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Evrim Erdemoğlu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Göksel İslamoğlu
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Womens Health Hospital, Ankara, Turkey
| | - Nuran Kıyak
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Womens Health Hospital, Ankara, Turkey
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