Endometriyozis Takip ve Tedavisinde ��üncül Merkez Deneyimleri

Yal�n Bahat, P�nar; Topbas Selcuki, Nura Fitnat; Ayd�n, Zelal; Bestel, Aysegul; �zdemir, �smail

Cilt : 35 Say� : 3 Y�l : 2024

35/3Son Say� Gelecek Say� Ar�iv Pop�ler Makaleler

Yay�n Hakk� Devir Formu

ICMJE COI Formu

H�zl� Arama

Endometriyozis Takip ve Tedavisinde ��üncül Merkez Deneyimleri [South Clin Ist Euras]

South Clin Ist Euras. 2021; 32(2): 146-149 | DOI: 10.14744/scie.2021.83435

Endometriyozis Takip ve Tedavisinde ��üncül Merkez Deneyimleri

P�nar Yal�n Bahat¹, Nura Fitnat Topbas Selcuki², Zelal Ayd�n¹, Aysegul Bestel¹, �smail �zdemir¹
¹SB�, �stanbul Kanuni Sultan Süleyman E�itim ve Ara�t�rma Hastanesi, Kad�n Hastal�klar� ve Do�um Klini�i �stanbul, Turkey
²Sa�l�k Bilimleri �niversitesi, �stanbul �i�li Hamidiye Etfal E�itim Ve Ara�t�rma Hastanesi, Kad�n Hastal�klar� Ve Do�um Klini�i �stanbul

G�R�� ve AMA�: Endometriyozis, üreme �a��ndaki kad�nlar�n %10�unu etkileyen kronik bir hastal�kt�r. Belirsiz patofizyoloji nedeniyle, küratif bir tedavi se�ene�i mevcut de�ildir. Bu nedenle hastal�kla ilgili klinik deneyim ve artan bilgi birikimi büyük �nem ta��maktad�r. Bu �al��man�n amac�, uzun d�nem klinik stratejileri de�erlendirmek i�in ü�üncü basamak bir jinekoloji klini�inde endometriyozis hastalar�n�n demografik �zelliklerini, semptomlar�n�, t�bbi al�m�n�, analjezik ihtiyac�n� ve tedavi y�ntemlerini ara�t�rmakt�r.
Y�NTEM ve GERE�LER: Bu geriye d�nük tan�mlay�c� olgu �al��mas�, ü�üncü basamak bir jinekoloji klini�inde ger�ekle�tirildi. Kas�m 2012 ile Temmuz 2020 aras�nda bir veri taban� ara�t�rmas� yap�ld� ve toplam 1098 hasta �al��maya dahil edildi. Hastalar�n ya�, gravite, parite, ameliyat �yküsü ve demografik �zellikleri kaydedildi. Tan� y�ntemleri, t�bbi ve cerrahi tedavi stratejileri, hastanede kal�� süresi ve analjezik ila� ihtiyac� i�in medikal dosyalar tarand�.
BULGULAR: Sekiz yüz yetmi� ü� hasta evre 3 hastal��a sahipken, sadece alt� hastaya evre 4 hastal�k te�hisi konmu�tur. Hastalar�n %47�si ultrason ile, %53�ü cerrahi olarak te�his edildi. Hastalar cerrahi tekniklere g�re de�erlendirildi�inde 144 hastaya laparoskopik, 235 hastaya laparotomi yap�ld�. Laparoskopi sonras� ortalama hastanede kal�� süresi 2.68�1.02, laparotomi sonras� ortalama süre 3.45�1.69 olarak hesapland�. T�bbi tedavi stratejileri a��s�ndan kay�tlar�n incelenmesi, 110 hastan�n kombine oral kontraseptif (KOK), 36�s�n�n progesteron ve 525�inin dienogest ald��n� ortaya koydu.
TARTI�MA ve SONU�: Endometriyozisin iyile�tirici tedavisi i�in büyük bir aray�� bir süredir devam etse de, tedavi se�enekleri y�llar i�inde büyük �l�üde de�i�medi. Cerrahlar�n tecrübesi artt�k�a, endometriyozis cerrahisinde laparotominin yerini laparoskopik cerrahi alm��t�r. Ayr�ca t�bbi tedavi se�enekleri olarak progestinler daha fazla �nem kazanm��t�r. Bununla birlikte, tedavi stratejilerine bak�lmaks�z�n, endometriyozis hastalar�n�n hala uzun süreli tedavilere ve takiplere ihtiyac� vard�r.

Anahtar Kelimeler: Endometriozis, endometriozis cerrahisi; hormon tedavisi; kombine oral kontraseptif; progestin.

Tertiary Center Experience with the Treatment and Follow-Up of Endometriosis

P�nar Yal�n Bahat¹, Nura Fitnat Topbas Selcuki², Zelal Ayd�n¹, Aysegul Bestel¹, �smail �zdemir¹
¹Department of Obstetrics and Gynecology, University of Health Sciences, �stanbul Kanuni Sultan Süleyman Training and Research Hospital, �stanbul, Turkey
²Department of Obstetrics and Gynecology, University of Health Sciences, Istanbul �i�li Hamidiye Etfal Training and Research Hospital, �stanbul, Turkey

INTRODUCTION: Endometriosis is a chronic disease that affects 10% of women of reproductive age. No curative treatment is currently available due to the as yet unclear pathophysiology. Therefore, clinical experience and additional knowledge of the disease has great value. This study was an investigation of the demographic characteristics, symptoms, medication use, analgesic need, and treatment methods of endometriosis patients at a tertiary gynecological clinic in order to evaluate long-term clinical strategies.
METHODS: This retrospective, descriptive case study was conducted at a tertiary gynecological clinic. A database search of records from November 2012 to July 2020 yielded a total of 1098 patients for initial inclusion in the study. Age, gravidity, parity, surgical history, and demographic characteristics were recorded, as well as the diagnostic methods, medical and surgical treatment strategies, hospitalization duration, and need for analgesic medication.
RESULTS: In all, 873 patients had stage 3 disease and 6 patients were diagnosed with stage 4 disease. Of the study group, 47% of the patients were diagnosed using ultrasound and 53% were diagnosed surgically. An assessment of the surgical techniques used revealed that 144 patients underwent laparoscopic surgery while 235 underwent a laparotomy. The mean duration of hospitalization following a laparoscopy was 2.68�1.02 days, whereas the mean length of stay following a laparotomy was 3.45�1.69 days. Analysis of the medical treatment strategies applied indicated that 110 patients were given a combined oral contraceptive (COC), 36 received progesterone, and 525 were treated with dienogest.
DISCUSSION AND CONCLUSION: Although there has been an ongoing search for a curative treatment for endometriosis for some time, the treatment options have not changed dramatically over the years. Laparoscopic surgery has largely taken the place of a laparotomy as surgeons became more experienced and progestins have gained more importance as a medical treatment option. However, at present, regardless of treatment strategy, endometriosis still requires a long period of treatment and follow-up.

Keywords: Combined oral contraceptive, endometriosis; endometriosis surgery; hormonal therapy; progestin.

Sorumlu Yazar: P�nar Yal�n Bahat, T�rkiye
Makale Dili: �ngilizce

ATIF KOPYALA

Tam Metin PDF At�f dosyas� indir RIS EndNote BibTex Medlars Procite Reference Manager Yazara e-posta g�nder Benzer makaleler PubMed Google Scholar