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Author: search.filters.author.Takmaz, OzgucHas files: Yes

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    Could the Long-Term Oncological Safety of Laparoscopic Surgery in Low-Risk Endometrial Cancer also Be Valid for the High-Intermediate- and High-Risk Patients? A Multi-Center Turkish Gynecologic Oncology Group Study Conducted with 2745 Endometrial Cancer Cases. (TRSGO-End-001)
    (MDPI, 2021-01-01) Vardar, Mehmet Ali; Guzel, Ahmet Baris; Taskin, Salih; Gungor, Mete; Ozgul, Nejat; Salman, Coskun; Kucukgoz-Gulec, Umran; Khatib, Ghanim; Taskiran, Cagatay; Duender, Ilkkan; Ortac, Firat; Yuce, Kunter; Terek, Cosan; Simsek, Tayup; Ozsaran, Aydin; Onan, Anil; Coban, Gonca; Topuz, Samet; Demirkiran, Fuat; Takmaz, Ozguc; Kose, M. Faruk; Gocmen, Ahmet; Seydaoglu, Gulsah; Gumurdulu, Derya; Ayhan, Ali
    This study was conducted to compare the long-term oncological outcomes of laparotomy and laparoscopic surgeries in endometrial cancer under the light of the 2016 ESMO-ESGO-ESTRO risk classification system, with particular focus on the high-intermediate- and high-risk categories. Using multicentric databases between January 2005 and January 2016, disease-free and overall survivals of 2745 endometrial cancer cases were compared according to the surgery route (laparotomy vs. laparoscopy). The high-intermediate- and high-risk patients were defined with respect to the 2016 ESMO-ESGO-ESTRO risk classification system, and they were analyzed with respect to differences in survival rates. Of the 2745 patients, 1743 (63.5\%) were operated by laparotomy, and the remaining were operated with laparoscopy. The total numbers of high-intermediate- and high-risk endometrial cancer cases were 734 (45\%) patients in the laparotomy group and 307 (30.7\%) patients in the laparoscopy group. Disease-free and overall survivals were not statistically different when compared between laparoscopy and laparotomy groups in terms of low-, intermediate-, high-intermediate- and high-risk endometrial cancer. In conclusion, regardless of the endometrial cancer risk category, long-term oncological outcomes of the laparoscopic approach were found to be comparable to those treated with laparotomy. Our results are encouraging to consider laparoscopic surgery for high-intermediate- and high-risk endometrial cancer cases.
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    Sentinel lymph node biopsy in early stage endometrial cancer: a Turkish gynecologic oncology group study (TRSGO-SLN-001)
    (BMJ PUBLISHING GROUP, 2020-01-01) Taskin, Salih; Altin, Duygu; Vatansever, Dogan; Tokgozoglu, Nedim; Karabuk, Emine; Turan, Hasan; Takmaz, Ozguc; Kahramanoglu, Ilker; Naki, Mehmet Murat; Gungor, Mete; Kose, Faruk; Ortac, Firat; Arvas, Macit; Ayhan, Ali; Taskiran, Cagatay
    Objective The aim of this multicenter study was to evaluate the feasibility of sentinel lymph node (SLN) mapping in clinically uterine confined endometrial cancer. Methods Patients who underwent primary surgery for endometrial cancer with an SLN algorithm were reviewed. Indocyanine green or blue dye was used as a tracer. SLNs and/or suspicious lymph nodes were resected. Side specific lymphadenectomy was performed when mapping was unsuccessful. SLNs were ultrastaged on final pathology. Results 357 eligible patients were analyzed. Median age was 59 years. Median number of resected SLNs was 2 (range 1-12) per patient. Minimal invasive and open surgeries were performed in 264 (73.9\%) and 93 (26.1\%) patients, respectively. Indocyanine green was used in 231 (64.7\%) and blue dye in 126 (35.3\%) patients. The dyes were injected into the cervix in 355 (99.4\%) patients. The overall and bilateral SLN detection rates were 91.9\% and 71.4\%, respectively. The mapping rates using indocyanine green or blue dye were comparable (P=0.526). There were 43 (12\%) patients with lymphatic metastasis. The SLN algorithm was not able to detect 3 of 43 patients who had isolated paraaortic metastasis. After SLN biopsy, complete pelvic lymphadenectomy was performed in 286 (80.1\%) patients. Sensitivity and negative predictive value were both 100\% for the detection of pelvic lymph node metastases. In addition, 117 (32.8\%) patients underwent completion paraaortic lymphadenectomy after SLN biopsy. In these patients, sensitivity for detecting metastases to pelvic and/or paraaortic lymph nodes was 90.3\% with a negative predictive value of 96.6\%. The risk of non-SLN involvement in patients with macrometastatic SLNs, micrometastatic SLNs, and isolated tumor cells in SLNs were 61.2\%, 14.3\% and 0\%, respectively. Conclusions SLN biopsy had good accuracy in detecting lymphatic metastasis. However, one-third of cases with metastatic SLNs also had non-SLN involvement and this risk increased to two-thirds of cases with macrometastatic SLNs. The effect of leaving these nodes in situ on survival should be evaluated in further studies.
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    Is Endometrial Receptivity Assay (ERA) Useful in Patients with Repeated Implantation Failure Undergoing Single, Autologous Euploid Embryo Transfer?
    (IMR PRESS, 2022-01-01) Ozaltin, Selin; Celik, Hale Goksever; Takmaz, Ozguc; Yagmur, Erbil; Ozbasli, Esra; Gungor, Mete; Yeh, John; Bastu, Ercan
    Background: Our aim in this study was to evaluate whether endometrial receptivity assay (ERA) test improves single, autologous euploid frozen-thawed embryo transfer (FET) outcomes in patients with repeated implantation failure. Methods: This was a retrospective cohort study which was conducted in a University affiliated private hospital. The study included 135 patients with repeated implantation failure who underwent single, autologous euploid ERA adjusted and non-adjusted FET. Patients were stratified into three groups, patients with receptive endometrium based on the ERA test, patients with non-receptive endometrium based on the ERA test and patients who did not receive the ERA test (control group). The three groups were compared in terms of FET outcomes. Results: Of 135 patients, 73 had the ERA test results available and 62 did not have the ERA test. Of 73 patients, 28 had non-receptive endometrium and 45 had receptive endometrium. The three groups are all the same in terms of age, body mass index, type of infertility, duration of infertility, number of previously embryo transfers and infertility causes (p > 0.05). Live birth rates were 46\%, 50\% and 51\% for receptive, nonreceptive and control groups, respectively (p > 0.05). Implantation and clinical pregnancy rates were similar between the groups, as well. Conclusions: Adjusting the embryo transfer day according to the ERA test results seems to improve FET outcomes in patients with repeated implantation failure.
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    Severe acute respiratory syndrome coronavirus (SARS-CoV-2) is not detected in the vagina: A prospective study
    (PUBLIC LIBRARY SCIENCE, 2021-01-01) Takmaz, Ozguc; Kaya, Eren; Erdi, Burak; Unsal, Gozde; Sharifli, Pari; Agaoglu, Nihat Bugra; Ozbasli, Esra; Gencer, Serap; Gungor, Mete
    Objective To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is present in the vagina of women diagnosed with coronavirus disease-19 (COVID-19) pneumonia. Study design The study was conducted prospectively in a university affiliated hospital. Forty-one women of reproductive age whose nasopharyngeal PCR test were positive for SARS-CoV-2 and clinically diagnosed with pneumonia were included in the study. Vaginal swabs were obtained for SARS-CoV-2 PCR tests when the patients were admitted to the inpatient service before pneumonia treatment was initiated. Results Vaginal swab samples of 38 patients were analysed with SARS-CoV-2 PCR tests. None of the vaginal swabs were positive for SARS-CoV-2. Conclusions SARS-CoV-2 does not infect the vagina of women diagnosed with SARS-CoV-2 pneumonia.
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    Is it Possible to Diagnose Endometrium Cancer with the Levels of Prolactin, Eotaxin, E-selectin and Ca 125?
    (GALENOS PUBL HOUSE, 2019-01-01) Takmaz, Ozguc; Berkman, Sinan
    Objective: The aim of this study to evaluate possible serum markers for distinction of endometrial carcinoma (EC) from benign uterine gynecologic diseases. Methods: The study group consisted of 65 patients who were diagnosed with histologically confirmed EC were compared with 65 women who had operation indication for benign uterine diseases with fasting blood serum levels which were taken prior to surgery in terms of prolactin, eotaxin, e-selectin and Ca 125 concentrations. Results: Serum prolactin (20.7 +/- 18 and 16.2 +/- 13), eotaxin (219.4 +/- 95 and 205.15 +/- 80) and e-selectin (67.2 +/- 29 and 61.5 +/- 29) levels were not significantly different between EC and the other group (p>0.05). Ca 125 levels (36.6 +/- 40 and 18.8 +/- 9) were significantly higher in EC group when compared with the benign uterine patology group (p<0.05). Conclusion: Although serum levels of prolactin, eotaxin, e-selectin were higher in EC group, those were not statistically significant. Although, serum Ca 125 levels were siginificantly higher in EC group, diagnostic role of Ca 125 is limited. There is currently no marker to distinguish EC from benign uterine pathologies.
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    Laparoscopic assisted robotic myomectomy of a huge myoma
    (GALENOS YAYINCILIK, 2019-01-01) Takmaz, Ozguc; Gundogan, Savas; Ozbasli, Esra; Karabuk, Emine; Naki, Murat; Kose, Faruk; Gungor, Mete
    Today, the adoption of minimal invasive gynecologic procedures is expanding their routine use in clinical practice. Until recently, a diameter of 8 cm was the recommended maximal size for laparoscopic removal of fibroids. However, robot-assisted laparoscopy improved the capacity and the feasibility of the many gynecologic procedures. Here, we report a video of robotic myomectomy of a huge myoma.
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    Robotic versus laparoscopic hysterectomy
    (GALENOS YAYINCILIK, 2020-01-01) Takmaz, Ozguc; Gungor, Mete
    Objective: To compare early surgical outcomes of robotic assisted laparoscopic hysterectomy with laparoscopic hysterectomy for benign diseases, in terms of operation time, estimated blood loss (EBL), perioperative complications, hospital stay and first gas discharge. Material and Methods: Medical records of 146 patients who either underwent laparoscopic (n=84) or robotic assisted laparoscopic hysterectomy (n=62) for benign diseases were extracted from records. Demographic characteristics and operation time, EBL, length of hospital stay and first gas discharge were compared between the groups. Results: Mean age and mean body mass index of both groups were comparable. The difference in the mean EBL was not statistically significant between laparoscopic (91 +/- 65 mL) and robotic group (80 +/- 37 mL, p=0.43). The difference in the mean first gas discharge time was not statistically different between laparoscopic (15 +/- 5 hours) and robotic group (17 +/- 6 hours, p=0.33). The length of hospital stay was comparable between groups (1.4 +/- 0.5 vs 1.5 +/- 0.7 days, p=0.64). The mean operation time was longer for the robotic group (150 +/- 180 minimum) when compared with laparoscopic group (105 +/- 18 minimum, p<0.01). The mean uterine weight of the robotic group was significantly heavier compared with laparoscopic group (234 +/- 157 grams vs 153 +/- 1I9 grams, respectively, p<0.01). Conclusion: Early surgical outcomes of robotic assisted laparoscopic and laparoscopic hysterectomy were comparable in terms of EBL, first gas discharge and hospital stay. Operation time was longer for robotic hysterectomy.
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    Comparison of factor XII levels in gestational diabetes, fetal macrosomia, and healthy pregnancies
    (BMC, 2020-01-01) Ozbasli, Esra; Takmaz, Ozguc; Karabuk, Emine; Gungor, Mete
    BackgroundIf not detected and treated, gestational diabetes mellitus (GDM) can cause serious pregnancy complications such as macrosomia, preeclampsia, and fetal/neonatal mortality. Many studies have examined underlying contributing factors for GDM, including hypercoagulation. Factor XII (FXII) is a coagulation factor that increases throughout normal pregnancies, and we evaluated the relationship of GDM with FXII, FXIIa (activated FXII), and other coagulation parameter levels. GDM and macrosomia are closely related, but it is not known whether FXII could be an independent causal factor for macrosomia.MethodsIn this prospective study, blood samples were taken from 69 pregnant women at the time of term delivery to determine levels of FXII, FXIIa, and other coagulation parameters. Based on the results, pregnancies fell into GDM, non-diabetic with macrosomia (M), or healthy (C {[}control]).ResultsFXII concentration levels were significantly higher in GDM patients compared with the M and C groups. There were no significant differences when comparing FXIIa, activated partial thromboplastin time, prothrombin time (PT), and international normalized ratio. The GDM group saw a significant negative correlation between FXII concentrations and maternal pregestational body mass index (BMI) and BMI before delivery. In the M group, a positive correlation was observed between FXII concentrations and newborn weight and newborn weight percentile.ConclusionsAn increase in FXII levels was observed in patients with gestational diabetes. Associations between coagulation parameters and GDM should be further analyzed to define the mechanisms of GDM and possible treatment modalities.Trial registrationOur study has been registered at clinicaltrials.gov (NCT03583216). Registered on July 11, 2018,