Araştırma Çıktıları
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Item 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, CagatayObjective 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.Item The outcomes of fertility sparing surgery in epithelial ovarian cancer(IMR PRESS, 2020-01-01) Karabuk, Emine; Karadag, Burak; Karadag, Ceyda; Kose, M. Faruk; Naki, M. Murat; Guler, E. NiluferConservative surgery has long been discussed as a treatment option in women with ovarian cancer at reproductive age. However, current guidelines recommend conservative surgery only in selected patients. There is considerable interest on pregnancy and delivery rates after fertility-sparing surgery (FSS), with several ongoing studies on this subject. The aim of the present multi-center study was to evaluate survival and pregnancy outcomes in patients that underwent fertility-sparing surgery. This retrospective study included 19 patients who underwent fertility-sparing surgery due to invasive epithelial ovarian cancer between 2002 and 2014. The median duration of follow-up was 59.5 months (range 10-152 months). A total of 10 full-term pregnancies and 3 spontaneous abortions occurred in 7 patients (36.8\%) following FSS. Ten patients (52.6\%) underwent prophylactic surgery after a median period of 49 months (16-119 months), while 2 patients (10.5\%) developed recurrent disease after prophylactic surgery. Accurate staging in patients with early stage epithelial ovarian cancer and regular follow-up has shown promising reproductive outcomes. In light of the current data, fertility-sparing surgery should be considered in selected patients with stage I epithelial ovarian cancer. There is still no consensus, however, on the selection criteria of eligible patients for fertility-sparing surgery.Item Hey Siri! Perform a type 3 hysterectomy. Please watch out for the ureter!'' What is autonomous surgery and what are the latest developments?(GALENOS YAYINCILIK, 2021-01-01) Gultekin, Ismail Burak; Karabuk, Emine; Kose, Mehmet FarukAs a result of major advances in deep learning algorithms and computer processing power, there have been important developments in the fields of medicine and robotics. Although fully autonomous surgery systems where human impact will be minimized are still a long way off, systems with partial autonomy have gradually entered clinical use. In this review, articles on autonomous surgery classified and summarized, with the aim of informing the reader about questions such as `` What is autonomic surgery?{''} and in which areas studies are progressing.Item 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, MeteToday, 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.Item Comparison of factor XII levels in gestational diabetes, fetal macrosomia, and healthy pregnancies(BMC, 2020-01-01) Ozbasli, Esra; Takmaz, Ozguc; Karabuk, Emine; Gungor, MeteBackgroundIf 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,Item Marsupialization versus Word catheter in the treatment of Bartholin cyst or abscess: retrospective cohort study(GALENOS PUBL HOUSE, 2022-01-01) Karabuk, Emine; Aygun, Elif GanimeObjective: Bartholin cysts or abscesses are observed in approximately 2\% of women, usually in their reproductive years. Although none of the treatments appear to be superior, there are several options including drainage with basic incision, Word catheter application, marsupialization, silver nitrate application, and excision. The primary outcome in this study was to evaluate the recurrence rates in patients who underwent marsupialization or Word catheter for the treatment of Bartholin cyst or abscesses, and the secondary outcome was to evaluate the rates of patient satisfaction. Material and Methods: A total of 196 patients who underwent either Word catheterization or marsupialization for the treatment of Bartholin cyst or abscesses between 2014 and 2017 were included in this retrospective cohort study. The size and location of the cyst/abscess, the operation duration, and the recurrence was recorded. A 5-point visual analog scale (VAS) was used to assess patient satisfaction and whether patients would recommend thier treatment to others. Results: Recurrence was observed in 11 (8.3\%) patients in the marsupialization group, and 12 (18.8\%) patients in the Word catheter group (p=0.034). Median (range) VAS scores in the marsupialization group were better than the Word catheter group {[}4 (1-5) vs 3 (1-5)Item Effects of Normal Morphology Sperm Count on Fertilization Time in Infertile Couples with Teratospermic Males: An Evaluation with an Embryoscope(GALENOS YAYINCILIK, 2022-01-01) Aygun, Elif Ganime; Karabuk, EmineObjective: Incubation of the embryo is the vital step in assisted reproductive techniques. Embryoscope systems are incubators that keep the embryo stable and allow for continuous observation without opening the lid. Therefore, the embryo is not displaced and goes through a temperature or air change. The primary aim of this study was to explore the effects of normal morphology sperm count on two pronucleus formation time following intracytoplasmic sperm injection in infertile couples with teratospermic males. The secondary aim was clinical pregnancy. Materials and Methods: Sixty-seven couples undergoing in vitro fertilization were included in this retrospective cohort study. First, intracytoplasmic sperm injection was performed to metaphase II-oocytes. Then, the embryos were placed in an embryoscope (a time-lapse system) for observation. The time that embryos demonstrated two pronuclei were recorded. Demographic and reproductive data were obtained and analyzed. Results: A statistically significant weak correlation was detected between sperm morphology the two pronucleus formation times (r=0.295, p=0.017). Severely decreased normal sperm count was significantly associated with pregnancy with less decreased normal sperm count (p>0.024). Moreover, decreased two pronucleus formation time was significantly associated with pregnancy. Conclusion: A statistically significant, albeit weak, correlation was detected between sperm morphology with two pronucleus formation time. Furthermore, having a lower normal sperm count was related to a higher pregnancy rate than having a higher normal sperm count. Lastly, reduced two pronucleus formation time was significantly associated with pregnancy.