Yazar "Akdemir, Ali" seçeneğine göre listele
Listeleniyor 1 - 5 / 5
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Comparison of laparoscopic enclosed electromechanical morcellation and vaginal enclosed scalpel morcellation at laparoscopic myomectomy: A prospective randomized trial(Wiley, 2023) Akdemir, Ali; Arı, Sabahattin A. A.; Taylan, Enes; Ökmen, Fırat; Şahin, ÇağdaşAimThis study aimed to compare the laparoscopic-enclosed electromechanical morcellation (LEM) with vaginal-enclosed scalpel morcellation (VSM) in laparoscopic myomectomy procedures. MethodsOne hundred eighteen patients who underwent laparoscopic myomectomy were enrolled the prospective randomized interventional clinical study in tertiary university hospital. After myomectomy, tissue removal was accomplished via either LEM using the in-glove morcellation technique or VSM. ResultsThe median tissue removal time was longer in the LEM group (25 min [range: 14-55]) than the VSM group (20 min [range: 6-38] [p = 0.001]). Rescue analgesia requirement was significantly higher in the LEM group than the VSM group (mean rank: 56.92 vs. 40.92 doses, respectively; p < 0.001). There was no significant difference between preoperative and postoperative third month total scores of female sexual function index (FSFI) and subdomains in the LEM group. Conversely, all subdomains and total scores of FSFI (26.5 [16.7-34.8] vs. 22.7 [15.2-28.7]) except pain significantly worsened 3 months after operation in the VSM group. ConclusionsLEM was associated with a longer tissue removal time and increased postoperative analgesic requirement. On the other hand, VSM was associated with worsened postoperative sexual function from baseline.Öğe Effectiveness of paracervical block in endometrial sampling procedures for pain control: a randomized controlled clinical trial(Via Medica, 2022) Arı, Sabahattin Anıl; Ari, Seyda Ceylan; Akdemir, AliObjectives: We aimed to evaluate the effect of paracervical block (PCB) on endometrial sampling procedures, to assess the effect on pain of waiting between PCB and intervention, and to compare the effectiveness of PCB with oral non-steroidal anti-inflammatory drugs (NSAID) for decreasing the pain levels associated with endometrial biopsy. Material and methods: A total of 123 participants were divided into four groups as Group 1: Waiting 1 minute after PCB, Group 2: Waiting 3 minute after PCB, Group 3: Control group, and Group 4: Waiting 60 minute after taking oral NSAIDs. The success of analgesic measures used for endometrial biopsy during and 30 minutes after the procedure was compared with the Numeric Pain Rating Scale (NPRS) system. Results:The Numeric Pain Rating Scale (NPRS) 0 score was 2.60 (+/- 2.42) in Group 1; 1.60 (+/- 1.73) in Group 2; 5.30 (+/- 2.10) in Groups 3; 5.63 (+/- 1.99) in Groups 4. NPRS 30 score was 0.80 (+/- 0.88) in Group 1; 0.43 (+/- 0.81) in Group 2; 1.90 (+/- 1.32) in Groups 3; 2.70 (+/- 1.41) in Groups 4. The pain was significantly less in the paracervical block groups compared to control and oral NSAIDs groups. However, there was no significant difference in NPRS 0 (p = 0.196) and NPRS 30 (p = 0.191) scores between Group 1 and Group 2. There was no significant difference in NPRS 0 and NPRS 30 scores between control group and oral NSAID group. Conclusions: Paracervical block (PCB) is an effective method and superior to oral NSAIDs. Waiting 1 minute or 3 minutes after PCB were equally effective.Öğe Is the presence of deep infiltrative endometriosis underestimated in the surgical management of endometriosis?(Via Medica, 2023) Arı, Sabahattin Anıl; Akdemir, Ali; Serin, Gürdeniz; Ulukuş, Murat; Şendağ, FatihObjectives:The aim of the study was to determine the presence of deep infiltrative endometriosis (DIE) in the surgical management of endometriosis.Material and methods: Operation notes and histopathological reports of women with endometriosis were retrospectively analyzed in the Ege University Hospital between 2008 and 2018. A total of 191 women with suspicious of endometriosis but without clinical signs of DIE were enrolled in the study. Laparoscopic diagnosis of DIE was compared with histopatho-logical reports. There was no histopathology before surgery. Endometriosis was suspected only based on symptoms.Results: A total of 213 lesions that were thought to be DIE were removed from 191 women with endometriosis. Among these 213 lesions, 179 specimens were reported as endometriosis and 34 lesions as fibro-adipose tissue. Forty-nine right uterosacral ligaments were excised, and endometriosis was detected in 44 out of 49 specimens. Histopathological examination of 45 left uterosacral ligaments revealed endometriosis in 35 specimens. Finally, 25 endometriotic nodules were removed from the recto-vaginal space, and 22 of these were verified as endometriosis by a pathologist. The positive predictive value of laparoscopic visualization for DIE in the group suspected of endometriosis but without any clinical findings of DIE was 84%.Conclusions: Women with the suspicious of endometriosis, qualified to surgery, because of infertility or pain, should be prudently investigated to confirm or to exclude coexistence of DIE even if no preoperative sign of DIE was observed to provide complete resection. Otherwise, DIE continues to grow, causes pain postoperatively, and complicates subse-quent surgery.Öğe A prospective cohort study: can advanced ultrasonography replace magnetic resonance imaging in the diagnosis of placental adhesion disorders?(Walter De Gruyter Gmbh, 2023) Ari, Sabahattin Anil; Suner, Asli; Senkaya, Ayse Rabia; Okmen, Firat; Akdemir, Ali; Ergenoglu, Ahmet MeteObjectives: To define and compare the diagnostic accuracy of ultrasonography (USG) and magnetic resonance imaging (MRI) for the placental adhesive disorder (PAD). Methods: A prospective study was conducted between January 2019 and February 2020 in a tertiary referral university hospital. A total of 115 placenta previa cases were included in the study during the third trimester of gestation. USG examination was performed, and the placenta was scanned in a systematic manner using gray-scale ultrasound, color Doppler flow mapping, and 3-D imaging for each participant. Thereafter, all participants underwent an MRI examination. USG and MRI findings were compared with histopathological findings. Results: Loss of the retroplacental sonolucent zone (71% [95% CI 47-88]) and an irregular retroplacental sonolucent zone (71% [95% CI 47-88]) were the most sensitive USG parameters. For MRI, the uterine bulging parameter was the most sensitive (60% [95% CI 36-80]) and specific (91% [95% CI 83-96]) findings, and it had the highest accuracy rate (85% [95% CI 77-91]). Overall, the USG sensitivity, specificity, and accuracy rates were 77% (95% CI 54-92), 87% (95% CI 79-93), and 85% (95% CI 77-91), respectively. The MRI sensitivity, specificity, and accuracy rates for all participants were 81% (95% CI 59-94), 85% (95% CI 76-92), and 84% (95% CI 76-90), respectively. Conclusions: In the diagnosis of PAD, the specificity and accuracy of USG are higher than that of MRI, whereas the sensitivity of MRI is better than that of USG.Öğe TERSİYER BİR MERKEZİN 5 YILLIK VERİLERİNİN RETROSPEKTİF ANALİZİ: PLASENTAL İNVAZYON DERECESİ OPERATİF TEKNİKLERİ ETKİLİYOR MU?(2023) Yeniel, Ahmet Özgür; Suner, Aslı; Akdemir, Ali; Arı, Sabahattin Anıl; Ökmen, Fırat; SAHİN, Cagdas; Ergenoğlu, Ahmet MeteAmaç: Çalışmanın amacı plasenta invazyon derecesi ile tedavide kullanılan cerrahi yöntemlerin ilişkisinin incelenmesiydi. Yöntem: Ege Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniği’nde 2017-2022 yılları arasında sezaryen yapılan ve histopatolojik inceleme sonrası plasenta akreata spektrumu (PAS) tanısı alan olgular çalışmaya dahil edildi. Olguların yaşı, gebelik sayısı, daha önce geçirdikleri sezaryen sayısı, uygulanan cerrahi yöntem, eritrosit transfüzyon ihtiyaçları ve histopatolojik inceleme sonuçları elektronik ve basılı hasta dosyalarından elde edilerek olgu formuna kaydedildi. Vakaların yönetiminde kullanılan operatif teknikler, sezaryen+bilateral uterin arter ligasyonu, sezaryen+segmental rezeksiyon, sezaryen+bilateral uterin arter ligasyonu+segmental rezeksiyon+bilateral internal iliak arter ön dal ligasyonu ve son olarak sezaryen+histerektomi şeklinde belirlendi. Bulgular: Dahil edilme kriterlerini karşılayan 109 olgu retrospektif çalışmaya alındı. Olguların medyan yaşı 33 (IQR:7), geçirilmiş sezaryen sayısı ise 2 (IQR:1) olarak bulundu. Yapılan analizlerde sezaryen sayısı ile invazyon derecesi arasında pozitif korelasyon saptandı. (p<.001). 52 (%48.6) olguda organ koruyucu cerrahi, 55 (%51.4) olguda ise sezaryen histerektomi operasyonu uygulandı. Histopatolojik incelemeler sonucunda 45 (%42.2) olguda PAS grade 1, 40 (%37.3) olguda PAS grade 2 ve 22 (%20.5) olguda PAS grade 3 saptandı. Uygulanan operatif yöntemler ile histopatolojik sonuçlar arasında bir korelasyon gösterilemedi (p=.394). Yine aynı şekilde cerrahi yöntemler ile daha önceden geçirilmiş sezaryen sayısı arasında bir korelasyon saptanmadı (p=.652). Olgular için gerekli olan eritrosit transfüzyon sayıları ile plasental invazyon derecesi arasında bir korelasyon gösterilmedi (p=.151). Sonuç: Plasental invazyon derecesi daha önce geçirilmiş sezaryen sayısı ile orantılı şekilde artmaktadır. Operasyon tipi ve eritrosit transfüzyon sayıları ile invazyon derecesi arasında ilişki yoktur.
