Browsing by Author "Yanik, A"

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    Multicenter Analysis of Gestational Trophoblastic Neoplasia in Turkey
    Ozalp, SS; Telli, E; Oge, T; Tulunay, G; Boran, N; Turan, T; Yenen, M; Kurdoglu, Z; Ozler, A; Yuce, K; Ulker, V; Arvas, M; Demirkiran, F; Bese, T; Tokgozoglu, N; Onan, A; Sanci, M; Gokcu, M; Tosun, G; Dikmen, Y; Ozsaran, A; Terek, MC; Akman, L; Yetimalar, H; Kilic, DS; Gungor, T; Ozgu, E; Yildiz, Y; Kokcu, A; Kefeli, M; Kuruoglu, S; Yuksel, H; Guvenal, T; Hasdemir, PS; Ozcelik, B; Serin, S; Dolanbay, M; Arioz, DT; Tuncer, N; Bozkaya, H; Guven, S; Kulaksiz, D; Varol, F; Yanik, A; Ogurlu, G; Simsek, T; Toptas, T; Dogan, S; Camuzoglu, H; Api, M; Guzin, K; Caliskan, E; Doger, E; Cakmak, B; Ilhan, TT
    Background: To evaluate the incidence, diagnosis and management of GTN among 28 centers in Turkey. Materials and Methods: A retrospective study was designed to include GTN patients attending 28 centers in the 10-year period between January 2003 and May 2013. Demographical characteristics of the patients, histopathological diagnosis, the International Federation of Gynecology and Obstetrics (FIGO) anatomical and prognostic scores, use of single-agent and multi-agent chemotherapy, surgical interventions and prognosis were evaluated. Results: From 2003-2013, there were 1,173,235 deliveries and 456 GTN cases at the 28 centers. The incidence was calculated to be 0.38 per 1,000 deliveries. According to the evaluated data of 364 patients, the median age at diagnosis was 31 years (range, 15-59 years). A histopathological diagnosis was present for 45.1% of the patients, and invasive mole, choriocarcinoma and PSTTs were diagnosed in 22.3% (n=81), 18.1% (n=66) and 4.7% (n=17) of the patients, respectively. Regarding final prognosis, 352 (96.7%) of the patients had remission, and 7 (1.9%) had persistence, whereas the disease was mortal for 5 (1.4%) of the patients. Conclusions: Because of the differences between countries, it is important to provide national registration systems and special clinics for the accurate diagnosis and treatment of GTN.
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    The availability of vaginal hysterectomy in benign gynecologic diseases: A prospective, non-randomized trial
    Guvenal, T; Ozsoy, AZ; Kilcik, MA; Yanik, A
    Objective: To determine whether vaginal hysterectomy can be performed in patients with benign gynecologic diseases regardless of uterine size, uterine mobility and previous pelvic surgery and to compare with abdominal hysterectomy. Study Design: Between 2003 and 2008, we compared 47 vaginal hysterectomies (VH) with 61 abdominal hysterectomies (AH). We excluded from the study the clinical conditions that mandate abdominal exploration and standard indications for VH such as uterovaginal prolapse. Large, immobile uterus and previous pelvic surgery were not accepted as a contraindication for VH. Demographic characteristics, primary diagnosis, uterine weight, operation time, intraoperative blood loss, complications, and hospital stay and cost in both groups were compared. Results: Groups were similar with respect to demographic features and primary indications. Mean uterine weight and mean operation time were similar in VH and AH groups (258.0 g vs 293.9 g and 93.7 min vs 101.4 min, respectively). Oopherectomy was performed in 44.7% of VH and in 83.6% of AH. Colporrhaphies and/or anti-incontinence surgery were performed in 15 patients in the VH group (31.9%). The intraoperative blood loss was lower in the VH group than the AH group (245.0 mL vs 408.6 mL, P < 0.001). Perioperative complications were increased with AHs. The mean hospital stay and operation cost in the VH group were significantly less than the AH group (P < 0.001). Conclusion: This study indicates that vaginal hysterectomy could be performed with less morbidity in patients with benign gynecologic diseases even in large, immobile uterus and previous pelvic surgery.