Mete Sucu

Prognostic value of pre-operative neutrophil/lymphocyte ratio, monocyte count, mean platelet volume, and platelet/lymphocyte ratio in endometrial cancer

OBJECTIVE Cancer-related inflammation is associated with poor long-term outcomes in various solid tumors. The aim of this study is to investigate the prognostic significance of pre-operative neutrophil lymphocyte ratio (NLR), monocyte count (MC), mean platelet volume (MPV), and platelet lymphocyte ratio (PLR) in endometrial cancer. STUDY DESIGN In this study, 763 patients with endometrial cancer were evaluated, who were followed between January 1996 and February 2016. Preoperative values of NLR, MC, MPV, and PLR were evaluated in terms of clinico-pathologic prognostic factors and overall survival (OS). RESULTS NLR, MC, and PLR were detected to be statistically significant with regard to advanced stage of the disease (p = 0.001, p = 0.02, and p = 0.001, respectively), but only MC was significant in terms of grade (p = 0.035). Higher NLR and PLR values were found to be associated with advanced stage of the disease, deep myometrial invasion, cervical involvement, lymphovascular space invasion (LVSI), and nodal involvement. When the cut-off value was considered as 3, sensitivity and specificity for NLR were found to be 68% and 69%, respectively, to predict lymph node metastasis. NLR was found as a prognostic factor for survival (p = 0.01). Age, the presence of comorbidity, stage, and cervical involvement were determined to be independent prognostic factors for OS in our cohort. CONCLUSION NLR was detected to be a prognostic factor for survival. Moreover, NLR and PLR are a predictive value for lymph node involvement and also for cervical invasion in endometrial cancer.

Detection of major anomalies during the first and early second trimester: Single-center results of six years

Objective: Fetal structural malformations affect approximately 2-3% of all pregnancies. Only focusing on trisomy screening in first trimester and deferring the anatomic screening to second trimester may result with late detection of major anomalies that can be diagnosed earlier with careful examination. Material and Methods: This was a descriptive study of retrospective data that were obtained from all terminated single pregnancies due to ultrasonographic findings of major anomalies from 2011 to 2016 in our department. The study was based on a chart review and only abnormalities that were diagnosed before the 16th week were included. Results: Two hundred forty-four first trimester pregnancy terminations were performed. In total, 273 anomalies were detected in the 244 patients. Cranial NTD comprised 32% of all anomalies (n=89). Fifteen percent of anomalies (n=41) needed detailed anatomic scanning for early diagnosis. Conclusion: In this study, we presented the number and percentage of our early diagnosed anomalies by years, as well showed our diagnostic performance for specific anomalies such as atrioventricular septal defect during a 5-year period. The study provides valuable information for future studies in Turkey and shows the need for an anatomic scan protocol while performing aneuploidy screening during early gestation.

Laparoendoscopic Single Site Total Hysterectomy: Single Institution Initial Experience

ABS TRACT Objective: To compare the periand post-operative outcomes between the laparoendoscopic transumblical single-site total hysterectomy (LESS-TH) and conventional three-port total laparoscopic hysterectomy (TLH). Material and Methods: A single institution retrospective review of patients operated on with LESS-TH (n= 24) and TLH (n=47) for benign uterine pathology or endometrial cancer with low-risk factors from March 2013 to March 2014. Patients underwent LESSTH surgery through a single 2-3 cm transumbilical incision with a multi-channel SILS TM port (Covidien®, Mansfield, MA, USA). Patient demographics and peri-operative and post-operative variables were analyzed and compared between the groups. Results: There was one conversion to conventional laparoscopy and one conversion to laparotomy in the LESS-TH group, and no cases converted to laparotomy in the LTH group. Demographic characteristics such as age, body mass index (BMI), and indications were similar between the groups (p=0.497, 0.07, 0.594, respectively). Operation time was significantly longer in the LESS-TH group than in the TLH group (p=0.01). The other periand post-operative variables such as uterus length and width, estimated blood loss, post-operative Hb level drop, post-operative hospitalization time and analgesic management were found to be similar between the two groups. There were no major complications in either of the groups. Conclusion: With the exception of operative time, the surgical outcomes of the LESS-TH group were comparable to those of the conventional multiport TLH group.

Prenatal diagnosis of pectus excavatum

Pectus excavatum (PE) is the depression of the lower part of manubrium sterni and xiphoid process. The main problem of PE depends on the cardiopulmonary morbidity caused by the narrowing of the thoracic space. To date, prenatal diagnosis of this deformity has been reported only once and was associated with Down syndrome. We present another case which we diagnosed as PE during a second-trimester fetal anatomic scan. The pectus severity index is used for these patients in postnatal life; however, prenatal adaption of this index is reported for the first time in our case.

First trimester fetal aortic Doppler for hemoglobinopathies

Objective: To evaluate fetal aortic Doppler for the prenatal diagnosis of hemoglobinopathies in the first trimester of pregnancy. Materials and Methods: Between January and November 2014, a total of 108 patients were enrolled in the study. The couples were carriers of either alpha/beta thalassemia, sickle cell disease or combined carriers of these and were admitted to Çukurova University Faculty of Medicine, Department of Obstetrics and Gynecology Prenatal Diagnosis Center. One hour before the chorionic villus sampling (CVS), patients were evaluated using fetal aortic Doppler. Pulsatility index, peak systolic velocity, and heart rate were noted. Results: There were no statistically significant differences in Doppler indices between different groups of CVS results when compared with the healthy controls. Conclusion: Fetal aortic Doppler investigation was found to be ineffective for the prenatal diagnosis of hemoglobinopathies.

Tek merkezli borderline over tümörlerinin 5 yıllık retrospektif analizi

Amac: Bu calismada, klinigimizde son 5 yilda opere edilen bordeline over tumorlu vakalarin degerlendirilmesi amaclanmistir. Gerec ve Yontem: Cukurova Universitesi Tip Fakultesi Jinekolojik Onkoloji biriminde son 5 yil icerisinde opere edilen borderline over tumorlu olgularin, patoloji raporlari ve birimin bilgisayar kayitlari ile arsiv dosyalari retrospektif bir sekilde tarandi. Toplam 41 vaka tespit edilip calismaya dahil edildi. Olgularin demografik karakteristikleri, preoperatif muayene bulgulari, operasyon ve patoloji ozellikleri degerlendirildi. Bulgular: Hastalarin ortalama yasi 41 idi ve %85’i premenopozal donemde idi. Preoperatif donemde bakilan ultrasonda, tumorun ortalama capi 10 cm olarak olculdu. Operasyon oncesi ortalama ca125 degeri 120 olarak tespit edildi. Total histerektomi + bilateral salpingooferektomi 12 hastaya uygulanirken, geri kalan 29 hastaya unilateral salpingooferektomi uygulandi. Lenfadenektomi, hastalarin %41.5’inde gerceklestirildi. En sik seroz histopatolojik tip (%70.7) izlendi. Hastalarin cogunda (%90.2) tumor, evre I’de idi. Hic bir olguda nuks tespit edilmedi. Sonuc: Borderline over tumorleri, iyi prognoza sahip oldugundan, fertilite arzusu olan hastalarda, unilateral salpingoferektomi guvenle onerilebilecek bir tedavi seklidir.

Gebelik ve Toksoplazma Enfeksiyonu

Toksoplazma gondii isimli bir protozoanin sebep oldugu toksoplazmozis enfeksiyonu gebelikte fetal anomalilere ve dusuk-olu dogum gibi olumsuz perinatal sonuclara yol acabildigi icin oldukca onemlidir. Ozellikle cig et, kontamine yiyeceklerle bulasan bu enfeksiyonun prenatal donemde uygun zamanda, dogru tani ve yonetimi ile ciddi norolojik sekel riski azaltilabilmektedir. Dolayisiyla gebe takibi yapan klinisyenlerin bu enfeksiyonu derinlemesine bilmesi onem arz etmektedir. Bu amacla makalemizde, toksoplazma enfeksiyonun prenatal donemde tanisi, komplikasyonlari ve tedavisini ozetlemeyi amacladik.