Muzaffer Seyhan Çıkman

Objectives: To compare the effects of leukocyte- and platelet-rich plasma (L-PRP) and pure platelet-rich plasma (P-PRP), both among themselves and with the control group, in preventing intra-abdominal adhesions in an experimental rat model study. Materials and Methods: 34 Sprague-Dawley rats were randomized and divided into the control group (n=8), L-PRP (n=8), and P-PRP (n=8) treatment groups. The fourth group was used only for PRP preparation (5 rats for L-PRP and 5 rats for P-PRP) and was not included in the outcome analysis. All of the rats were operated on by the same two surgeons under general anesthesia for the uterine horn adhesion modeling. Apart from the control group, 1 mL of L-PRP and P-PRP solutions prepared for the other two treatment groups were applied to the lesion. Postoperative adhesion evaluation was performed on the 14th postoperative day. Adhesions were evaluated both macroscopically (presence, severity, and degree of adhesion) and histopathologically (levels of inflammation and fibrosis), and the evaluation was blinded by two similar surgeons. Results: One rat was lost during the study in each treatment group. There was a statistically significant difference in terms of the extent of adhesions among the groups (P = 0.025), the tenacity of the adhesions (P = 0.045), and total adhesion scores (7.13±2.7, 3.86±1.5, and 6.71±2.1; control, L-PRP, and P-PRP, respectively, P = 0.028). This difference was due to Group 2 during binary comparisons. However, the statistical difference between the groups after Bonferroni correction disappeared, apart from the tenacity of adhesions category. In the tenacity of adhesion category, the difference was only between the control group and L-PRP (12.5% in the gentle traction separation control group vs. 85.7% in L-PRP; P = 0.005). On histopathological examination, there was no difference between the groups in inflammation or fibrosis. Conclusions: In the experimental rat uterine horn adhesion modeling, neither L-PRP nor P-PRP was effective in preventing postoperative adhesion formation. However, the adhesion formed in the L-PRP group was more readily separated by gentle traction than in both the control and P-PRP groups.

Objective: This study aimed to evaluate any potential associations between uterine leiomyornas and endornetrial cancer. Materials and Methods: This is a retrospective study of 153 female patients who have been operated because of endometrial carcinoma in our hospital between 2012 and 2017. Data were collected from hospital records. Study participants were divided into two groups according to the presence and absence of leiomyomas. These two groups were compared in terms of histopathological adenocarcinoma type, nuclear and histological grades, disease stage, para-aortic lymph node involvement, and myometrial invasion. For data analysis, Statistical Package for Social Sciences 15.0 software package was used. Comparison between the two groups was made using the chi-square test, and each variable was tested with the Student's t-test for statistical significance. Results: No statistically significant differences were found between the groups with respect to age, tumor type, myometrial invasion, nuclear grade, or histological grade (p>0.05 for all). A significant difference was found between leiomyomas presence and lymph node metastases. The lymph node metastases were more common in patients without uterine leiomyomas (20.55%) than in those with them (5%; p=0.004). Analysis using the Federation of Obstetrics and Gynecology stages for the presence of leiomyomas indicated that the mean stages were 1A and 1B in patients with and without uterine leiomyomas, respectively (p=0.002). Conclusion: Uterine leiomyomas did not adversely affect the prognosis of patients with endometrial carcinoma. Moreover, lymph node involvement was less common, and stages were lower in patients with leiomyomas.

To determine the possible detrimental effects of multiple methotrexate doses has on the ovarian reserve and to determine the beneficial effects of dehydroepiandrosterone supplementation. The rats (n:24) divided into three groups; Group 1: control group, Group 2: dehydroepiandrosterone and methotrexate group (6mg/kg dehydroepiandrosterone dissolved in 0.1 ml sesame seed oil subcutaneously for ten days and 1mg/kg intramuscular methotrexate at the 1st, 3rd, 5th and 7th days) and Group 3: methotrexate group (1mg/kg intramuscular methotrexate at the 1st, 3rd, 5th and 7th day). The groups compared in regards to their histopathological ovarian damage scores and AMH values. It established that multiple methotrexate applications had a considerable effect on reducing vascular congestion in the ovarian tissue. Both in groups 2 and 3 AMH values found to be significantly lower. When this decline in the ovarian reserve examined comparatively; while both the group 2 and 3 reported having a considerable and continuous reduction in the AMH levels correlative to the control group; the primordial, primary and total follicle counts shown to stay statistically the same in the group 2 (p

To determine the possible detrimental effects of multiple methotrexate doses has on the ovarian reserve and to determine the beneficial effects of dehydroepiandrosterone supplementation. The rats (n:24) divided into three groups; Group 1: control group, Group 2: dehydroepiandrosterone and methotrexate group (6mg/kg dehydroepiandrosterone dissolved in 0.1 ml sesame seed oil subcutaneously for ten days and 1mg/kg intramuscular methotrexate at the 1st, 3rd, 5th and 7th days) and Group 3: methotrexate group (1mg/kg intramuscular methotrexate at the 1st, 3rd, 5th and 7th day). The groups compared in regards to their histopathological ovarian damage scores and AMH values. It established that multiple methotrexate applications had a considerable effect on reducing vascular congestion in the ovarian tissue. Both in groups 2 and 3 AMH values found to be significantly lower. When this decline in the ovarian reserve examined comparatively; while both the group 2 and 3 reported having a considerable and continuous reduction in the AMH levels correlative to the control group; the primordial, primary and total follicle counts shown to stay statistically the same in the group 2 (p<0.0167). The dehydroepiandrosterone supplementation, while did not have a significant effect on reducing ovarian damage induced by methotrexate, also was not shown to provide any considerable increase in AMH levels. However, prolonged usage of dehydroepiandrosterone by contributing to the antral follicle pool considered promising in increasing the AMH levels conceivably

Amaç: Benign nedenlerle yapılan total laparoskopik histerektomiden (TLH) sonra dren kullanımı rutin bir uygulama olmayıp tartışılan bir konudur. Amacımız dren kullanımının hasta kan değerlerine, postoperatif takip parametrelerine ve taburcu olma sürelerine etkisini araştırmaktır.Gereç ve Yöntemler: Kartal Dr. Lütfi Kırdar Eğitim ve Araştırma Hastanesi’nde Ocak 2015 ile Aralık 2017 arasında benign jinekolojik nedenlerle TLH yapılan hastalar retrospektif olarak tarandı. Çalışmaya 103 hasta dahil edildi. Hastalar dren kullanılan (n:57) ve kullanılmayan (n:46) olmak üzere iki gruba ayrıldı. Gruplar; operasyon süresi, kullanılan port sayısı, hemoglobin-hematokrit düşüşü, ateş, ilave analjezik ihtiyacı ve taburcu olma süresi açısından karşılaştırıldı. Bulgular SPSS 15 programı ile analiz edildi.Bulgular: Dren kullanılan vakalarda hemoglobin ve hematokrit değerleri istatistiksel olarak anlamlı şekilde düşük izlendi. Postoperatif analjezik ihtiyacında artış, kan transfüzyonu ihtiyacı ve taburcu olma süreleri açısından anlamlı farklılıklar olmadığı belirlendi. Hastaların hiçbirinde relaparatomi ihtiyacı olmadı.Sonuç: Benign jinekolojik nedenlerle TLH yapılan hastalarda dren kullanılması hemoglobin ve hematokrit değerlerinde düşüş ile birliktelik göstermektedir. Bu tip operasyonlarda dren kullanılmasını gerekli görülmedikçe önermiyoruz.