Ferhan ELMALI, Serpil AYDOĞMUŞ, Hüseyin AYDOĞMUŞ, Zafer KOLSUZ, Halil İbrahim TIRAŞ

BENİGN PATOLOJİ ÖNTANISI İLE HİSTEREKTOMİ YAPILAN OLGULARDA POSTOPERATİF İNSİDENTAL ENDOMETRİAL PRE-/MALİGN PATOLOJİ SAPTANMA ORANI

Amaç: Benign endikasyonlarla histerektomi yapılması planlanan ve preoperatif ‘endometrial örnekleme/biyopsi yapılan’ ve ‘yapılmayan veya yapılsa dahi yetersiz materyal nedeniyle sonuç alınamayan’ olgularınpostoperatif endometrium histopatoloji sonuçları ile insidental saptanan endometrial patoloji oranlarınınsaptanmasıdır.Gereç ve Yöntemler: Bu kesitsel çalışmaya benign jinekolojik endikasyonlarla histerektomi operasyonu ya-pılan 163 olgu dahil edildi. Bu olgulardan 100’ünde preoperatif endometrial örnekleme/biyopsi yapılmış veendometrial histopatolojik tanı almıştı (Grup 1). 63 olguda ise preoperatif endometrial patolojik incelemeyapılmamış veya sonucu yetersiz materyal olarak rapor edilmişti. (Grup 2). Olguların demografik verileri ilepostoperatif endometrium histopatolojik inceleme sonuçları kaydedildi ve gruplar arasında karşılaştırıldı.Gruplar arası karşılaştırmalarda independent sample T test, Mann-Whitney testi ve Fisher Ki-kare exact testikullanıldı. p0.05). Postoperatif histopatolojik incelemede her iki grupta insidental saptanan endometrial pre-/malignpatoloji oranları benzerdi (Grup 1’de %3’e karşı Grup 2’de %4.8, p= 0.677). Grup 2’de endometrial pre-/malign patoloji saptanan üç olgu da postmenopozal dönemde idi, 2 olguda ise obezite ve diabet tanılarımevcuttu.Sonuç: Postoperatif insidental endometrial patoloji saptanma oranları benzer olarak saptanmış olsa dahibenign jinekolojik patolojilerle histerektomi yapılması planlanan hastalarda endometrial patolojiler açısın-dan mevcut risk faktörlerinin belirlenmesi ve özellikle riskli olgularda preoperatif dönemde endometrialincelemenin yapılmasını, histopatolojik tanı yetersiz ise gerekirse tekrarlayan biyopsiler veya histeroskopi ileincelenmesi gerektiğini önermekteyiz.

The Rate of Incidental Malignant Pathologies in Patients Who Underwent Hysterectomy Due to Benign Gynecological Conditions

Objectives: The aim of this study is to compare endometrial histopathological findings of patients having been exposed to hysterectomy due to benign gynecological conditions, who have been through preoperative endometrial sampling and the ones who have not yet or whom from no results could be achived due to inadequate sample. Materials and methods: In this cross-sectional study, a total of 163 cases who underwent hysterectomy operation due to benign gynecological indications were evaluated. Group 1 (n=100) patients were applied endometrial sampling / biopsy and had histopathological diagnosis preoperatively. Group 2 patients (n=63) had no preoperative endometrial pathologic examination or their endometrial biopsy results were inadequate for diagnosis. The demographic data of the patients and the results of postoperative endometrial histopathological examination were recorded and compared between the groups. Comparisons between the two groups were made using the independent sample T-test, Mann-Whitney test, and Fisher’s Chi- square test. The statistical significance level was accepted as p0,05). On postoperative final pathologic examination the incidence of incidental diagnosis of premalignant/malignant endometrial pathology were similar between both groups (3% in Group 1 versus 4.8% in Group 2, p=0.677). All of the three patients who were diagnosed premalignant/malignant endometrial pathology in Group 2 were postmenopausal and furthermore two of them had diabetes and obesity. Conclusion: Although our results exposed that two groups have similar incidence of incidental diagnosis of endometrial pathologies, we suggest that current risk factors for endometrial pathology should be determined before hysterectomy. In high risk group patients if preoperative histopathologic diagnosis is insufficient, endometrial biopsy should be performed one more times as required or hysteroscopy should be performed.

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