Murat EKİN, Hediye DAĞDEVİREN, Sema SÜZEN ÇAYPINAR, Ammar KANAWATİ, Hüseyin CENGİZ

Clinical and pathological investigation of adnexal masses in adolescents who underwent surgery in a tertiary center

Amaç: Adneksiyel kitleler adölesan hastalarda jinekolojik cerrahinin en sık nedenidir. Erken tanı ve yeterli tedavi fertilitenin korunmasında ve yaşamın devamında çok önemlidir. Bu çalışmada hastanemizde adneksiyel kitle nedeniyle ameliyat edilen 106 hastanın klinik özelliklerini inceledik. Yöntemler: Çalışma Ocak 2008 ve Aralık 2013 yılları arasında adneksiyel kitle nedeniyle ameliyat edilen 20 yaş altı 106 hastayı içermektedir. Hastaların klinik özellikleri geriye dönük olarak hastane kayıtlarından elde edildi. Kayıtlardan hastaların demografik özellikleri, başvuru şikayetleri, ameliyat öncesi radyolojik bulguları, operasyon şekli, patolojik bulguları ve kitlenin maksimum çapı elde edildi.Bulgular: Hastaların yaşları 12 ile 20 arasında değişmekteydi. (ort, 18,8). Hastaların en sık başvuru semptomu karın ağrısı idi (%56,6). Benign ovaryan lezyonlar yönünden incelediğimizde hastaların 7 tanesinde (%6,6) korpus hemorajikum, 10 tanesinde (%9,4) korpus luteum, 4 tanesinde (%3,8) paratubal kist ve 7 tanesinde (%6,6) basit kist vardı. Benign neoplastik lezyonlardan hastaların 20 tanesinde (%18,9) matur kistik teratom (dermoid tümör), 10 tanesinde (%9,4) seröz kistadenom, 1 tanesinde (%0,9) müsinöz kistadenom ve 7 tanesinde (%6,6) endometrioma vardı. En sık cerrahi yaklaşım laparoskopi (%67,0) ve en sık uygulanan ameliyat kistektomiydi. (%60,4). Sonuç: Laparoskopi ve fertilite koruyucu cerrahi adölesan yaşta bütün hastalarda ilk tercih edilen yöntem olmalıdır. Cerrahi yapılan ve benign kitlesi olan hastalarda gelecekteki fertiliteyi korumak için over koruyucu cerrahi teknikler uygulanmalıdır.

Tersiyer bir merkezde ameliyat olan adölesanlardaki adneksiyel kitlelerin klinik ve patolojik incelenmesi

Objective: Adnexal masses are the most common reason for gynecologic surgery in adolescent patients. Early detection and adequate management of adnexal lesions are very important for saving lives and preserving fertility. In this study, we analyzed the clinical characteristics of 106 Turkish adolescent women who underwent surgery for adnexal masses.Methods: The study included 106 patients aged

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Logsdon VK. Common problems in pediatric and ado- lescent gynecologic surgery. Curr Opin Obstet Gyne- col 2001;5:453-458.
Kirkham YA, Lacy JA, Kives S, Allen L. Characteristics and management of adnexal masses in a canadian pediatric and adolescent population. J Obstet Gynae- col Can 2011;33:935-943.
Cartault A, Caula-Legriel S, Baunin C, et al. Ovarian masses in adolescent girls. Endocr Dev 2012;22:194- 207
Spinelli C, Pucci V, Strambi S, et al. Treatment of Ovar- ian Lesions in Children and Adolescents: A Retro- spective Study of 130 Cases. Pediatr Hematol Oncol 2015;32:199-206.
Liu H, Wang X, LuD, et al. Ovarian masses in children and adolescents in China: analysis of 203 cases. J Ovarian Res 2013;6:47.
Eskander Rn, Bristow RE, Saenz NC, Saenz CC. A ret- rospective review of the effect of surgeon specialty on the management of 190 benign and malignant pediat- ric and adolescent adnexal masses. J Pediatr Adolesc Gynecol 2011;24:282-285.
Batt RE. Adnexal masses in Korean children and ado- lescents. J Minim Invasive Gynecol 2010; 17: 665
Ryoo U, Lee DY, Bae DS, et al. Clinical characteristics of adnexal masses in Korean children and adoles- cents: retrospective analysis of 409 cases. J Minim Invasive Gynecol 2010;2:209-213.
Powell JK. Benign adnexal masses in the adolescents. Adolesc Med Clin 2004;15:535-547.
Cass DL, Hawkins E, Brandt ML, et al. Surgery for ovarian masses in infants, children, and adolescents: 102 consecutive patients treated in a 15-year period. J Pediatr Surg 2001;36:693-699.
Piippo S, Mustaniemi L, Lenko H, et al. Surgery for ovarian masses during childhood and adolescence: a report of 79 cases. J Pediatr Adolesc Gynecol 1999;12:223-227.
Templeman C, Fallat ME, Blinchevsky A, Hertweck SP. Noninflammatory ovarian masses in girls and young women. Obstet Gynecol 2000;96:229-233.
Deligeoroglou E, Eleftheriades M, Shiadoes V, et al. Ovarian masses during adolescence: Clinical, ultra- sonographic and pathological findings, serum tumor markers, and endocrinological profile. Gynecol Endo- crinol 2004;19:1-8.
Knudsen UB, Tabor A, Mosgaard B, et al. Manage- ment of ovarian cysts. Acta Obstet Gynecol Scand 2004;83:1012-1021.
Templeman CL, Fallat ME, Lam AM, et al. Managing mature cystic teratomas of the ovary. Obstet Gynecol Surv 2000;55:738-745.
Berek JS, Natarajan S. Ovarian and fallopian tube cancer. In: Berek JS, editor. Berek & Novak's Gy- necology. Philadelphia, USA: Lippincott Williams & Wilkins, 2007, p. 1457-1547.
Reddy J, Laufer MR. Advantage of conservative surgi- cal management of large ovarian neoplasms in ado- lescents. Fertil Steril 2009;91:1941-1944.
Warner MA, Fleischer AC, Edell SL, et al. Uterine adnexal torsion: Sonographic findings. Radiology 1985;154:773-775.
Templeman C, Hertweck SP, Fallat ME. The clinical course of unresected ovarian torsion. J Pediatr Surg 2000;35:1385-1387.
Broach AN, Mansuria SM, Sanfilippo JS. Pediatric and adolescent gynecologic laparoscopy. Clin Obstet Gynecol 2009;52:380-389.
Oltmann SC, Fischer A, Barber R, et al. Cannot exclude torsion - a 15-year review. J Pediatr Surg 2009;44:1212-1216.
Lo Lm, Chang SD, Horng SG, et al. Laparoscopy ver- sus laparotomy for surgical intervention of ovarian tor- sion. J Obstet Gynaecol Res 2008;34:1020-1025.
Eckler K, Laufer MR, Perlman SE. Conservative man- agement of bilateral asynchronous adnexal torsion with necrosis in a prepubescent girl. J Pediatr Surg 2000;35:1248-1251.
Mayer JP, Bettolli M, Kolberg-Schwerdt A, et al. Lapa- roscopic approach to ovarian mass in children and adolescents: already a standard in therapy. J Laparo- endosc Adv Surg Tech 2009;19:111-115.
Mettler L, Semm K, Shive K. Endoscopic manage- ment of adnexal masses. J Soc Laparoendosc Surg 1997;1:103-112.
Jawad AJ, Al-Meshari A. Laparoscopy for ovarian pathology in infancy and childhood. Pediatr Surg Int 1998;14:62-65.
Mansuria SM, Sanfilippo JS. Laparoscopy in the pedi- atric and adolescent population. Obstet Gynecol Clin North Am 2004;31:469-483.
Worster A, Haines T. Advanced statistics: understand- ing medical record review (MRR) studies. Acad Emerg Med 2004;11:187-192.