Histerektomi Materyallerinde Histopatolojik Tanıların Değerlendirilmesi

Yıl 2016, Cilt: 6 Sayı: 2, 87 - 91, 19.10.2016

Çiğdem Kunt İşgüder , Hatice Yılmaz Doğru , Asker Zeki Özsoy , Bülent Çakmak , İlhan Bahri Delibaş , Akgül Arıcı Fazlı Demirtürk

https://doi.org/10.16899/ctd.65609

Öz

Amaç: Bu çalışmanın amacı; benign endikasyonlarla yapılan histerektomilerin preoperatif klinik endikasyonlarının ve postoperatif histopatolojik tanılarının değerlendirilmesidir.

Gereç ve Yöntem: Mart 2013-Mayıs 2015 tarihleri arasında Gaziosmanpaşa Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniği’nde benign endikasyonlarla histerektomi uygulanan 170 hastanın klinik özellikleri ve postoperatif histopatolojik tanı raporları retrospektif olarak değerlendirildi.

Bulgular: Hastaların yaş ortalaması 50.48±7.50 (min:38, max:74) idi. En sık histerektomi endikasyonu 77 olgu (%45.3) ile leiomyoma idi. Daha sonra sırası ile disfonksiyonel uterin kanama 50 (%29.49) ve endometrial hiperplazi 22 (%12.9) olarak tespit edildi. Diğer klinik endikasyonlar  uterus prolapsus 17 (%10), kronik pelvik ağrı 2 (%1.2) ve adenomyozis 2 (%1.2) idi. Histerektomi materyallerinin histopatolojik raporlarının değerlendirilmesi sonucunda, en yaygın patoloji leiomyoma 87olguda (%51.2), takiben adenomyozis 35 olguda (% 20.5) ve endometrial hiperplazi 31 (18.3) saptandı. Endometrial polip 10 olguda (%5.9) ve 7 olguda (%4.1) ise atrofik endometrium mevcuttu. 44 histerektomi materyalinde kombine patoloji tanımlandı. %50 oranında leiomyoma ve endometrial hiperplazi en yaygın kombibasyon olarak tespit edildi. Ayrıca histerektomi materyallerinin serviks incelemelerinde %64.7 ‘sinde kronik servisit olduğu gözlendi.

Sonuç: 4. ve 5. dekatta açıklanamayan menometroraji, sekonder dismenore ve kronik pelvik ağrı ile başvuran hastaların tanısında ve tedavileri planlanırken mutlaka adenomyozis akla gelmelidir. Leiomyama ve endometrial hiperplazilerin yüksek oranda birlikteliğinden dolayı leiomyoma tanısıyla histerektomi planlanan olgularda menometroraji de mevcut ise endometrial örnekleme yapılmasının gerekli olduğu görülmektedir.

 

Anahtar Kelimeler

Histerektomi, histerektomi endikasyonları, patoloji

The Evaluation Of Histopathological Diagnosis In Hysterectomy Materials

Öz

-The aim of this study is to assess the preoperative clinic indications and postoperative histopathological diagnosis of hysterectomies with benign indications.Materilas and Methods- Clinical features and reports of postoperative histopathological diagnosis of 170 patients, whose underwent hysterectomy with benign indications in Gaziosmanpasa University Medical Faculty Department of Obstetrics and Gynecology, were retrospectively evaluated.Results- The mean age of the patients was 50.48±7.50 (min-38, max-74). Leiomyoma with 77 case (E.3) was the most hysterectomy indicated disease. Thereafter, dysfunctional uterine bleeding in 50 ().49), and endometrial hyperplasia 22 (%12.9) were detected. The other clinical indications were uterine prolapse in 17 patients (%10), chronic pelvic pain in 2 (%1.2) and adenomyosis in 2 (%1.2). The results of histopathological reports belong to hysterectomy materials indicated that leiomyoma was the most common pathological finding with 87 cases (Q.2), subsequently adenomyosis in 35 cases (% 20.5) and endometrial hyperplasia in 31 (18.3) was detected. Endometrial polyp was found in 10 cases (%5.9) and atrophic endometrium in 7 cases (%4.1). Combined pathology was defined in 44 hysteterctomy materials. Leiomyoma and endometrial hyperplasia were detected as the most common combination with a ratio of P. In addition, chronic cervicitis was seen in d.7 of cervical examinations of hysterectomy materials. Conclusion- Adenomyosis should be kept in mind while planning the diagnosis and treatment of patients whose admitted with compliants of menometrorrhagia, seconder dysmenorrhea and chronic pelvic pain in 4th and 5th decade. Endometrial sampling caused by the co-existence of leiomyoma and endometrial hyperplasia must be necessary in hysterectomy planned cases for leiomyoma those already have menometrorrhagia-

Anahtar Kelimeler

hysterectomy, hysterectomy indications, pathology.

Kaynakça

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