ERKEN EVRE SERVİKS KANSERLİ LAPARASKOPİK SİNİR KORUYUCU RADİKAL HİSTEREKTOMİ YAPILAN 13 OLGUDA Kİ KLİNİK İLK DENEYİMİMİZ

Yıl 2019, Cilt: 4 Sayı: 3, 28 - 36, 31.12.2019

Ünal Turkay , Ahmet Kale Hasan Terzi Mehmet Salıcı Bahar Sarıibrahim Astepe

Öz

Erken evre serviks kanseri (EvreIA1-Evre IIA) tedavisinde geleneksel radikal histerektomi yapılan hastalarda postoperatif dönemde pelvik taban disfonksiyonu görülmektedir. Bu çalışmada Kocaeli Derince Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniğinde Ocak 2015-Ocak 2018 yılları arasında Erken evre serviks tanısı alan laparaskopik sinir koruyucu radikal histerektomi (LSKRH) yapılan 13 olgunun klinik ilk deneyimini, operasyon sonrası kontrollerinde Urogenital Distress Inventory (UDİ 6) anket testi ve hasta memnuniyet skoru (HMS) sonuçlarını değerlendirmek amaçlandı. Çalışma kapsamında 13 hastanın dosyası retrospektif olarak incelendi.Hastalarımızın yaş ortalaması 52,7±11,00 idi ve %61,53’ü postmenapozal dönemde idi. Hastaların operasyon süresi ortalama 223,46±51,85 dk, hastanede kalış süresi ortalama 8±3,05 gün ve sonda çekilme süresi ortalama 4,76± 5,19 gün olarak tespit edildi. Postoperatif rezidü ortalaması 38,84±11,39 ml olarak tespit edildi. Komplikasyon olarak 1 (%7,6) hastada üreter yaralanması ve 1 (%7,6) hastada vena iliaca externa yaralanması gerçekleşti. Postoperatif erken dönemde 1 (%7,6) hastada ileus, 1 (%7,6) hastada idrar yapamama ve 1 (%7,6) hastada da pulmoner emboli görüldü. Postoperatif 6.ay kontrollerinde UDİ-6 anket testi iritatif bulgular ortalama 1,76±2,27 ; stres bulguları ortalama 1,23±1,87, obstrüktif bulgular ortalama 1,23±1,09 ve HMS ortalama 8,84±1,46 olarak tespit edildi. LSKRH pelvik taban disfonksiyonu önleme açısından geleneksel radikal histerektomiden daha etkili olabilir.

Anahtar Kelimeler

Mesane fonksiyonu, servikal kanser, sinir koruyucu, laparaskopik radikal histerektomi

Kaynakça

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