Endometriozis ön tanılı 69 olgunun tedavi modalitelerinin karşılaştırılması

Abstract

Çal mam z n amac Dicle Üniversitesi T p Fakültesi Kad n Hastal klar ve Do um klini inde endometriozis tedavisinde uygulanan tedavi modalitelerinin etkinlik, güvenirlilik aç s ndan kar la t r lmas d r. Çal mam zda endometriozis ön tan s yla tedaviye karar verilen 69 hastan n 40 na laparoskopi, 16 s na laparotomi, 13 üne kombine tedavi (preoperatif medikal tedavi veya postoperatif medikal tedavi) uyguland . Her 3 gruptaki olgular n da l m nda ya , medeni durumu, meslek, sigara kullan p kullanmad , ikayetleri, fertilite durumu, infertil hastalar n tedavi sonras gebelik durumu, gebelik olu anlar n hangi yöntemle gebe kald , tedavi öncesi ve sonras tümör belirteçleri, tedavi öncesi ve sonras USG ik bulgular kaydedildi. 3 grup aras nda ya da l m n n homojen olmad görüldü ve gruplar aras nda istatiksel olarak anlaml farkl l k oldu u tespit edildi (p=0.002). Laparotomik cerrahi grubu daha ileri ya taki hastalara, laparoskopik cerrahi daha genç hastalara uygulanm t . Gruplar aras nda tümör belirteçleri tedavi öncesi ve sonras kar la t r ld . CA 15-3 düzeyinde 3.grupta istatiksel olarak anlaml farkl l k izlendi (p=0.015). Gruplar aras nda medeni durum, meslek, sigara kullan p kullanmad , tedavi öncesi ve sonras a r ikayetinin durumu, tedavi öncesi infertilite ikayeti olanlar n gebelik durumu ve tedavi öncesi ve sonras USG bulgular aras nda istatiksel olarak anlaml bir farkl l k izlenmedi. Tedavi sonras gebelik olu anlar n gebelik meydana gelme yöntemi aç s ndan 1.grup lehine istatiksel olarak anlaml farkl l k oldu u izlendi (p=0.036).

The aim of this study is to compare the efficiency and safety of the treatment modalities of endometriosis administered in Obstetrics and Gynecology department of Dicle University Faculty of Medicine Hospital. In our study, 40 of 69 patients whom were treated with the pre-diagnosis of endometriosis had laparoscopy, while 16 had laparotomy and 13 had combined treatment (preoperative medical treatment or postoperative medical treatment). Age, marital status, occupational status, cigarette smoking, complaints, fertility status, the presence of pregnancy of infertile patients after appropriate treatment, the method used in those became pregnant, tumor marker levels before and after treatment, and sonografical findings before and after treatment were registered in the distribution of all 3 patient groups. It was detected that the age distrubition among 3 groups was not homogeous and statistically significant difference was seen among the groups (p=0.002). Laparotomical surgical intervention was performed to older patients and laparoscopical surgical intervention was performed to younger patients. Ca 15-3 levels of the third group was found to be statistically significant when tumor marker levels before/after treatment were compared among the groups (p=0.015). No statistical significance were shown in marital status, occupational status, cigarette smoking, pain complaints of before and after treatment; the presence of pregnancy in those with infertility before treatment and subsequent sonografical findings among the groups. The method used in those who conceived after treatment in the first group were established to be statistically significant (p=0.036).