Benign Nedenlerle Yapılan Histerektomi Olgularında Histerektomi Öncesi Endometrial Örnekleme ve Histerektomi Sonrası Patoloji Sonuçlarının Karşılaştırılması

To Compare the Results of the Endometrial Biopsy Before The Hysterectomy and the Results of the Pathology After Hysterectomy in the Cases of Hysterectomy Which Was Done for Benign Reasons

Özet

Amaç: Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesindeki Ocak 2011 ile Haziran 2012tarihleri arasında benign sebeplerle yapılan histerektomi olgularında histerektomi öncesi endometrial biyopsi ve his- terektomi sonrası patoloji sonuçlarını karşılaştırmak. Yöntem ve Gereçler: Ocak 2011 ile Haziran 2012 tarihleri arasında benign sebeplerle yapılan histerektomiolgularının dosyaları retrospektif olarak incelendi. Bulgular: Ocak 2011 ile Haziran 2012 tarihleri arasında benign sebeplerle histerektomi yapılan toplam 332 olguincelendi. Olguların ortalama yaşı 46 (41-56) idi. Histerektomi endikasyonları 225 olguda myoma uteri, 56 olgudatedaviye dirençli kanama, 36 olguda tekrarlayan endometrial hiperplazi ve 15 olguda prolapsus uteri idi. Sonuç: Preoperatif endometriyal örnekleme bulguları proliferatif endometrium (%30.4), sekretuar endometrium(%34.9), endometrial hiperplazi (%10.8), endometrial polip (%6.6), kronik endometrit (%7.8) ve yetersiz materyal(%9.3) şeklinde olup endometriyal kanser saptanmadı. Postoperatif endometriyal bulgular proliferatif endometrium(%34.3), sekretuar endometrium (%37.9), endometriyal hiperplazi (%10.2), inaktif endometrium (%2.4), atrofik en- dometrium (%3.6), bazal endometrium (%3.0), endometriyal polip (%7.8) ve endometrioid adeno kanser (%0.6)şeklinde idi. Postoperatif patoloji sonucu Adeno CA olarak gelen 2 olgunun preoperatif endometrial biyopsi sonuçlarıkompleks atipili hiperplazi idi ve bu hastalara preoperatif olarak anormal uterin kanama nedeniyle endometrial biy- opsi yapılmıştı. Bu çalışmada benign nedenlerle histerektomi planlanan olgularda operasyon öncesi endometrialörneklemenin gerekli olmadığı görülmüştür.

Abstract

Aim : To compare the results of the endometrial biopsy before the hysterectomy and the results of the pathology afterhysterectomy in the cases of hysterectomy which was done for benign reasons at the Etlik Zübeyde Hanım Maternityand Women's Health Teaching and Research Hospital between January 2011 and June 2012.Materials and Methods :The files of the hysterectomy cases done for benign reasons between January 2011 andJune 2012 was examined retrospectively. Findings: 332 cases in total to which hysterectomy was conducted for benign reasons between January 2011 andJune 2012 were examined. The average age of the cases was 46 (41-56). The indications of the hysterectomy were myoma uteri in 225 of the cases, bleeding resistant to the treatment in 56 of the cases, recurrent endometrial hyper- plasia in 36 of the cases and prolapsus uteri in 15 of the cases. Results: The findings of preoperative endometriyal sampling were proliferative endometrium (30.4%), sekretuar en- dometrium (34.9%), endometrial hyperplasia (10.8%), endometrial polyp (6.6%) , chronic endometrit (7.8%) and in- sufficient material (9.3%). Endometrial cancer was not detected. Postoperative endometriyal findings were prolifera- tive endometrium (34.3%), sekretuar endometrium (37.9%), endometrial hyperplasia (10.2%), inactive endometrium(2.4%), atrophic endometrium (3.6%), basal endometrium (3.0%), endometriyal polyp (7.8%) and endometrioidadeno cancer (0.6%). The preoperative endometrial biopsy results of two cases whose postoperative pathology re- sults came as adeno cancer were complex atypical hyperplasia and preoperative endometrial biopsy was conductedto these patients because of the abnormal uterin bleeding. In this study it was seen that endometrial sampling beforethe operations was not necessary in the cases for which hysterectomy was planned for benign reasons.