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Dergiler / Düzce Tıp Fakültesi Dergisi / 2025 / Volume: 27 Issue: 3

Obez Kadınlarda Bening Endikasyonlu Histerektomi: Laparoskopik mi, Abdominal mı?

Hysterectomy for Benign Indications in Obese Women: Laparoscopic or Abdominal Approach?

Arife Akay(Yalova State Hospital)0000-0001-9640-2714
Yıldız Akdaş Reis(UNIVERSITY OF HEALTH SCIENCES, ANKARA ETLİK ZÜBEYDE HANIM HEALTH RESEARCH CENTER FOR GYNECOLOGICAL DISEASES)0000-0001-9345-6899
Asya Kalaycı Öncü(UNIVERSITY OF HEALTH SCIENCES, ANKARA ETLİK ZÜBEYDE HANIM HEALTH RESEARCH CENTER FOR GYNECOLOGICAL DISEASES)0000-0001-8582-6175
Sena Ünlü(UNIVERSITY OF HEALTH SCIENCES, ANKARA ETLİK ZÜBEYDE HANIM HEALTH RESEARCH CENTER FOR GYNECOLOGICAL DISEASES)0009-0002-5652-4543
Vakkas Korkmaz(Etlik City Hospital)0000-0001-8895-6864
Yaprak Ustun(UNIVERSITY OF HEALTH SCIENCES, ANKARA ETLİK ZÜBEYDE HANIM HEALTH RESEARCH CENTER FOR GYNECOLOGICAL DISEASES)0000-0002-1011-3848
Sayfa
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Yayın Tarihi
2025-12-25
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Bulgular: Çalışmaya 146 (%34,4) AH ve 279 (%65,6) LH olgusu olmak üzere toplam 425 hasta dahil edildi.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Amaç: Bu çalışmanın amacı, obez kadınlarda laparoskopik histerektomi (LH) ve abdominal histerektomi (AH) ile ilişkili cerrahi sonuçları değerlendirmektir.
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Temel Bulgular & Veri:Gereç ve Yöntemler: 2018 ve 2022 yılları arasında iyi huylu endikasyonlarla histerektomi geçiren obez kadınlar (vücut kitle indeksi, VKİ, >30 kg/m2) geriye dönük olarak incelendi.
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Sonuç & Katkı:Bulgular: Çalışmaya 146 (%34,4) AH ve 279 (%65,6) LH olgusu olmak üzere toplam 425 hasta dahil edildi.
🔬Tür:Research Article
📍Kapsam:2018 · 425 hasta
⚙️Değişkenler:Body mass index · hysterectomy · laparoscopy

Özet

Amaç: Bu çalışmanın amacı, obez kadınlarda laparoskopik histerektomi (LH) ve abdominal histerektomi (AH) ile ilişkili cerrahi sonuçları değerlendirmektir. Gereç ve Yöntemler: 2018 ve 2022 yılları arasında iyi huylu endikasyonlarla histerektomi geçiren obez kadınlar (vücut kitle indeksi, VKİ, >30 kg/m2) geriye dönük olarak incelendi. Hastalar cerrahi yaklaşıma göre, LH ve AH olarak iki gruba ayrıldı. Demografik özellikler, operasyon süresi, hastanede kalış süresi ve perioperatif komplikasyonlar karşılaştırıldı. Bulgular: Çalışmaya 146 (%34,4) AH ve 279 (%65,6) LH olgusu olmak üzere toplam 425 hasta dahil edildi. Gruplar ortalama yaş açısından benzerdi (49,0±6,4 ve 47,8±5,7 yıl, p=0,057), ancak VKİ, LH grubunda anlamlı derecede daha yüksekti (33,4±3,7 ve 32,4±2,9 kg/m2, p<0,001). LH grubu anlamlı derecede daha kısa ortalama ameliyat süresi (104,0±20,6 ve 117,0±17,6 dakika, p<0,001) ve daha kısa ortanca hastanede kalış süresi (2, aralık: 1-15 ve 3, aralık: 2-14 gün, p<0,001) gösterdi. İntraoperatif komplikasyon oranı her iki grupta da benzerdi (n=5, %3,4 ve n=2, %0,7, p=0,050). Ancak AH grubunda anlamlı derecede daha yüksek bir postoperatif komplikasyon oranı gözlendi (n=12, %8,2 ve n=9, %3,2, p=0,024). Sonuç: Obez kadınlarda LH, AH'ye kıyasla daha kısa ameliyat süresi, daha kısa hastanede kalış süresi ve daha düşük postoperatif komplikasyon oranları ile ilişkilendirilmiştir. Genel bulgular, LH'nin obez hastalarda AH'ye güvenli ve etkili bir alternatif olduğunu göstermektedir. Bu retrospektif sonuçları doğrulamak ve heterojenliği kontrol etmek için daha fazla prospektif çalışmalara ihtiyaç vardır.

Abstract

Aim: This study aimed to evaluate surgical outcomes associated with laparoscopic hysterectomy (LH) and abdominal hysterectomy (AH) in obese women. Material and Methods: A retrospective review was conducted of obese women (body mass index, BMI, >30 kg/m2) who underwent hysterectomy for benign indications between 2018 and 2022. Patients were divided into two groups based on surgical approach, LH and AH. Demographic characteristics, operative time, hospitalization day, and perioperative complications were compared. Results: A total of 425 patients were included, comprising 146 (34.4%) AH and 279 (65.6%) LH cases. The groups were comparable in mean age (49.0±6.4 vs. 47.8±5.7 years, p=0.057), though BMI was significantly higher in the LH group (33.4±3.7 vs. 32.4±2.9 kg/m2, p<0.001). The LH group demonstrated significantly shorter mean operative time (104.0±20.6 vs. 117.0±17.6 minutes, p<0.001) and also reduced median hospitalization day (2, range: 1-15, vs. 3, range: 2-14 days, p<0.001). The rate of intraoperative complications was comparable in both groups (n=5, 3.4% vs. n=2, 0.7%, p=0.050). However, a significantly higher postoperative complication rate was observed in the AH group (n=12, 8.2% vs. n=9, 3.2%, p=0.024). Conclusion: LH in obese women was associated with shorter operative time, reduced hospitalization days, and lower rates of postoperative complications compared with AH. The overall findings suggest that LH is a safe and effective alternative to AH in obese patients. Further prospective studies are required to confirm these retrospective results and control for heterogeneity.

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Bu Makaleye Atıf Yap

Akay, A., Reis, Y. A., Öncü, A. K., Ünlü, S., Korkmaz, V., Ustun, Y. (2025). Obez Kadınlarda Bening Endikasyonlu Histerektomi: Laparoskopik mi, Abdominal mı?. Düzce Tıp Fakültesi Dergisi, Volume: 27 Issue: 3. https://doi.org/10.18678/dtfd.1677200

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