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Öğe 10-15 ve 20-25 Haftalarda Ölçülen Servikal Uzunluğunun Preterm Doğumu Öngörmedeki Yeri(2014) Onat, Taylan; Abalı, Remzi; Turgut, Niyazi Emre; Çelik, Serdar; Boran, Ahmet Birtan; Çelik, CemAmaç: Düşük riskli gebelerde, 10-15. haftalar ve 20-25. haftalar arasında ölçülen serviks uzunluğu ile preterm doğum ilişkisini belirlemek amaçlanmıştır. Yöntemler: İstanbul Eğitim ve Araştırma Hastanesi Gebe Polikliniğine Nisan 2008- Ocak 2009 tarihleri arasında rutin antenatal takip amacıyla başvuran, çalışma kriterlerine uyan 118 gebe ile çalışma grubumuz oluşturuldu. Çoğul gebelikler, daha önce preterm doğum yapanlar, kronik hastalığı olanlar, bilinen uterin anomalisi olanlar ve fetal anomalili gebelikler çalışma dışı tutuldu. 37. gebelik haftasından önceki doğumlar preterm doğum grubunu, 37. gebelik haftasından sonraki doğumlar term doğum grubunu oluşturdu. Bulgular: Çalışma kapsamındaki gebelerin %88,99'u 37. gebelik haftasının üzerinde, %11,01'i 37. gebelik haftasının altında doğum yaptı. Term grupta 10-15. ve 20-25. haftalardaki servikal uzunluk değerleri, preterm gruba göre anlamlı derecede fazla bulunmuştur (p<0,01, p<0,001). Preterm doğum için eşik değer 10-15 hafta servikal uzunluk ölçümleri için 41,4 bulunurken, 20-25 hafta için 33,7 bulundu. Sonuç: Asemptomatik gebelerin taranmasında ve riskli olguların belirlenmesinde 20-25. haftada yapılan transvaginal ulatrasonografi etkili görülmektedir. Erken doğum açısından kötü obstetrik öyküye sahip olan ve risk altında olan gebelerin taranmasına daha erken başlanıp başlanmayacağı konusunda daha ileri çalışmalara ihtiyaç vardır.Öğe Clinicopathological Evaluation of Cervical Polyps(Aves, 2011) Yüksel, Mehmet Aytaç; Çelik, Serdar; Abalı, Remzi; Temel, İlkbal; Boran, Ahmet Birtan; Purisa, SevimObjectives: The aim of this study was to evaluate the clinicopathologic and demographic features in patients with cervical polyps. Methods: We performed a search of the database to retrieve all cases with a cervical polyp who were treated in the Obstetrics and Gynecology Department of Istanbul Education and Research Hospital between January 2006 and December 2010. The patients' symptoms and the size and histopathologic diagnosis of the polyp were reviewed. Patients were divided into four age groups as: Group I: <30, Group II: 30-44, Group III: 45-55, and Group IV: >55 years. Results: The mean age was 50.36 +/- 9.36 years. The mean polyp size was 12.46 +/- 8.31 mm and the recurrence rate was 1.8% (7/381). The majority of cervical polyps were asymptomatic (66.1%). Furthermore, there was no primary malignancy on the cervical polyps. There were no significant differences in terms of diameter, symptoms, rate of recurrence, and histopathologic findings between the four groups (p>0.05). Conclusion: Cervical polyps are benign lesions. Many of them are asymptomatic and are found at the time of routine gynecologic examination. Routine removal of polyps is reasonable and easy; pathological evaluation is needed to rule out other possibilities.Öğe Histopathological Correlation of Squamous Cell Abnormalities Detected on Cervical Cytology(De Gruyter Open Ltd, 2011) Abalı, Remzi; Bacanakgil, Besim Haluk; Çelik, Serdar; Aras, Özlem; Koca, Pelin; Boran, Birtan; Dursun, NevraObjective: To investigate the correlation between cytology and cervical biopsy in patients with squamous cell abnormality on cervical cytology. Material and Method: The cervical smears diagnosed in our clinic between 2005-2008 were reviewed retrospectively. Cases which exhibited squamous cell abnormality (n: 374) were evaluated. Results: The mean age was 45.15 +/- 10.78. In the cytopathological results, 256 (68.4%) ASC-US, 21 (5.6%) ASC-H, 31 (8.2%) LSIL, 48 (12.8%) HSIL, and 8 (4.8%) invasive carcinomas were diagnosed. Histopathological results were 213 (57%) nonneoplastic, 85 (22.7%) CIN I, 14 (3.7%) CIN II, 34(9.0%) CIN III and 28 (7.5%) invasive squamous cell carcinomas. Including all squamous cell abnormalities, the sensitivity of the smear test in CIN I and higher grade lesions was 56.95% and the false positivity was 43.04%. Excluding ASC-US and ASC-H lesions, the sensitivity of the smear test was 77.31% and the false positivity was 22.68%. After evaluating cervical cyto-histopathological correlation, the positive predictive value was found to be 100% in invasive carcinoma, 62% in HSIL and 38% in LSIL. Conclusion: As the grade of cytopathological result increases, the correlation between biopsy and the smear test also increases. The high sensitivity of the cervical smear test for high-grade lesions shows that it is an effective screening test.Öğe Servikal poliplerin klinik-patolojik değerlendirilmesi(2011) Yüksel, Mehmet Aytaç; Çelik, Serdar; Abalı, Remzi; Temel, İlkbal; Boran, Ahmet Birtan; Purisa, SevimAmaç: Servikal polipli hastaların klinikopatolojik ve demografik özellikleri incelendi. Gereç ve Yöntem: İstanbul Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği’nde Ocak 2006 ile Aralık 2010 yılları arasında servikal polip nedeniyle tedavi edilen 381 hastanın verileri geriye dönük olarak incelendi. Hastalar yaşlarına göre dört gruba ayrıldı; Grup I: < 30, Grup II: 30-44, Grup III: 45-55, Grup IV: >55. Hastaların, polip çapları, semptomları ve histopatolojik tanıları karşılaştırıldı. Bulgular: Hastaların ortalama yaşı 50,36±9,36 idi. Poliplerin ortalama çapı; 12,46±8,31 mm idi. Nüks oranı %1,8 (7/381) idi. Poliplerin büyük çoğunluğu asemptomatikdi (%66,1). Servikal poliplerde primer malignensi saptanmadı. Dört grup arasında çap, semptom, nüks oranı ve histopatolojik tanı açısından istatistiki bir fark yoktu (p>0,05). Sonuç: Servikal polipler iyi huylu lezyonlardır. Çoğu servikal polipler asemptomatik olup rutin jinekolojik muayene sırasında tespit edilirler. Çıkarılmalarının kolay olması, diğer patolojileri ekarte etmek için patolojik değerlendirme gerekliliğinden dolayı rutin çıkarılması mantıklı olabilir.Öğe Survival Outcomes of Treatment Modalities in Patients with Variant Histopathology of Bladder Cancer in First Transurethral Resection of the Bladder(2024) İzol, Volkan; Değer, Mutlu; Akdoğan, Bülent; Akgül, Murat; Aslan, Güven; Çelik, Serdar; Argun, BurakObjective: Diagnoses of variant histopathology (VH) in bladder cancer (BC) are increasing, and although there is a standard treatment algorithm for BC, the guidelines lack a standardized approach for treating VH in BC. We aimed to compare the survival results of the treatment algorithm applied to patients with BC with VH in the first transurethral resection of the bladder (TUR-B) procedure. Materials and Methods: We retrospectively assessed data on patients with VH of BC in the first TUR-B between January 2000 and January 2021. After the first TUR-B, we determined TUR-B+/- BCG, radical cystectomy (RC), and trimodal therapy (TMT) as the three potential treatments for patients according to the initial plans applied by the clinics. Results: A total of 289 patients with VH of BC in the first TUR-B were included in the study. Their mean age was 66.7±10.1 years, and most (246, 85.1%) were male. We found that TMT was associated with lower survival, and BCG administration offered no advantage in terms of overall survival (OS) or cancer specific survival (CSS) among patients with non-muscle-invasive bladder cancer (NMIBC). In patients with MIBC, immediate RC provided a significant advantage over other treatment methods in terms of both OS and CSS. Conclusions: There is still no standard treatment for patients with VH of BC. Patients are less likely to survive TMT than other treatment modalities.Öğe The Value of Cervical Length Measurement at 10-15 and 20-25 Weeks to Predict Preterm Birth(Aves, 2014) Onat, Taylan; Abalı, Remzi; Turgut, Niyazi Emre; Çelik, Serdar; Boran, Ahmet Birtan; Çelik, CemObjective: We aimed to predict the risks of preterm labor by measuring the cervical length between 10 and 15 weeks gestation and between 20 and 25 weeks gestation, in low risk pregnants. Methods: Our study group was formed in the outpatient clinic of the Ministry of Health Istanbul Education and Research Hospital with 118 pregnants who fulfilled the inclusion criteria and wished to attend our study during routine antenatal screening. Delivery before 37 weeks gestation constituted the preterm labor group, delivery after 37 weeks gestation constituted the term group. Multiple pregnancies, previous preterm delivery, chronic diseases, history of preterm labor, previously diagnosed uterine abnormalities and fetal anomalies were stated as exclusion criteria. Results: In our study pregnant patients who delivered after 37 weeks gestation constituted 88.99% (n: 105) of the study group, whereas 11.01% (n: 13) pregnant patients delivered before 37 weeks gestation. Cervical length measurements in both 10-15 weeks and 20-25 weeks were significantly higher in the term group (p<0.01, p<0.001). Cut off value of cervical length for preterm labor was found as 41.4 among 10 to 15 gestation weeks and 33.7 among 20 to 25 gestation weeks. Conclusion: Transvaginal sonography performed at 20 to 25 gestational weeks has an impressive role when screening asymptomatic pregnants and defining the risks. We need more studies to decide whether to begin earlier screening or not for preterm labor when an individual has a poor obstetric history and is under such risks.
