Evaluation of inflammatuar response in hysterectomies: a retrospective study in Kocaeli, Turkey.

OBJECTIVES: The authors aimed to detect the inflammatory marker changes in laparoscopic hysterectomy (LH) and abdominal hysterectomy (AH) and to determine whether oophorectomy affected the results. MATERIAL AND METHODS: The patients who underwent LH and AH with or without oophorectomy between 2018 and 2019 were identified as two groups. The records of patients were reviewed retrospectively. Preoperative and postoperative in the first 24 hours hematocrit (HCT), hemoglobin (HB), white blood cell (WBC), platelet-lymphocyte ratio (PLR), and neutrophil-lymphocyte ratio (NLR) values were compared. RESULTS: WBC, NLR, and PLR were statistically increased, and HB and HCT were decreased in all groups in the postoperative period. However, all changes were more prominent in the AH group than in the LH group. In other words, in the postoperative period, there were fewer changes in the inflammatory markers WBC, NLR, and NLR in the LH group. Oophorectomy did not affect these results. CONCLUSIONS: LH, as in other laparoscopic operations, was associated with lower inflammatory response. The addition of oophorectomy did not increase inflammation in either AH or LH. Clinical Trials registration number is NCT04184765.

Comparison of pregnant Turkish women and Syrian refugees: Does living as a refugee have an unfavorable effect on pregnancy outcomes?

OBJECTIVE: To compare pregnant Turkish women and Syrian refugee women in terms of demographic data and obstetric and neonatal outcomes. METHODS: In a retrospective study, the records of Turkish women and Syrian refugee women who gave birth at the Health Sciences University Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey, between January 1, 2016, and July 31, 2017 were examined. Maternal characteristics and obstetric and neonatal outcomes were compared between the two groups. RESULTS: The study, which included 7950 Turkish women and 620 Syrian refugee women, found significant differences in maternal age according to nationality. The rate of normal delivery was significantly lower for the Turkish women at 51.6% (P=0.001) compared to 61.3% for the Syrian refugee women. The rate of delivery prior to 37 weeks of gestation was 1.8% for the Turkish women and 3.2% for the Syrian refugee women, indicating earlier delivery for the Syrian refugees than the Turkish women (P=0.017). A significant difference was found between the birth weights of infants born in the two groups (P=0.001). CONCLUSION: According to the study results, Syrian refugees have a higher rate of adolescent birth and low-birth-weight neonates which could be attributed to poor care and insufficient nutrition during pregnancy while living as a refugee in Turkey.

Comparison of the pregnancy results between adolescent Syrian refugees and local adolescent Turkish citizens who gave birth in our clinic.

Adolescence is the transition period from childhood to adulthood; the World Health Organization has defined it as the ages between 10 and 19. Approximately 11% of all births in the world are by adolescent mothers. Pregnant adolescent refugees who have been forced to emigrate due to civil wars raging on in their native countries often face difficult social life conditions, have little or no access to hospitals, and experience language barriers and poor nutritional status have been found to experience poor maternal and obstetric outcomes. These include an increase in cesarean births, premature births, intrauterine growth retardation, and low-birth-weight infant rates. The purpose of the article was to share with you the comparative results of the adolescent pregnancies among the immigrants and among the local adolescents who gave birth between January 2016 and July 2017 in Kocaeli Derince Training and Research Hospital Gynecology Clinic in Kocaeli, Turkey. Its materials and method is a comparative study planned retrospectively between 67 adolescent Syrian refugees and 188 adolescent Turkish locals who gave birth between January 2016 and July 2017. The demographic data, obstetric outcomes, hospitalization durations, and neonatal outcomes of the patients were compared between the groups. Results, no statistically significant difference was found between pregnancy numbers, normal birth rates, cesarean sections and interventional birth rates, nullipara-multipara birth rates, or premature birth rates (<37 weeks) of the pregnant Turkish adolescents and pregnant immigrant adolescents (p > .05). The number of days these patients were hospitalized was found to be lower among Syrian immigrants than among the Turkish locals and statistically significant (p = .045 and p < .05, respectively). In addition, an analysis of the birth rates of low-birth-weight infants revealed that said rates were higher among the Syrian refugees than the Turkish local and statistically borderline significant (p = .049, p < .05, respectively). Between January 2016 and July 2017, a total of 8,570 live births were performed in our clinic. In our study of the 255 patients under the age of 19 who gave live births, 188 were Turkish and 67 were Syrian refugees. The average age of Turkish mothers under 19 was found to be 17.30 ± 1.01 years and the average age of immigrant mothers was found to be 17.27 ± 0.82 years. In conclusion, adolescent pregnancies are more common among Syrian refugees. Adolescent pregnancies are at risk for obstetric and neonatal outcomes. Therefore, studies should be done to prevent these pregnancies.

Hysterectomy and salpingo-oophorectomy by transvaginal natural orifice transluminal endoscopic surgery (V-NOTES) assisted by an umbilical camera: Case report and new hybrid technique in gynecology.

INTRODUCTION: Natural orifice transluminal endoscopic surgery (NOTES) is a new development in the field of minimally invasive surgery. The aim of this study was to demonstrate a new hybrid NOTES technique in gynecology which can be used for hysterectomy and salpingo-oophorectomy in patients with adnexal pathology and multiple operation histories. PRESENTATION OF CASE: A 50-year-old woman with gravida 2 para 2 was referred to our clinic with left-sided abdominal pain. She had a history of two previous abdominal surgeries and a persistent ovarian cyst for 2 years. An ultrasound examination revealed a left complex hypoechoic ovarian cyst of 10 cm. Tumor markers were normal and the patient had no suspicion for malignancy. The hybrid NOTES technique assisted by an umbilical camera was planned due to the possibility of pelvic adhesions and her concerns about cosmesis. DISCUSSION: The major difference between NOTES and umbilical camera assisted NOTES is seeing all of the major structures, such as the ureters, uterine vessels, bowels, and pelvic adhesions, which can lead to complications during the surgery. In fact, hybrid NOTES can make surgeries more feasible. CONCLUSION: This new hybrid NOTES offers effective and safer surgical management in patients who have had previous surgery and adnexal masses.