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    Laparoscopic management of selected adnexal masses
    (Journal Amer Assoc Gynecologic Laparoscopists, 1999) Sadik, S; Onoglu, AS; Gokdeniz, R; Turan, E; Taskin, O; Wheeler, JM
    Objective. To investigate the significance, safety and intraoperative and immediate postoperative outcomes of laparoscopic management of adnexal masses thought to be at low risk for malignancy. Design. Prospective cohort study (Canadian Task Force classification II-2). Setting. Tertiary-care teaching hospital. Patients. Two hundred twenty women undergoing laparoscopic surgery for adnexal masses. Interventions. Laparoscopic treatment including cystectomy oophorectomy, adnexectomy, and peritoneal cytology, and, if necessary, frozen sections. A histologic diagnosis was obtained in every patient. Measurements and Main Results. Only one ovarian cancer and one borderline ovarian tumor were diagnosed by histologic examination, and both were managed by laparotomy. The remaining 218 patients had laparoscopy for benign adnexal masses. Conclusion. Operative laparoscopy with the finding of incidental ovarian malignancy is rare, as shown by pathologic examination. With appropriate preoperative evaluation, laparoscopic surgery is technically feasible, safe, and advantageous, with minimal morbidity, and should replace laparotomy in the management of most adnexal masses.
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    Long-term histopathologic and morphologic changes after thermal endometrial ablation
    (Journal Amer Assoc Gynecologic Laparoscopists, 2002) Taskin, O; Onoglu, A; Inal, M; Turan, E; Sadik, S; Vardar, E; Postaci, H
    Study Objective. To outline long-term histologic features of endometrial ablation. Design. Prospective longitudinal study (Canadian Task Force classification II-3). Setting. Tertiary-care teaching hospital. Patients. Twenty-six patients. Intervention. Thermal ablation followed by second-look office hysteroscopy with endometrial biopsy. Measurements and Main Results. Mean follow-up time to second-look hysteroscopy after ablation was 33.4 +/- 2, 1 months. Complete atrophy, partial adhesions or obliteration of the cavity, and fibrosis were observed at second-look hysteroscopy. Whereas all random biopsies were normal before ablation, biopsies after ablation revealed diminished endometrial glands with necrosis and scarring. The number of endometrial glands was not correlated with amount of bleeding or menstrual pattern. No premalignant or malignant lesions were found after ablation, Conclusion, Although efficacy of endometrial ablation is related to initial thermal destruction and correlated with postablation hysteroscopic and histologic findings, endometrial regrowth is an expected development, not a failure of ablation.