Abstract:

Objective: Our objective in this study was to present our four years of experience in laparoscopic surgery for urinary system accompanied by literature.

Material and Methods: Between January 2014 and October 2018, laparoscopic surgical intervention was made on urinary system for 97 patients in our clinic. 54 patients had right and 42 patients had left laparoscopic surgical intervention and 1 patient had radical prostatectomy. Patients were retrospectively examined for operation duration, average blood loss, intraoperative and postoperative complications, hospitalization duration and drain installation time after separating into two groups as right and left.

Results.

Average age of the patients was 44(16-67). Male/Female rate was 54/43. Apart from radical prostatectomy, 54 patients had right and 42 patients had left kidney laparoscopic surgical intervention. Average operation duration was 145 (40-210) minutes, average drain removal time was 3.1 (1-10) days, hospitalization duration was 3.4 (1-14) days and bleeding amount was 150(20-500) cc in all interventions. Lengthened urinary drainage was observed from the drain in one patient who had pyelolithotomy and one patient who had radical prostatectomy. When all interventions were considered, the average complication ratio was found 5.1%. No differences were observed in the parameters compared among right and left laparoscopic surgery interventions.

Conclusion: For a surgeon in the first learning phase of laparoscopy, choosing relatively simpler procedures in the beginning but passing to more complex operations without much delay may quickly shorten the learning phase. Through the selection of suitable patients and adequate equipment, laparoscopic surgery can also be applied safely in peripheral centers.

 Many of the colorectal cancers originales from polips.We wanted to discuss a case accompanied with literature who has a complicated giant rectal polip which presented with an unusual clinic and confusion in diagnosis. 36 years old male patient.He has cramp like stomache and changing in volonic habits for about a year.During colonoscopy a malign mass in caecum and a giant villous adenoma in rectum is identified.The mass in caecum is excised via laparoscopic surgery.The mass in rectum received polipectomy via local excision.Altough a cancer has seen in the polip the surgery is considered opprepriote because of the surgical frontier and acceptable histologic properties. Colorectal polips are lesions which has the risk to turn into cancers thus, detoiled histopatologic examination and gently decission of surgery is needed.

Objective: Pap smear test is a commonly used and effective screening method in detection of cervical cancer and its precursor lesions. There is a very limited number of studies on use of Pap smears in diagnosis of the endometrial carcinomas. We have aimed to investigate the incidence rate of atypical endometrial cells in Pap smears of the patients diagnosed with endometrial carcinoma and the correlation between these cells and clinicopathological parameters.

Material and methods: In this study, patients who were diagnosed with endometrial carcinoma and who had smear sampling between January 2015 and September 2017 were examined retrospectively. Histological type, nuclear grade and Pap smear results of endometrial carcinoma cases were evaluated.

Results: Pap smear sampling was concurrently performed in 59 of the 97 patients diagnosed with endometrial carcinoma. The ages of the patients who underwent smear sampling ranged between 42 and 82 years (mean 57.43±9.08 years). The menopausal status evaluation of the women revealed that 12 (20.3%) and 47 (79.7%) patients were premenopausal and postmenopausal, respectively. Endometrioid type carcinoma was encountered in 51 (86.4%) patients as the most commonly found histological type. Serous, clear cell and mucinous carcinomas were determined in 6 (10%), 1 (1.8%) and 1 (1.8%) patients, respectively. The results of Pap smear tests were atypical in 24 (40.7%) patients whereas normal results were obtained in 35 (59.3%) patients. Nuclear grade assessment of the carcinomas showed that grade 1, grade 2 and grade 3 carcinomas were discovered in 24 (40.7%), 25 (42.3%) and 10 (17%) patients, respectively. The rate of the atypical endometrial cells encountered by Pap smears has increased as grade of the tumors increased.

Conclusion: We have concluded that the detection rate of atypical cells by Pap smear in endometrial carcinomas is considerably high. The incidence of atypical cells is higher in nonendometrioid and high-grade carcinomas.