DİE Cerrahisi, Üreter Diseksiyonu Nasıl Yapılır? DİE’de Ürolojik Operasyonlar
Özet
Endometriozis, üreme çağındaki kadınların yaklaşık %10'unu etkileyen en yaygın jinekolojik hastalıklardan biridir. Endometriozisin çeşitli formları ve belirtileri olmasına rağmen, yüzeysel peritoneal endometriozis, over endometriomaları ve derin endometriozis hastalığın üç ana türüdür. Derin endometriozis, periton yüzeyinin 5 mm altına uzanan derin infiltratif endometriozis olarak tanımlanmıştır. Bu lezyonlar tipik olarak nodüler olup, bitişik yapıları istila edebilir ve fibrozis ile ilişkilidir, bu da normal anatominin bozulmasına yol açar. Bu tür lezyonlar genellikle retro-servikal boşluğu, rekto-vajinal septumu, uterosakral bağları ve sigmoid kolon, rektum, mesane ve üreterler gibi yakın organları içerir. Endometriozis eksizyonel cerrahisinin temel prensipleri, görüntülenen endometriotik lezyonların komplikasyonsuz rezeksiyonu, adhesioliz yapılması ve normal pelvik anatominin geri kazanılmasıdır. Minimal invaziv cerrahi (MİS), kan kaybını, postoperatif ağrıyı ve hastanede kalış süresini azalttığı için tercih edilen yaklaşımdır.
Endometriosis is a common gynecological disease, affecting approximately 10% of women of reproductive age. Endometriosis has many different forms and manifestations, but the three most common are superficial peritoneal endometriosis, ovarian endometriomas, and deep endometriosis. Deep endometriosis is defined as infiltrative endometriosis that extends 5 millimeters below the peritoneal surface. These lesions are typically nodular in nature, can invade adjacent structures, and are associated with fibrosis, causing distortion of normal anatomy. These lesions usually affect the retro-cervical space, the recto-vaginal septum, the uterosacral ligaments, and nearby organs such as the sigmoid colon, rectum, ureters, and bladder. Endometriosis excisional surgery is based on simple resection of visible endometriotic lesions, adhesiolysis, and the restoration of normal pelvic anatomy. Minimally invasive surgery (MIS) is the preferred method because it minimizes blood loss, postoperative pain, and hospitalization.
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