This study analyzed the safety of myomectomy during the cesarean section (CS). Pregnant women who underwent myomectomy during CS in a tertiary center between January 2015 and November 2019 were inc...

Objective: We aimed to analyze the impact of stage shifts on disease-free survival and overall survival in patients with uterine carcinosarcoma stratified based on FIGO 2009 and 2023 staging systems. Materials and Methods: A total of forty-five patients diagnosed with uterine carcinosarcoma between 2010 and 2024 were included in the study. Patients were classified and analyzed according to both the 2009 and the revised 2023 FIGO staging systems to evaluate the impact of the updated staging criteria on oncologic outcomes. The median disease-free (DFS) and overall survival (OS) rates were calculated and compared when stage shifts occurred. Results: A total of 17 upstage shifts (37.7%) occurred between the 2009 and 2023 FIGO staging system. All patients with upstage shifts were stage I patients categorized according to the FIGO 2009 classification. Restaging from the FIGO 2009 to the FIGO 2023 criteria resulted in a reduction in the number of stage I cases and an increase in the number of stage II cases. The two main factors leading to upstage were serous histology and LVSI positivity. The 5-year DFS and OS rates for stage I disease were 80% and 75%, respectively, according to the 2009 FIGO staging system, whereas the 2023 FIGO staging system demonstrated significantly higher rates of 100% for both DFS and OS. In stage II patients, the 5-year DFS and OS rates were 33.5% and 33.7%, respectively, according to the 2009 FIGO staging system, while the 2023 FIGO staging system demonstrated higher rates of 58.8% for DFS and 65% for OS. Conclusions: The revised FIGO 2023 staging system has better performance in predicting disease prognosis than the previous version.

Aim. To investigate the effect of the triggering method on the results of fresh embryo transfer in patients who underwent gonadotropin‐releasing hormone antagonist cycles. Methods. The study was conducted retrospectively at a university‐based tertiary reproductive center. The sample consisted of a total of 295 patients, of whom 111 were in the human chorionic gonadotropin (hCG) trigger group and 184 were in the dual trigger group. The main outcome measure of this study was the live birth rate, and secondary outcomes were the implantation rate, clinical pregnancy rate, miscarriage rate, and good‐quality embryo rate. Results. Patient demographics and baseline characteristics did not significantly differ between the dual and hCG trigger groups. The results also indicated statistically nonsignificant differences between the two groups in terms of the number of oocytes retrieved (p > 0.05), the number of mature oocytes (p > 0.05), and the fertilization rate (p > 0.05). The number of good‐quality embryos (p = 0.002) was higher in the dual trigger group compared with the hCG trigger group. However, the rates of clinical pregnancy and live births did not significantly differ between the groups (p > 0.05). Conclusions. Although the number of total and high‐quality embryos obtained was higher in the dual trigger group, there were no significant differences between the two groups in terms of pregnancy outcomes. The fresh embryo transfer yielded similar rates of implantation and live births in both trigger groups.

Background: Wound complications in gynecologic oncology, especially among patients with overweight and obesity, can significantly impact post-operative recovery and delay the initiation of adjuvant treatment. Although staples are commonly used for vertical incisions, sutures may offer clinical advantages; however, direct comparative data remain limited. This study aimed to compare post-operative wound complication rates between staples and non-absorbable sutures in patients with gynecologic cancer with a body mass index ≥25 kg/m ² and undergoing a vertical incision surgical procedure. Patients and Methods: A retrospective review was conducted at a gynecologic oncology center between January 2022 and September 2023. Patients who underwent midline laparotomy with either staples or 3-0 non-absorbable monofilament sutures for skin closure were included. Patients with prior chemotherapy, benign pathology, or age <18 were excluded. Wound complications—including seroma, hematoma, dehiscence (superficial and fascial), and infection—were recorded within eight weeks postoperatively. Results: Of 72 patients, 29 received staples and 43 received sutures. Wound complications occurred in 41% of the staple group and 21% of the suture group (p = 0.061). Fascial dehiscence was observed in four cases (two in each group). Although rates of dehiscence and infection were higher with staples, differences were not statistically significant. Hospital stay was significantly longer in the staple group (p = 0.045). Conclusion: Although not statistically significant, suture closure was associated with fewer wound complications and a shorter hospital stay, suggesting potential advantages in wound healing. These findings may inform future recommendations, and further prospective studies are warranted.

Background/Objectives: Laparoscopic hysterectomy is commonly performed for benign gynecologic conditions, and the choice of uterine manipulation technique may influence surgical outcomes. The Boztosun technique, a modification of the classical Rein technique, enables intra-abdominal manipulation of the uterus without requiring transvaginal instruments. This study aimed to compare the Boztosun technique with a conventional vaginal uterine manipulator in terms of surgical efficiency and perioperative outcomes. Methods: This retrospective study included 30 patients who underwent laparoscopic hysterectomy for benign indications at Akdeniz University Hospital between March 2022 and March 2024. Fifteen patients underwent surgery using the Boztosun technique, and fifteen with a vaginal uterine manipulator. Operative time, colpotomy time, manipulator placement time, hospital stay, uterine weight, hemoglobin change, and complications were compared. Results: The Boztosun technique was associated with significantly shorter operative time (81.67 ± 11.02 min vs. 109 ± 10.85 min, p < 0.001), colpotomy time (4.13 ± 0.92 min vs. 8.87 ± 0.92 min, p < 0.001), manipulator placement time (0.81 ± 0.27 min vs. 8.07 ± 1.22 min, p < 0.001), and hospital stay (2.13 ± 0.35 days vs. 3.53 ± 0.92 days, p < 0.001). No significant differences were found in uterine weight, hemoglobin decrease, or complication rates. All procedures were completed laparoscopically without conversion to open surgery. Conclusions: The Boztosun technique may serve as a safe, efficient, and cost-effective alternative to vaginal uterine manipulators in laparoscopic hysterectomy. Its simplified intra-abdominal approach offers advantages in surgical workflow and recovery. Further prospective studies are needed to validate these findings and assess their applicability in broader clinical settings.

Background: The aim of this study is to compare the concordance of Preoperative Magnetic Resonance Imaging (MRI) and Intraoperative Frozen Section Analysis, widely used worldwide for Endometrial Cancer (EC), with final pathology results, to calculate their sensitivity and specificity, and to evaluate their diagnostic agreement with final pathology results. Positive predictive values for both MRI and frozen section analysis will also be calculated. Methods: In this retrospective cohort study, patients diagnosed with Endometrioid-Type Endometrial Cancer at the Gynecologic Oncology Surgery Department of Akdeniz University Hospital between January 2020 and December 2023 underwent preoperative MRI to assess the depth of myometrial invasion and intraoperative frozen section examination for surgical staging. The results of both methods were compared with the final pathology reports. Results: A total of 88 patients were included in the study. Patient ages ranged from 34 to 80 years, with a mean age of 57.57 years (SD: 9.65), predominantly in the middle-aged and older population. In the assessment of myometrial invasion depth, MRI demonstrated a sensitivity of 81.6% and a specificity of 88%, while frozen section analysis showed a sensitivity of 73.7% and a specificity of 98.0%. Conclusions: In our study, preoperative MRI demonstrated similar sensitivity and specificity to intraoperative frozen section analysis in determining the depth of myometrial invasion in cases of Endometrioid-Type Endometrial Cancer. Therefore, when intraoperative frozen section analysis is not available, MRI findings may assist surgical planning, particularly in centers where frozen section is limited.