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Background: To evaluate the efficacy of the preoperative ultrasonographic sliding sign in predicting intra-abdominal adhesions., Methods: This was a single-center, double-blinded, prospective observational study undertaken from March and September 2021 on 110 patients with a history of previous abdominal surgery. All patients who were scheduled for laparoscopy underwent slide test in 5 zones of abdomen: right lower quadrant, left lower quadrant, previous operation site, vesicouterine pouch, and rectovaginal pouch. Adhesions were assessed by the same gynecologic surgeon using ultrasonography before the surgery and by gynecological surgeons during surgery, and by a third gynecologic surgeon to compare the preoperative slide test findings and laparoscopic findings after the surgery., Results: Seventy-three (66.4%) patients underwent laparoscopic surgery, and 37 (33.6%) patients underwent laparotomy. The mean age of patients was 46.9 ± 1.0 years. Sensitivity, specificity, and positive and negative predictive values of preoperative ultrasonography in predicting adhesions were 89.5%, 91.7%, 97.5%, and 71.0%, respectively. The accuracy of the slide test was calculated as 90.0%. It was found that as the total number of cesarean sections increased the estimates of vesicouterine adhesions and actual adhesions increased ( P = .008). Also, the prediction of intra-abdominal adhesions and actual adhesions significantly increased as the total number of surgical operations increased ( P = .002)., Conclusions: Intra-abdominal adhesions can be detected with the slide test, which is a non-invasive and well-tolerated procedure. Slide test can guide the physician before the elective operation in patients with previous abdominal surgery and may assist in counseling patients.

Objective: The clinical outcome of high-risk HPV (hr-HPV) infection varies according to genotype(s). Patients may harbor either one single hr-HPV (s-HPV) or multiple HPV (m-HPV) genotypes. Recently, the relationship between m-HPV infections and high-grade dysplasia has been investigated, and controversial results have been obtained. Therefore, the clinical significance of m-HPV is not clear. This study aimed to evaluate which group is associated with higher grade dysplasia by analyzing colposcopic punch biopsies., Material and Methods: A total of 690 patients who were scheduled for a diagnostic excisional procedure between April 2016 and January 2019 due to the detection of high-grade cervical intraepithelial neoplasia (CIN 2/3) in colposcopy were included. Patients who were not scheduled for colposcopic examination or cervical punch biopsy, or who were scheduled for an excisional procedure due to smear-biopsy incompatibility or persistent low-grade dysplasia were excluded. Patients with a negative HPV test and an unknown HPV genotype were also excluded., Results: Among the patients scheduled for excision (n=404), 74.5% had a s-HPV and 25.5% had a m-HPV infection. The proportion of CIN 1, 2 and 3 per patient in the m-HPV group was significantly higher than the s-HPV group (p=0.017). When this analysis was made for the number of CIN 2+3 per patient in the s-HPV and m-HPV groups, it was 1.29 (389/301) and 1.36 (140/103), respectively, and no difference was found (p=0.491)., Conclusion: Patients in the m-HPV group, who underwent more colposcopic cervical biopsies, had higher numbers of CIN lesions, regardless of age and cytology results., Competing Interests: Conflict of Interest: No conflict of interest is declared by the authors., (©Copyright 2023 by the Turkish-German Gynecological Education and Research Foundation. Journal of the Turkish-German Gynecological Association is published by Galenos Publishing House. Licensed under a Creative Commons Attribution-NonCommercial (CC BY-NC-ND) 4.0 International License.)

The aim of this study was to investigate the effect of drains used in current clinical practice on operation parameters and post-operative morbidity. The comprehensive data obtained through the prospective design were analysed in detail according to whether abdominal drainage was applied. Abdominal drainage was present in 44.1% of patients who met the inclusion criteria. Drains were placed significantly more frequently during oncologic surgery ( p  = .007). The mean mobilisation ( p  = .001), first flatus ( p  = .001), and first oral intake ( p  = .029) times were longer in the drain group than those in the non-drain group. In patients who underwent oncological surgeries, no significant differences were observed except for the pre-operative duration of bowel preparation ( p  = .006) and first flatus time ( p  = .003). Our results suggest that drain placement in gynecological procedures does not provide an additional advantage.IMPACT STATEMENT What is already known on this subject? Post-operative drainage of the abdominal cavity has been controversial for many years. However, whether abdominal drainage provides an additional benefit in lower and upper abdominal surgical procedures remains unclear. What do the results of this study add? Most studies have examined post-operative pain and surgical site infections. We examined the relationship between abdominal drainage and demographic and pre-/post-operative clinical features in detail. We demonstrated that abdominal drainage in gynecological procedures may not provide an additional advantage. What are the implications of these findings for clinical practice and/or further research? The present study provides valuable information that can guide physicians in deciding whether to use post-operative abdominal drainage. This topic warrants investigation with randomised data in the future.

We aimed to evaluate the gynaecological oncology surgeries in the COVID-19 pandemic. A total of 800 operations performed between January and December 2020 were retrieved. Since the COVID-19 pandemic affected operations as of April 1 2020, we compared the cases of the last nine months of the year with the first three months. Of the operations, 265 (33.1%) were performed between January and March and 535 (66.9%) between April and December. Of 168 malignant operations; 78 (46%) were uterine cancer, 58 (35%) ovarian cancer, 28 (17%) cervical cancer and four (2%) vulvar cancer. If we compared the last nine months of the year with the first three months, a significant increase was observed in the rates of malignant and premalignant, while a significant decrease was detected in benign operations ( p <.001). Gynaecological oncology surgeries performed with open or laparoscopic approaches during the COVID-19 pandemic should continue by taking preventive measures. Impact Statement What is already known on this subject? During the COVID-19 pandemic, many international associations and organisations recommended the suspension of elective surgeries. It is still controversial whether the gynaecologic oncology surgical procedures to be performed in this unprecedented time should be laparoscopic or laparotomic. What do the results of this study add? The malignant and premalignant gynaecological oncology surgeries should be safely performed laparoscopically or by laparotomy in the COVID-19 pandemic. What are the implications of these findings for clinical practice and/or further research? Gynaecologic oncology surgeries can be safely performed by attaching appropriate personal protective equipment procedures with pre-operative COVID-19 PCR testing in the COVID-19 era.

Purpose: To evaluate the effects of mechanical bowel preparation (MBP) on the intraoperative visualization of the surgical field, bowel handling, intestinal load, and overall ease of surgery in patients undergoing elective laparoscopic gynecological surgeries., Methods: The patients randomized to a MBP group and a no preparation (NMBP) group. The senior surgeon remained blinded to the bowel regimen used by the patient. Intraoperative visualization of the surgical field, bowel handling, intestinal load, and overall ease of surgery were evaluated using a numeric rating scale (NRS)., Results: We enrolled 120 patients, of whom 109 completed the study, with 51 and 58 patients in the MBP and NMBP groups, respectively. The intraoperative visualization of the surgical field, intestinal load, and NRS scores for overall ease of surgery were better in the NMBP group ( p  = .03, p  = .048, and p  = .022, respectively). The results of the assessments also revealed no significant differences in surgical field visualization, ease of bowel handling, overall ease of surgery, or the time that patients experienced passage of flatus between obese (BMI > 30 kg/m 2 ) and non-obese (BMI ≤ 30 kg/m 2 ) patients in the two groups., Conclusions: The current study revealed that MBP did not improve the intraoperative visualization of the surgical field or the overall ease of surgery. Moreover, MBP had no benefit when operating on patients who had a high BMI. Therefore, we do not recommend routine MBP before laparoscopic gynecological surgeries.

Objective: Studies on eosinophils have mostly been directed to parasitic infections and allergic diseases, but the role of eosinophils in oncology has been largely ignored. Eosinophils are an important modulator of the immune response and components of the inflammatory process against the tumor. This study was performed to investigate the pre-operative peripheral blood eosinophil percentages in patients with a histopathologically diagnosed pure endometrioid type endometrial carcinoma., Material and Methods: Patients’ data were analyzed in two groups as present/absent according to whether there are tumor metastases in the adnexes, lymph nodes, cervical stroma, and whether there was lymphovascular space invasion. FIGO grade was taken as the basis of the tumor grade: Low-grade equated to grade 1 or 2, and high-grade equated to grade 3. The requirement for lymph node dissection was based on the Mayo criteria., Results: The data of a total of 268 patients were included. The mean percentage of eosinophils in high-grade patients (n=29) was 2.75±0.35, and was significantly higher than the mean percentage of eosinophils of found in low-grade patients (n=239), which was 1.79±0.09 (p=0.013). Receiver operator curve analysis showed that a cut-off eosinophil percentage of 1.95% resulted in a sensitivity of 62% and specificity of 67% (p=0.004)., Conclusion: Eosinophil percentages, which are a simple, easily accessible, and inexpensive can be an important pre-operative predictive tool. Eosinophil percentages can be used in determining the need for surgical staging in endometrial cancer., Competing Interests: Conflict of Interest: No conflict of interest is declared by the authors., (©Copyright 2022 by the Turkish-German Gynecological Education and Research Foundation)

Background: Glandular cell abnormalities may indicate the presence of pre-malignant or malignant lesions., Aim: This study aimed to investigate the relationship between atypical glandular cells (AGC) and patients' demographics, histopathological outcomes, Human Papillomavirus (HPV) test results., Material and Methods: Between January 2015 and December 2019, women with AGC on Pap tests were retrieved from the hospital electronic database. The patients with AGC on cervicovaginal smears who underwent further pathological, laboratory, and imaging diagnostic testing and who were followed up at least 1-year were included in the study, while those who had a history of cervical dysplasia or cancer, lost during follow-up, or had missing data were excluded., Results: Of 85,692 Pap smears, 114 (0.13%) were diagnosed with AGC, of those 88 cases were eligible for final analysis. Gynecological malignancies were detected in 13 (14.8%) patients; including 6 (6.8%) endometrioid endometrial cancers, 3 (3.4%) non-endometrioid endometrial cancers, 2 (2.3%) cervical adenocarcinomas, 1 (1.1%) cervical squamous cell carcinoma, and 1 (1.1%) high-grade tubal serous cancer. Multivariate analysis revealed that presence of concomitant abnormal squamous lesion ( P = 0.002), being 50 years and older ( P = 0.028), HPV positivity ( P < 0.001), and menopause ( P = 0.023) were risk factors for significant pathology., Conclusion: The diagnosis of AGC may be related to the preneoplastic/neoplastic processes. A further comprehensive histopathological examination is required in women with AGC, aged 50 years and older, postmenopausal, HPV-positivity and concomitant squamous cell abnormality Clinicians should consider ovarian pathologies when there is no pathological finding on endometrial or cervical histopathological examination., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Cytology.)