Abstract
Study Objective
To report results of a retrospective multicentric Italian survey concerning the management
of pediatric ovarian torsion (OT) and its recurrence.
Design
Multicenter retrospective cohort study.
Setting
Italian Units of Pediatric Surgery.
Participants
Participants were female aged 1-14 years of age with surgically diagnosed OT between
2004 and 2014.
Interventions
Adnexal detorsion, adnexectomy, mass excision using laparoscopy or laparotomy. Different
kinds of oophoropexy (OPY) for OT or recurrence, respectively.
Main Outcome Measures
A total of 124 questionnaires were returned and analyzed to understand the current
management of pediatric OT and its recurrence. The questionnaires concerned patient
age, presence of menarche, OT site, presence and type of mass, performed procedure,
OPY technique adopted, intra- and postoperative complications, recurrence and site,
procedure performed for recurrence, OPY technique for recurrence, and 1 year follow-up
of detorsed ovaries.
Results
Mean age at surgery was 9.79 ± 3.54 years. Performed procedures were open adnexectomy
(52 of 125; 41.6%), laparoscopic adnexectomy (25 of 125; 20%), open detorsion (10
of 125; 8%), and laparoscopic detorsion (38 of 125; 30.4%). Recurrence occurred in
15 of 125 cases (12%) and resulted as significant (P = .012) if associated with a normal ovary at the first episode of torsion. Recurrence
occurred only in 1 of 19 cases after OPY (5.2%). Ultrasonographic results of detorsed
ovaries were not significant whether an OPY was performed or not (P = 1.00).
Conclusion
Unfortunately, oophorectomy and open technique are still widely adopted even if not
advised. Recurrence is not rare and the risk is greater in patients without ovarian
masses. OPY does not adversely affect ultrasonographic results at 1 year. When possible
OPY should be performed at the first episode of OT.
Key Words
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Article info
Publication history
Published online: November 25, 2016
Footnotes
The authors indicate no conflicts of interest.
Identification
Copyright
© 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
