TY - JOUR
T1 - Adnexal Torsion in Children and Adolescents
T2 - A Retrospective Review of 245 Cases at a Single Institution
AU - Adeyemi-Fowode, Oluyemisi
AU - Lin, Emily G.
AU - Syed, Fatima
AU - Sangi-Haghpeykar, Haleh
AU - Zhu, Huirong
AU - Dietrich, Jennifer E.
N1 - Publisher Copyright:
© 2018 North American Society for Pediatric and Adolescent Gynecology
PY - 2019/2
Y1 - 2019/2
N2 - Study Objective: Adnexal torsion (AT) requires urgent surgical intervention to preserve ovarian function. Historically, treatment for AT was oophorectomy because of concerns related to leaving a nonviable ischemic ovary. No published studies support these theoretical concerns and current literature supports conservative management. The aim of this study was to review the institutional outcomes for AT cases, including salvage rates and complications. Design, Setting, Participants, Interventions, and Main Outcome Measures: This study was approved by the institutional review board at Baylor College of Medicine. A retrospective chart review on cases of AT from 2007 to 2016 at a single Children's hospital was performed on the basis of International Classification of Diseases, 10th revision and Current Procedural Terminology codes. A standardized chart review form was used in data extraction. Statistical analysis was performed using SAS version 9.4 (SAS Institute). Results: Chart review identified 245 torsion cases in 237 patients. The mean age was 12.4 ± 3.29 years. Of the participants, 230 (94%) underwent minimally invasive laparoscopy with ovarian preservation in 233 (95%) of the cases. There were no complications due to detorsion of the affected adnexa. Intraoperatively, the right adnexa was affected in 134 (55%) cases and a lesion was noted in 193 (79%) cases, most commonly paratubal cysts and mature teratomas. The malignancy rate was low, noted only in 4/245 patients at (1.2%). Pediatric gynecology performed most of the cases (n = 214; 87%). Conclusion: The findings of our study continue to support the conservative management of patients with AT.
AB - Study Objective: Adnexal torsion (AT) requires urgent surgical intervention to preserve ovarian function. Historically, treatment for AT was oophorectomy because of concerns related to leaving a nonviable ischemic ovary. No published studies support these theoretical concerns and current literature supports conservative management. The aim of this study was to review the institutional outcomes for AT cases, including salvage rates and complications. Design, Setting, Participants, Interventions, and Main Outcome Measures: This study was approved by the institutional review board at Baylor College of Medicine. A retrospective chart review on cases of AT from 2007 to 2016 at a single Children's hospital was performed on the basis of International Classification of Diseases, 10th revision and Current Procedural Terminology codes. A standardized chart review form was used in data extraction. Statistical analysis was performed using SAS version 9.4 (SAS Institute). Results: Chart review identified 245 torsion cases in 237 patients. The mean age was 12.4 ± 3.29 years. Of the participants, 230 (94%) underwent minimally invasive laparoscopy with ovarian preservation in 233 (95%) of the cases. There were no complications due to detorsion of the affected adnexa. Intraoperatively, the right adnexa was affected in 134 (55%) cases and a lesion was noted in 193 (79%) cases, most commonly paratubal cysts and mature teratomas. The malignancy rate was low, noted only in 4/245 patients at (1.2%). Pediatric gynecology performed most of the cases (n = 214; 87%). Conclusion: The findings of our study continue to support the conservative management of patients with AT.
KW - Adnexal torsion
KW - Adolescents
KW - Ovarian torsion
KW - Pediatrics
KW - Surgical management
KW - Tubal torsion
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U2 - 10.1016/j.jpag.2018.07.003
DO - 10.1016/j.jpag.2018.07.003
M3 - Article
C2 - 30012428
AN - SCOPUS:85056316379
SN - 1083-3188
VL - 32
SP - 64
EP - 69
JO - Journal of pediatric and adolescent gynecology
JF - Journal of pediatric and adolescent gynecology
IS - 1
ER -