Management of pediatric ovarian torsion: evidence of follicular development after ovarian preservation.

Autor: Walker SK; Division of Pediatric Surgery, Stead Family Children's Hospital, University of Iowa Health Care, Iowa City, IA, USA. Electronic address: sarah-walker@uiowa.edu., Lal DR; Division of Pediatric Surgery, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA., Boyd KP; Pediatric Radiology Section, Division of Diagnostic Radiology, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA., Sato TT; Division of Pediatric Surgery, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2018 Mar; Vol. 163 (3), pp. 547-552. Date of Electronic Publication: 2018 Jan 09.
DOI: 10.1016/j.surg.2017.11.019
Abstrakt: Purpose: This study reviews contemporary management and follow-up of pediatric ovarian torsion.
Methods: This is a retrospective series of patients from birth to 19 years undergoing operative management of ovarian torsion from 2012 to 2016.
Results: We studied 43 girls who underwent 51 operations for ovarian torsion. The median age was 8.3 years. Ultrasound was utilized for diagnosis in 24/29 patients (83%) evaluated in a children's hospital. In contrast, computed tomography was used initially in 7 cases (50%) in children imaged at non-children's hospitals before transfer. Initial operation for ovarian torsion was completed laparoscopically in 38 (88%). Overall, ovarian preservation was performed in 37 (86%) patients, while 6 (13%) underwent oophorectomy. Indications for oophorectomy included 5 infants with in utero torsion and an 18-year-old with a suspected malignancy. In girls with acute ovarian torsion, the oophorectomy rate was reduced to 2%. Postoperatively, 1 patient developed a small bowel obstruction requiring operation after laparoscopic ovarian detorsion. Recurrent torsion occurred in 3 patients (7%). In total, 34 patients underwent postoperative ovarian imaging. A total of 25 (74%) had follicles visualized in the previously torsed ovary.
Conclusion: Ovarian-sparing operations for acute torsion are safe and result in ovarian salvage and preservation of follicular development in more than 70% of children and adolescents.
(Copyright © 2017 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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