Nowadays treatment of testicular appendix torsion in children
| Autor: | E. N. Gasanova, D.Yu. Garova, O. O. Saruhanyan, E.V. Morozov, M. V. Grigoryeva, D. N. Shedrov, I.S. Shormanov |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Gonad business.industry Incidence (epidemiology) 030232 urology & nephrology Torsion (gastropod) Diagnostic tools Appendix Surgery Conservative treatment 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Homogeneous 030220 oncology & carcinogenesis medicine Surgical treatment business |
| Zdroj: | Russian Journal of Pediatric Surgery. 24:370-376 |
| ISSN: | 1560-9510 |
| DOI: | 10.18821/1560-9510-2020-24-6-370-376 |
| Popis: | Introduction. Currently, a modern tactics as to the treatment of testicular appendix torsion in children is not an indisputable axiom but it is a subject of discussion in domestic and foreign literature. Modern diagnostic tools, wide implementation of expert-class equipment as well as gaining more experience have reduced, to a minimum , the risk of diagnostic error with fatal consequences for the gonad. So, it impels to revise the existing algorithms and to consider the conservative treatment as the method of choice in uncomplicated testicular appendix torsion.Objective. To analyze the gained experience in treating testicular appendix torsion and to suggest reasonable algorithms which correspond to modern diagnostic techniques and treatment options. Material and methods. 2875 cases with testicular appendix torsion have been analyzed. Of these, 2 069 (71.96%) patients were operated on; 755 (26.26%) patients had conservative treatment and 51 (1.78%) had to be operated on despite conservative treatment.Results. The material obtained in three statistically homogeneous groups has been аnalyzed. When comparing clinical and ultrasound criteria, it was found out that the incidence of orchalgia in the surgical group is slightly higher than in the conservative one. It may indicate that the adhesive process in the scrotal cavity after surgical trauma is more frequent than after a possible aseptic inflammation. Asymmetry of gonad volumes with smaller diseased testicle was seen in all groups. The decrease in testicular volume is minimal in all cases and is not statistically significant. The incidence of heterogeneity in the testicular and appendage echo structure, which indicates sclerotic changes in the parenchyma, is also not statistically significant in the analyzed groups. Patients who were operated despite their conservative care do not have much worse outcomes after long-lasting follow-up period than groups with other curative options.Conclusion. Torsion of the testicular appendix in children is a challenging problem that is far from being solved. There is no consensus as to the indications for surgical treatment and to the assessment of postoperative outcomes. Modern diagnostic and monitoring techniques allow to dynamically monitor the scrotal organs in conservative treatment. The conservative treatment of testicular appendix torsion is an effective and safe method. The conservative tactics which was changed for surgical one does not lead to gonad deterioration. |
| Databáze: | OpenAIRE |
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