Conservative surgery of adnexal torsion is worth to be recommended for reproductive-aged females,imp

来源 :第四届华夏医学妇产科论坛、多学科协作妇产国际论坛、第三届华夏医学妇产科青年医师论坛 | 被引量 : 0次 | 上传用户:iror163
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  Objective: Adnexal torsion affects children and reproductive-aged females most.Preserving affected ovary instead of removing it is of great importance to children and reproductive-aged females.We aimed to evaluate the safety and effect of conservative surgery of adnexal torsion.Methods: Data of all patients were collected from patients files in hospital computer database.124 patients who were surgically confirmed as adnexal torsion between October 2006 and April 2017 were included in this study.12 patients who were only confirmed as tubal cyst torsion were excluded.The remaining 111 patients with ovarian cyst torsion were assigned #I# 2 groups according to their surgical procedures: adnexectomy group(AE)(n=63)and conservative surgery(CS)group(n=48).CS here include detorsion followed by ovarian cystectomy.48 patients in CS group were followed up.The ovarian morphology and blood flow were followed up by transvaginal or transabdominal color Doppler ultrasound 3 months after operation.In order to reflect the postoperative ovarian reservation,we followed up two contents: the fertility rate and menstruation status Results: The median age was 28.2 years old(range from 6 to 83 years old).Patients in AE group had a longer interval from onset of abdominal pain to medical intervention,higher white blood cell count,larger adnexal mass and more circles of torsion than those in CS group.No patients in either group suffered from thromboembolism.40 patients in CS group were followed up and 13 were loss to follow-up.The ovarian morphology in ultrasound pictures were recovered normally in 27 patients 3 months after surgery.No apparent change of menstruation status in 24/27 patients.Three out of four patients who tried to conceive within 1 year after operation conceived naturally with full term delivery.Conclusion: Diagnosis in a timely fashion and correct medical intervention are of great importance to minimize the injury of twisting adnexa and preserve the ovarian reserve.Conservative surgery is recommended to be the first choice of treatment for children and reproductive-aged females.
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