Ogburn Tony, Wurzel James, Espey Eve, Espey David
Departments of Obstetrics and Gynecology, University of New Mexico, Albuquerque 87131-0001, USA.
J Reprod Med. 2005 Aug;50(8):591-4.
To review the management of adnexal torsion over an 11-year period at a single institution and to assess trends in the surgical approach, including laparoscopy vs. laparotomy, and ovarian conservation vs. removal.
A chart review of all patients treated for adnexal torsion at the University of New Mexico from 1990 to 2001 was performed.
Sixty-eight cases of adnexal torsion were identified. Laparoscopic management was accomplished in 22 cases (32%) and ovarian conservation in 14 cases (20.6%). There were no differences in the use of laparoscopy (OR 2.24, CI 0.65-7.93), or ovarian conservation (OR 1.24, CI 0.31-5.35) in patients treated before 1996 vs. later in the study period.
Despite evidence supporting conservative management of adnexal torsion with laparoscopy and ovarian conservation, most cases at our institution are managed with open laparotomy and removal of the affected adnexa.
回顾单一机构11年间附件扭转的治疗情况,并评估手术方式的趋势,包括腹腔镜手术与开腹手术,以及卵巢保留与切除。
对1990年至2001年在新墨西哥大学接受附件扭转治疗的所有患者进行病历回顾。
共确定68例附件扭转病例。22例(32%)采用腹腔镜治疗,14例(20.6%)保留卵巢。1996年之前治疗的患者与研究后期治疗的患者在腹腔镜使用(比值比2.24,可信区间0.65 - 7.93)或卵巢保留(比值比1.24,可信区间0.31 - 5.35)方面无差异。
尽管有证据支持采用腹腔镜和保留卵巢的保守方法治疗附件扭转,但我们机构的大多数病例仍采用开腹手术并切除患侧附件。