Department of Obstetrics and Gynecology, Meram Medicine Faculty, Selcuk University, Meram 42080, Konya, Turkey.
Arch Gynecol Obstet. 2011 Sep;284(3):643-6. doi: 10.1007/s00404-010-1702-z. Epub 2010 Oct 6.
To discuss the surgical results of patients with diagnosis of adnexal torsion.
One hundred and fifty patients with diagnosis of adnexal torsion who presented to our clinic between January 2005 and December 2009 were included in this retrospective analysis. Data regarding age, gravidity, parity, size of mass, operation time, and duration of hospitalization were recorded and compared between the patients who had laparoscopy to those who had laparotomy. The pathological results of patients were also recorded.
Fifty-eight patients were treated laparoscopically while 92 patients had laparotomy. The most frequent presenting symptom was pelvic pain (96%). Laparoscopy group consisted of young patients with low parity; operation and hospital stay time was shorter in laparoscopy group. Velocity loss in Doppler ultrasonography was noted in 81.3% of the patients. Of the laparotomy group 35 postmenopausal patients had hysterectomy and bilateral salpingo-oopherectomy, and staging surgery was done for 16 of them. The pathological finding was found to be malignant in four and borderline serous tumor in four patients.
Laparoscopy is preferred for young patients who want to preserve their fertility. Because of high risk of malignancy in postmenopausal ovarian masses presenting with torsion; frozen section should be used. If not possible or not conclusive, staging surgery is more appropriate especially if there is suspicion of malignancy.
探讨附件扭转患者的手术治疗结果。
回顾性分析 2005 年 1 月至 2009 年 12 月期间在我院就诊的 150 例附件扭转患者的临床资料。记录患者的年龄、孕次、产次、肿块大小、手术时间和住院时间，并比较腹腔镜组和开腹组患者的上述数据。同时记录患者的病理结果。
58 例患者接受腹腔镜治疗，92 例患者接受开腹治疗。最常见的症状是盆腔痛（96%）。腹腔镜组患者年龄较小、产次较低，手术和住院时间均较短。81.3%的患者多普勒超声检查提示血流速度降低。开腹组中 35 例绝经后患者行子宫及双侧附件切除术，其中 16 例患者行分期手术。病理结果显示 4 例为恶性肿瘤，4 例为交界性浆液性肿瘤。
对于有生育要求的年轻患者，腹腔镜是首选治疗方法。由于绝经后卵巢肿块扭转时恶性风险较高，应使用冷冻切片。如果不可行或结果不确定，则分期手术更为合适，特别是怀疑恶性肿瘤时。
