Bertozzi Mirko, Magrini Elisa, Riccioni Sara, Giovenali Paolo, Appignani Antonino
S.C. di Clinica Chirurgica Pediatrica, University of Perugia, S. Maria della Misericordia Hospital, Loc. S. Andrea delle Fratte, 06100 Perugia, Italy.
S.C. di Clinica Chirurgica Pediatrica, University of Perugia, S. Maria della Misericordia Hospital, Loc. S. Andrea delle Fratte, 06100 Perugia, Italy.
J Pediatr Surg. 2017 Oct;52(10):1553-1560. doi: 10.1016/j.jpedsurg.2017.07.005. Epub 2017 Jul 13.
To quantify our experience with and assess the literature on diagnosis and management of isolated fallopian tube torsion (IFTT) with hydrosalpinx (HSX) in children.
A PubMed search was performed on pediatric cases of IFTT with HSX to provide a comprehensive review analyzing details and management of this association, focusing on the problem of fertility preservation.
In addition to our 3 cases, 17 patients of pediatric IFTT associated with HSX were identified, for a total of 21 cases (median age 12.2 years). Menarchal status was present in 10/13 (76.9%); blood tests were reported in 9/20 (42%) showing leucocytosis in 7/9 (75%). Ultrasonography was performed in all cases except one. Laparoscopy was the surgical approach in 84.6% of the reported cases. The torsion was to the right in 36.8%, and to the left in 63.2% of the cases. In one case the torsion was bilateral and asynchronous. Performed procedures were salpingectomy (52.4%) and partial salpingectomy (14.3%); conservative management was reported in 33.3% of the cases.
The literature describes different management techniques. Salpingectomy is the most frequently performed procedure but recently conservative management seems to be increasingly applied. A long-term study is necessary to define the most effective treatment for the preservation of future fertility in pediatric patients.
Treatment study (Retrospective Study): LEVEL IV.
量化我们在儿童孤立性输卵管扭转（IFTT）合并输卵管积水（HSX）的诊断和管理方面的经验，并评估相关文献。
对PubMed上关于儿童IFTT合并HSX的病例进行检索，以提供一份全面的综述，分析这种关联的细节和管理，重点关注生育力保留问题。
除了我们的3例病例外，还确定了17例儿童IFTT合并HSX的患者，共计21例（中位年龄12.2岁）。13例中有10例（76.9%）已月经初潮；20例中有9例（42%）报告了血液检查，其中9例中有7例（75%）显示白细胞增多。除1例病例外，所有病例均进行了超声检查。84.6%的报告病例采用腹腔镜手术。36.8%的病例扭转发生在右侧，63.2%的病例扭转发生在左侧。1例病例扭转是双侧且不同步的。所实施的手术包括输卵管切除术（52.4%）和部分输卵管切除术（14.3%）；33.3%的病例报告采用保守治疗。
文献描述了不同的管理技术。输卵管切除术是最常实施的手术，但最近保守治疗似乎应用得越来越多。有必要进行一项长期研究，以确定对儿科患者保留未来生育力最有效的治疗方法。
治疗研究（回顾性研究）：IV级。
