Department of Obstetrics and Gynecology, the Chaim Sheba Medical Center, Ramat-Gan, Israel; Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Department of Obstetrics and Gynecology, the Chaim Sheba Medical Center, Ramat-Gan, Israel; Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
J Pediatr Surg. 2022 Mar;57(3):497-501. doi: 10.1016/j.jpedsurg.2021.03.052. Epub 2021 Mar 28.
To describe the clinical characteristics of children and adolescents that underwent diagnostic laparoscopy for suspected adnexal torsion (AT), and to develop a prediction model for preoperative detection of AT among young women.
A retrospective cohort study. We included all girls ≤18 years old with clinically suspected AT who underwent a diagnostic laparoscopy between 3/2011 and 6/2020. We compared patients with AT to those without AT and constructed a prediction model.
Overall, 120 children and adolescents with suspected AT were included in the study. Of those, AT was identified in 83 (69.2%). In a multivariate analysis, the following risk factors were independently associated with AT and included in the prediction model: absence of right lower quadrant tenderness upon examination [adjusted odds ratio (aOR) (95% Confidence interval (CI)) 3.23 (1.23-8.47), p = 0.017], platelets level >240 K [aOR (95% CI) 3.15 (1.19-8.36), p = 0.021], and neutrophils level >5.4 [aOR (95% CI) 2.71 (1.02-7.52), p = 0.046]. The rate of AT was 12.5% in cases without risk factors for AT, 56.7% with one, 68.8% with two, and 94.1% with three risk factors present, respectively.
We have identified preoperative indicators independently associated with surgically confirmed AT in a large cohort of young women. Level of evidence- III.
描述因疑似附件扭转（AT）而行诊断性腹腔镜检查的儿童和青少年的临床特征，并建立一种预测年轻女性术前 AT 的模型。
回顾性队列研究。我们纳入了所有年龄在 18 岁以下且疑似 AT 而行诊断性腹腔镜检查的女孩。我们比较了 AT 患者与非 AT 患者，并构建了预测模型。
研究共纳入了 120 例疑似 AT 的儿童和青少年。其中，83 例（69.2%）诊断为 AT。多因素分析显示，以下独立的危险因素与 AT 相关，并纳入预测模型：检查时右下象限无压痛[校正优势比（aOR）（95%置信区间（CI））3.23（1.23-8.47），p=0.017]、血小板计数＞240×109/L[aOR（95% CI）3.15（1.19-8.36），p=0.021]和中性粒细胞计数＞5.4×109/L[aOR（95% CI）2.71（1.02-7.52），p=0.046]。无 AT 危险因素的病例中，AT 发生率为 12.5%；有一个危险因素的病例中，AT 发生率为 56.7%；有两个危险因素的病例中，AT 发生率为 68.8%；有三个危险因素的病例中，AT 发生率为 94.1%。
我们在一个大型年轻女性队列中发现了与手术确诊的 AT 独立相关的术前指标。证据等级-III。
