The Hospital for Sick Children, Toronto and University of Toronto, Ontario, Canada.
The Hospital for Sick Children, Toronto and University of Toronto, Ontario, Canada.
J Pediatr Adolesc Gynecol. 2022 Jun;35(3):353-358. doi: 10.1016/j.jpag.2021.10.013. Epub 2021 Nov 4.
Our objective was to determine if ovarian surgery at the time of ovarian detorsion is associated with impaired short-term ovarian function as indicated by ovarian morphology on ultrasound when compared with detorsion alone.
Retrospective cohort study SETTING: The Hospital for Sick Children, Toronto PARTICIPANTS: Patients ≤ 18 years old with confirmed ovarian torsion from January 1, 2004, to December 31, 2018, with ovarian-sparing surgery.
Data were collected on demographics, procedure, intraoperative findings, and postoperative ultrasound. To determine ovarian function, we compared the morphology on the postoperative ultrasound between those with surgery to the ovary and those without surgery to the ovary at the time of detorsion. We also compared the ovarian volume of affected and contralateral ovaries after detorsion and surgery to the affected ovary.
One hundred and nineteen patients met the inclusion criteria, of whom 67 (56%) had detorsion with surgery to the ovary and 52 (44%) had detorsion alone. There was no statistically significant difference in appearance on the postoperative ultrasound between these groups (P =.446). There was also no statistically significant difference on the postoperative ultrasound of affected and contralateral ovarian volumes after detorsion and surgery to the affected ovary (P = .69). Patients who underwent surgery to the ovary experienced a lower rate of recurrence; however, this did not reach statistical significance, with a P value of 0.080.
Our study demonstrates that surgery, eg cystectomy to the ovary at the time of ovarian detorsion, does not appear to impact ovarian function when compared with detorsion alone, as indicated on postoperative imaging. There was also no difference in volume of the affected and contralateral ovaries in those cases that underwent surgery at the time of initial detorsion. This evidence would support that immediate cystectomy at the time of initial ovarian detorsion is not associated with impaired ovarian function, thus avoiding the need for an interval cystectomy.
本研究旨在确定与单纯卵巢复位术相比，卵巢复位术时行卵巢切除术是否会导致卵巢形态学改变，从而影响短期卵巢功能。
回顾性队列研究
多伦多 SickKids 医院
2004 年 1 月 1 日至 2018 年 12 月 31 日期间确诊为卵巢扭转且年龄≤18 岁的患者，行卵巢保留手术。
收集人口统计学资料、手术方式、术中发现及术后超声资料。为了评估卵巢功能，我们比较了复位术中行卵巢切除术和单纯复位术患者的术后超声卵巢形态。我们还比较了复位术和卵巢切除术治疗患侧卵巢后患侧和对侧卵巢的体积。
符合纳入标准的患者有 119 例，其中 67 例（56%）行卵巢复位术联合卵巢切除术，52 例（44%）行单纯卵巢复位术。两组患者术后超声表现无统计学差异（P=.446）。复位术和卵巢切除术治疗患侧卵巢后，患侧和对侧卵巢体积的术后超声结果也无统计学差异（P=.69）。行卵巢切除术的患者复发率较低，但差异无统计学意义（P 值为 0.080）。
本研究表明，与单纯卵巢复位术相比，卵巢复位术时行卵巢切除术（如卵巢切除术）似乎不会影响术后影像学检查提示的卵巢功能。在初次卵巢复位术时行手术的患者中，患侧和对侧卵巢的体积也没有差异。该证据支持在初次卵巢复位术时立即行卵巢切除术并不影响卵巢功能，从而避免了间隔期行卵巢切除术的需要。
