Akdam Amir, Bor Nati, Fouks Yuval, Ram Maya, Laskov Ido, Levin Ishai, Cohen Aviad
Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv (Drs. Akdam, Fouks, Ram, Laskov, Levin, and Cohen), Israel.
Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Beilinson Hospital, Petah Tikva (Dr. Bor), Israel.
J Minim Invasive Gynecol. 2022 Aug;29(8):1011-1018. doi: 10.1016/j.jmig.2022.05.007. Epub 2022 May 13.
To identify risk factors for recurrent ovarian torsion and evaluation of the efficacy of oophoropexy techniques.
Case control study.
Tertiary university-affiliated medical center.
A total of 79 women with recurrent ovarian torsion (study group) were matched with 158 women with a single episode of ovarian torsion (control group).
Laparoscopic detorsion and oophoropexy.
Demographic data, clinical characteristics, ultrasound characteristics, surgical findings, surgical procedures, and torsion recurrence rates were analyzed and compared between the 2 groups between 2001 to 2020.
There was an inverse association between women's age and the risk of recurrent torsion (adjusted odds ratio [aOR], 0.89; 95% confidence interval [CI], 0.83-0.96, p = .003). Moreover, in women younger than 20 years, the risk of recurrent event was substantially higher (aOR, 5.0; 95% CI, 1.56-6.15, p = .007). In addition, the absence of ovarian pathology was associated with increased risk for recurrent torsion (aOR, 14.3; 95% CI, 6.15-33.42; p <.001). Oophoropexy was performed in 46 women in the study group. The risk of recurrent torsion after oophoropexy was 30%. A long duration of pain before admission was associated with oophoropexy failure (37.5 ± 6.3 hours vs 11.7 ± 6.0 hours, p = .003). No single fixation procedure was superior to the others in terms of therapeutic success.
Recurrent ovarian torsion is more common in young women with a normal-appearing ovary. Oophoropexy is a safe procedure with a risk of retorsion in 30% of the patients. We found no advantage for one fixation technique over the others.
确定复发性卵巢扭转的危险因素并评估卵巢固定术的疗效。
病例对照研究。
大学附属三级医疗中心。
共有79例复发性卵巢扭转患者（研究组）与158例单次卵巢扭转患者（对照组）进行匹配。
腹腔镜下扭转复位和卵巢固定术。
分析并比较了2001年至2020年两组患者的人口统计学数据、临床特征、超声特征、手术发现、手术过程及扭转复发率。
女性年龄与复发性扭转风险呈负相关（调整优势比[aOR]，0.89；95%置信区间[CI]，0.83 - 0.96，p = 0.003）。此外，20岁以下女性复发性事件的风险显著更高（aOR，5.0；95% CI，1.56 - 6.15，p = 0.007）。另外，卵巢无病变与复发性扭转风险增加相关（aOR，14.3；95% CI，6.15 - 33.42；p < 0.001）。研究组46例患者进行了卵巢固定术。卵巢固定术后复发性扭转的风险为30%。入院前疼痛持续时间长与卵巢固定术失败相关（37.5 ± 6.3小时对11.7 ± 6.0小时，p = 0.003）。就治疗成功率而言，没有一种固定方法优于其他方法。
复发性卵巢扭转在卵巢外观正常的年轻女性中更常见。卵巢固定术是一种安全的手术，30%的患者有再次扭转的风险。我们未发现一种固定技术优于其他技术。
