Smorgick Noam, Mor Matan, Eisenberg Neta, Dovev Maya Naor, Vaknin Zvi
Department of Obstetrics and Gynecology, Shamir (Assaf Harofe) Medical Center, (affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel), Beer Yaakov, 70300, Zerifin, Israel.
Arch Gynecol Obstet. 2023 Mar;307(3):821-825. doi: 10.1007/s00404-022-06831-7. Epub 2022 Nov 3.
Recurrence of adnexal torsion involving otherwise normal adnexa is not rare. Various oophoropexy (ovarian fixation) procedures have been suggested to prevent recurrence; however, long-term information of their efficacy is lacking. The aim of this study was to investigate the recurrence rate of adnexal torsion following oophoropexy.
Retrospective cohort study, including all consecutive patients who underwent an oophoropexy procedure for the prevention of recurrent torsion of "normal adnexa" in our department from 2008 to 2019 by shortening of the utero-ovarian ligament.
Nineteen patients (age range 7-35 years) with a mean follow-up of 90.9 ± 57.7 months were identified. Fifteen of them (78.9%) were re-operated for recurrent torsion following an oophoropexy procedure, while four (21.1%) did not experience recurrence. Nine torsion recurrences following an oophoropexy occurred within the first 2 postoperative years. There were no differences in mean age and menarcheal status )pre- or post-menarcheal) at the time of the first torsion event, age at the time of oophoropexy, oophoropexy side, number of adnexal torsion events before oophoropexy, and follow-up duration between those with and those without post-oophoropexy recurrences.
Oophoropexy procedure by shortening of the utero-ovarian ligament may not prevent recurrent torsion of otherwise normal adnexa. Further studies to determine whether combined fixation (utero-ovarian and round ligament plication) is more efficacious than isolated utero-ovarian plication for the prevention of recurrent torsion are warranted.
附件扭转复发累及其他方面正常的附件并不罕见。已提出各种卵巢固定术来预防复发；然而，缺乏关于其疗效的长期信息。本研究的目的是调查卵巢固定术后附件扭转的复发率。
回顾性队列研究，纳入2008年至2019年在我科因缩短子宫卵巢韧带而接受卵巢固定术以预防“正常附件”复发性扭转的所有连续患者。
确定了19例患者（年龄范围7 - 35岁），平均随访90.9±57.7个月。其中15例（78.9%）在卵巢固定术后因扭转复发而再次手术，4例（21.1%）未复发。9例卵巢固定术后的扭转复发发生在术后的头2年内。首次扭转事件时的平均年龄和月经初潮状态（月经初潮前或后）、卵巢固定术时的年龄、卵巢固定术的侧别、卵巢固定术前附件扭转事件的数量以及卵巢固定术后复发组和未复发组之间的随访时间均无差异。
通过缩短子宫卵巢韧带进行的卵巢固定术可能无法预防其他方面正常的附件的复发性扭转。有必要进一步研究确定联合固定（子宫卵巢和圆韧带折叠）在预防复发性扭转方面是否比单纯子宫卵巢折叠更有效。
