Choi Euna, Kim Hye In, Seo Seok Kyo, Cho Si Hyun, Choi Young Sik, Lee Byung Seok, Yun Bo Hyon
Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2023 Nov;66(6):562-571. doi: 10.5468/ogs.23071. Epub 2023 Oct 16.
We aimed to determine whether ovarian-preserving surgery for adnexal torsion helps preserve ovarian function without increasing the risk of postoperative complications.
We retrospectively evaluated 71 women who were surgically diagnosed with adnexal torsion between January 2015 and December 2019 at Severance Hospital, Yonsei University College of Medicine (ovarian preservation group, 56; oophorectomy, 15). Serum anti-Müllerian hormone (AMH) levels measured within 6 months before surgery were compared to levels measured 6-24 months after surgery. Surgical findings and postoperative complications were compared between the groups.
There was a borderline significant difference in the decrease in serum AMH levels between the oophorectomy group and ovarian preservation group before and after surgery. There were no significant differences between the groups in terms of fever, infection, or duration of admission. Discoloration of the twisted ovary was found in 27.3% and 33.3% of the patients in the ovarian preservation and oophorectomy groups, respectively. There was no difference in the decrease in serum AMH levels between patients with and those without discoloration.
Ovarian-preserving surgery may not increase postoperative complications in patients with adnexal torsion, even if a twisted mass is suspected to be necrotic. Moreover, the ovarian reserve may not be affected by torsion if the ovary is preserved. Conservative ovarian surgery can be safely performed to preserve the reproductive potential of women with adnexal torsion and cystic masses.
我们旨在确定附件扭转的保留卵巢手术是否有助于保留卵巢功能,同时不增加术后并发症的风险。
我们回顾性评估了2015年1月至2019年12月在延世大学医学院Severance医院经手术诊断为附件扭转的71名女性(保留卵巢组56例;卵巢切除术组15例)。将手术前6个月内测得的血清抗苗勒管激素(AMH)水平与术后6 - 24个月测得的水平进行比较。比较两组的手术结果和术后并发症。
卵巢切除术组和保留卵巢组术前和术后血清AMH水平下降存在临界显著差异。两组在发热、感染或住院时间方面无显著差异。保留卵巢组和卵巢切除术组分别有27.3%和33.3%的患者出现扭转卵巢变色。有变色和无变色患者的血清AMH水平下降无差异。
保留卵巢手术可能不会增加附件扭转患者的术后并发症,即使怀疑扭转肿块已坏死。此外,如果保留卵巢,卵巢储备可能不受扭转影响。对于附件扭转和囊性肿块的女性,可安全地进行保守性卵巢手术以保留其生殖潜力。