Yagur Yael, Klein Amit, Tiosano Lisa, Weitzner Omer, Daykan Yair, Rosen David, Klein Zvi, Schonman Ron
Gynecology Division, Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., Kfar Saba, Israel.
School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Arch Gynecol Obstet. 2025 Oct;312(4):1317-1325. doi: 10.1007/s00404-025-08128-x. Epub 2025 Jul 28.
To compare the effectiveness of ovarian ligament plication and ovario-round ligament fixation ("hot-dog" technique) in preventing recurrent adnexal torsion.
This is a retrospective cohort study performed in the gynecology department, of a university-affiliated tertiary medical center. Women of reproductive age who underwent first fixation following adnexal torsion surgery on the ipsilateral side between 2014 and 2023. The study included a homogenous population with normal ovarian size. Primary outcome was the recurrence rate of adnexal torsion following each fixation technique. Two fixation techniques of ovarian ligament plication and ovario-round ligament fixation were compared.
A total of 525 adnexal torsion events were reviewed, involving 413 patients. After applying strict inclusion criteria, 38 patients who underwent their first fixation on the ipsilateral side were included in the final analysis. Among them, 27 (71%) underwent ovarian ligament plication, and 11 (29%) underwent ovario-round ligament fixation. Recurrent torsion occurred in 25.9% (7 of 27) of patients in the ovarian ligament plication group, while no recurrences were observed in the ovario-round ligament fixation group. While clinically promising, the difference did not reach statistical significance (p = 0.08). Fixation was also safely performed during pregnancy, primarily in the first trimester, with no postoperative complications observed.
Ovario-round ligament fixation shows promise as a technique for preventing recurrent torsion with a favorable safety profile. Due to the limited sample size, further larger-scale studies are required to confirm these findings and comprehensively evaluate long-term outcomes.
比较卵巢韧带折叠术和卵巢-圆韧带固定术（“热狗”技术）在预防附件扭转复发方面的有效性。
这是一项在一所大学附属三级医疗中心妇科进行的回顾性队列研究。研究对象为2014年至2023年间在同侧附件扭转手术后首次进行固定手术的育龄妇女。研究纳入了卵巢大小正常的同质人群。主要结局是每种固定技术后附件扭转的复发率。比较了卵巢韧带折叠术和卵巢-圆韧带固定术这两种固定技术。
共回顾了525例附件扭转事件，涉及413例患者。应用严格的纳入标准后，最终分析纳入了38例在同侧进行首次固定手术的患者。其中，27例（71%）接受了卵巢韧带折叠术，11例（29%）接受了卵巢-圆韧带固定术。卵巢韧带折叠术组25.9%（27例中的7例）患者发生了复发性扭转，而卵巢-圆韧带固定术组未观察到复发。虽然在临床上有前景，但差异未达到统计学意义（p = 0.08）。固定手术在孕期也安全进行，主要是在孕早期，未观察到术后并发症。
卵巢-圆韧带固定术作为一种预防复发性扭转的技术显示出前景，且安全性良好。由于样本量有限，需要进一步开展更大规模的研究来证实这些发现并全面评估长期结局。
