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. 2023 Jul;308(1):1-12.
doi: 10.1007/s00404-022-06522-3. Epub 2022 Jun 25.

Ovarian torsion in the pediatric population: predictive factors for ovarian-sparing surgery-an international retrospective multicenter study and a systematic review

Claudio Spinelli  1 , Ralf-Bodo Tröbs  2 , Matthias Nissen  3 , Silvia Strambi  4 , Marco Ghionzoli  4 , Alessia Bertocchini  4 , Valentina Cagnetta Domass  4 , Beatrice Sanna  4 , Riccardo Morganti  5 , Francesco Molinaro  6 , Mario Messina  6 , Stefano Tursini  7 , Vito Briganti  7 , Fabrizio Gennari  8 , Gabriele Lisi  9 , Pierluigi Lelli Chiesa  9
Affiliations

Ovarian torsion in the pediatric population: predictive factors for ovarian-sparing surgery-an international retrospective multicenter study and a systematic review

Claudio Spinelli et al. Arch Gynecol Obstet. 2023 Jul.

Abstract

Study objective: Ovarian torsion (OT) in pediatric age is a challenging condition to diagnose and treat. To date, there is still no clear consensus about its management. Our aim was to assess some possible associated factors that can help surgeons in decision-making.

Design: We conducted a retrospective multicentric study of pediatric OT surgically treated between 2010 and 2020 in six Italian and German institutions, comparing our findings with a literature review of the last 10 years (2010-2020).

Participants: Patients aged 0-18 years with a diagnosis of OT intraoperatively confirmed and surgically treated at the involved institutions.

Results: Ninety-seven patients with a mean age at diagnosis of 8.37 years were enrolled in the study. Severe abdominal pain was present in 82 patients (84.5%). Eighty children (82.5%) presented an enlarged ovary with an US diameter > 5 cm and only 32 (40%) of them underwent conservative surgery. A laparoscopic approach was performed in 60 cases (61.9%) although in 15 (15.5%) conversion to open surgery was deemed necessary. A functional cyst was present in 49 patients (50.5%) while 11 children (11.3%) suffered from OT on a normal ovary.

Conclusions: Our results showed that a post-menarchal age (p = .001), a pre-operative US ovarian size < 5 cm, (p = .001), the presence of severe abdominal pain (p = .002), a laparoscopic approach (p < .001), and the presence of a functional cyst (p = .002) were significantly associated with conservative surgery.

Keywords: Adolescents; Conservative surgery; Oophorectomy; Ovarian torsion; Ovarian-sparing surgery; Pediatrics.

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Conflict of interest statement

The authors declare they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA 20201 flow diagram for new systematic reviews which included searches of databases and registers only. 1The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. For more information, visit: http://www.prisma-statement.org/. Search terms: “Pediatric ovarian torsion”
See this image and copyright information in PMC

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