Claudio Spinelli1, Ralf-Bodo Tröbs2, Matthias Nissen3, Silvia Strambi4, Marco Ghionzoli4, Alessia Bertocchini4, Valentina Cagnetta Domass4, Beatrice Sanna4, Riccardo Morganti5, Francesco Molinaro6, Mario Messina6, Stefano Tursini7, Vito Briganti7, Fabrizio Gennari8, Gabriele Lisi9, Pierluigi Lelli Chiesa9. 1. Pediatric and Adolescent Surgery Division, Department of Surgical Pathology, Medical, Molecular and Critic Area, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy. claudio.spinelli@unipi.it. 2. Department of Pediatric Surgery, St. Johannes Hospital, Helios Group, Duisburg, Germany. 3. Department of Pediatric Surgery, Marien Hospital, Ruhr-University of Bochum, St. Elisabeth Group, Witten, Germany. 4. Pediatric and Adolescent Surgery Division, Department of Surgical Pathology, Medical, Molecular and Critic Area, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy. 5. Department of Clinical and Experimental Medicine, Section of Statistics, University of Pisa, Pisa, Italy. 6. Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy. 7. Department of Pediatric Surgery and Urology Unit, San Camillo Forlanini Hospital, Rome, Italy. 8. Department of Pediatric Surgery, Ospedale Regina Margherita, Torino, Italy. 9. Department of Pediatric Surgery "Spirito Santo", Hospital of Pescara "G.D'annunzio", University Chieti-Pescara, Pescara, Italy.
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.
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.
Authors: Margot Ollivier; Sami Sfar Mohamed; Benoit Tessier; Yosra Ben Ahmed; Amandine Coffy; Sarah Garnier; Marie Pierre Guibal; Charles Sultan; Francoise Paris; Nicolas Kalfa Journal: J Pediatr Surg Date: 2019-03-01 Impact factor: 2.545
Authors: Julia Tasset; Monica Woll Rosen; Sara Bell; Yolanda Regina Smith; Elisabeth H Quint Journal: J Pediatr Adolesc Gynecol Date: 2018-10-25 Impact factor: 1.814