A retrospective study of surgical treatment and outcome among women with adnexal torsion in eastern Taiwan from 2010 to 2015

Abstract

BackgroundAdnexal torsion is a gynecologic emergency that requires surgical treatment. In this study, we reviewed the surgical outcomes of women with adnexal torsion in eastern Taiwan (Hualien county, area 4,629 km2, 330,000 residents).MethodsThis retrospective study included 42 women diagnosed with surgically-proven adnexal torsion from January 1, 2010, to September 31, 2015. We compared the symptoms, objective findings, and surgical outcomes of patients who underwent laparotomy or laparoscopy.ResultsThe laparoscopy and laparotomy groups included 27 and 15 patients, respectively. The most common symptom and sign was abdominal pain, followed by nausea and vomiting. In all patients, an adnexal tumor was detected through ultrasound. The median and range of time from admission to surgery was 1.5 (1–11.5) and 1.0 (1–11) hours in the laparotomy and laparoscopy groups, respectively. Compared with those undergoing laparotomy, the smaller tumor size [7 (4.2–10) vs. 10 (7–17) cm] and shorter hospital stay [4 (2–8) vs. 6 (3–9) days] in patients undergoing laparoscopy were significantly noted, respectively (P < 0.01). No differences were observed in age, operative time, and blood loss between both groups. The surgeries performed were mostly detorsion with cystectomy and adnexectomy. The most common pathology was a simple ovarian cyst, followed by teratoma. Regarding the surgical types, older age is the only risk factor for radical surgery.DiscussionAcute onset of abdominal pain with a presenting ovarian tumor is the most common feature of adnexal torsion. Laparoscopic surgical group showed a small tumor size and a short ER hospital stay than laparotomy. Older age is the risk factor for radical surgery.

Acute abdomen with adnexal masses in the reproductive age group: diagnosis and management

“…Laparoscopy resulted in lesser hospital stay. 11 In a study comparing laparoscopy versus laparotomy for management of ectopic pregnancy, laparoscopy resulted in lesser operative time and lesser hospital stay. 12…”

Can ovaries be preserved after an ovarian arteriovenous disconnection? One case report and a review of surgical treatment using Da Vinci robots for aggressive ovarian fibromatosis

“…Therefore, several months after the initial procedure and during a follow-up examination, the appearance and function of the patient’s ovaries were found to be postive. Huang et al [17] analyzed the surgical method applied during 42 cases of ovarian cyst pedicle torsion. Their findings determined that when compared with traditional surgical methods of ovarian resection, ovarian preservation surgical methods have distinct advantages for postoperative endocrine function recovery, and it has additional safety and effectiveness outcomes [17].…”

“…Huang et al [17] analyzed the surgical method applied during 42 cases of ovarian cyst pedicle torsion. Their findings determined that when compared with traditional surgical methods of ovarian resection, ovarian preservation surgical methods have distinct advantages for postoperative endocrine function recovery, and it has additional safety and effectiveness outcomes [17]. Taskin et al [18] established the mouse model with uterine adnexal torsion in 1998.…”

Comparing outcomes of ovarian cystectomy by vaginal natural orifice transluminal endoscopic surgery versus laparoendoscopic single-site surgery: A retrospective cohort study

“…Ovarian torsion is a true surgical emergency that must be considered in the differential diagnosis of any female patient presenting with acute abdominal pain. 8,9 Recently, it has been proven that the most common cause of ovarian torsion is an ovarian cyst. 10…”

“…7 Ovarian torsion is a true surgical emergency that must be considered in the differential diagnosis of any female patient presenting with acute abdominal pain. 8,9 Recently, it has been proven that the most common cause of ovarian torsion is an ovarian cyst. 10 Regarding surgical techniques in gynecology, minimal-invasive surgery (MIS) has become mainstream, with the advantages of cosmetic effects and rapid recovery.…”