Conservative laparoscopic management of adnexal torsion based on a 17-year follow-up experience

Abstract

Laparoscopic unwinding of adnexal torsion has been proposed for decades. However, this technique is still controversial regarding the concern of thromboembolic events. We present two cases of conservative laparoscopic management of adnexal torsion. In the first case, a 16-year-old adolescent with serous cystadenoma was successfully managed by untwisting and cystectomy. We followed up this patient for 17 years with regular re-examinations in our hospital. To the best of our knowledge, this is the longest follow-up reported of this condition. In the second case, a 32-year-old infertile woman who received oocyte retrieval 3 days before being admitted to hospital was referred to hospital with right ovarian torsion. We treated her successfully based on our long-term follow-up experience, and she is now asymptomatic and in her 7th month of pregnancy.

Conservative surgery for ovarian torsion in young women: perioperative complications and national trends

“…Our study may also indirectly support ovarian preservation even in the setting of a necrotic‐appearing ovary given the fact that conservative surgery was not associated with perioperative complications. While our results are consistent with previous small studies that demonstrate no increase in complications following conservative surgery as compared with oophorectomy even with necrotic‐appearing ovaries, these observational data need to be followed by randomised prospective studies, especially to confirm the safety and utility of leaving necrotic‐appearing ovaries in situ following torsion …”

“…Studies have suggested no significant increase in complications with conservative surgery for ovarian torsion, although existing evidence is based on few studies with limited sample size . Practice patterns in the treatment of ovarian torsion are also unknown.…”

Conservative surgery for ovarian torsion in young women: perioperative complications and national trends

“…While our results are consistent with previous small studies that demonstrate no increase in complications following conservative surgery as compared with oophorectomy even with necrotic-appearing ovaries, these observational data need to be followed by randomised prospective studies, especially to confirm the safety and utility of leaving necrotic-appearing ovaries in situ following torsion. 8,13,15,17,23…”

“…[8][9][10][11][12][13][14] Studies have suggested no significant increase in complications with conservative surgery for ovarian torsion, although existing evidence is based on few studies with limited sample size. 12,[15][16][17] Practice patterns in the treatment of ovarian torsion are also unknown. An understanding of current practice patterns in the USA and the incidence of perioperative complications is crucial to influence individual surgeon decision-making, set quality standards, fuel specialty-wide initiatives aimed at practice change and identify specific target populations that warrant attention.…”

Bilateral ovarian torsion with ovarian fusion in the setting of polycystic ovarian syndrome: A case report

“…However, several studies have demonstrated ovarian preservation of function in 88–100% of cases of human torsion [ 4 ]. Other reports of ovarian function despite apparently ischemic-hemorrhagic appearance of torsed adnexa have been documented, favoring de-torsion rather than removal of the adnexa [ 9 ]. Several authors have demonstrated no difference in antral follicle count in small numbers of patients who underwent conservative detorsion of adnexa [ 10 , 11 ].…”