Long-term follow-up of the twisted ischemic adnexa managed by detorsion

Oelsner, Gabriel; Bider, David; Goldenberg, Mordechai; Admon, Dahlia; Mashiach, Shlomo

doi:10.1016/s0015-0282(16)56395-x

Cited by 223 publications

(136 citation statements)

References 2 publications

Supporting

Mentioning

127

Contrasting

Unclassified

Order By: Relevance

“…In this study, the mean CRP level was significantly higher in the group undergoing surgery at 10 h or more than in the group undergoing surgery at less than 10 h. Histologically confirmed necrosis was only observed in the group undergoing surgery at 10 h or more. Some studies have reported that ovarian torsion could occur following ovarian stimulation [14][15][16]. In this study, however, all ovarian torsion cases were associated with ovarian tumor.…”

Section: Discussioncontrasting

confidence: 51%

Clinical indices and histological changes over time in ovarian torsion related to ovarian tumors

et al. 2011

View full text Add to dashboard Cite

In some emergency surgeries for ovarian torsion, the ovary cannot be conserved because of necrosis. Ovarian necrosis and the time from the onset of symptoms to surgery are likely to be directly correlated. In this study, we retrospectively evaluated the clinical indices from the time of onset of acute abdomen to surgery at our hospital, in patients with tumor-related ovarian torsion. Among cases diagnosed preoperatively with benign ovarian tumors between 1995 and 2010, there were 54 patients who developed acute abdomen that was surgically diagnosed as ovarian torsion. For evaluation, these patients were divided into two groups according to the time from the onset of acute abdomen to surgical intervention as follows: <10 and ≥10 h. C-reactive protein (CRP) levels, leukocyte counts, body temperature, tumor size, and degree of torsion were compared between the two patient groups. Ovarian status based on postoperative histopathology was classified as necrotic, congestive, or normal, and was also evaluated. The mean CRP level was significantly higher in the ≥10-h patient group than in the patients undergoing surgery in <10 h. No differences were observed between the two groups for leukocyte counts, body temperature, tumor size, and mean degree of torsion. Ovarian necrosis was only observed only in patients undergoing surgery at ≥10 h. When tumorrelated ovarian torsion is suspected, surgery should be performed within 10 h after the onset of acute abdomen to conserve ovarian function.

show abstract

Section: Discussioncontrasting

confidence: 51%

Clinical indices and histological changes over time in ovarian torsion related to ovarian tumors

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Laparoscopy has been shown to be a favorable option in patients with torsion. There has been a trend towards increased used of laparoscopy and adnexal-sparing procedures in many centers because of its obvious benefits regarding safety, reliability, and preserving fertility [1,7,18,19].…”

Section: Discussionmentioning

confidence: 99%

“…More than half of the patients having an adnexectomy were postmenopausal. In the recent literature, the rate of conservative laparoscopic treatment varies from 35 to 93 % [1,4,7,18,20].…”

Section: Discussionmentioning

confidence: 99%

Management of adnexal torsion by laparoscopic approach

et al. 2012

View full text Add to dashboard Cite

The study aimed to evaluate the effectiveness and safety of laparoscopic management of adnexal torsion. Early minimal invasive surgical management of adnexal torsion with the main emphasis on an organ-preserving procedure can safely be recommended. Although the incidence of adnexal torsions has increased, the morbidity rate has declined due to safer diagnostics and operative strategies. This is a retrospective case-control study (Canadian Task Force classification II-3) of 33 cases of adnexal torsion over an 11-year period (December 1999-September 2010) in a gynecologic endoscopy unit of a university hospital. Interventions include early diagnostic laparoscopy and utmost protection of the surrounding tissue. Thirty-three cases of laparoscopically managed adnexal torsions were analyzed. Fifty-two percent had conservative organ-sparing procedures, while 48 % underwent resection of ovary, tube, or both. The mean operating time was 69.2 min. There were no complications or conversions to laparotomy. The most common predisposing factor was an adnexal mass with symptoms of pain. Torsion on the right tube is more common than on the left. Laparoscopic surgery is an effective, safe, and feasible method in the diagnosis and treatment of adnexal torsion.

show abstract

“…The degree of rotation and duration of torsion determine the severity of the injury [12]. Some authors concluded that ischemic-necrotic appearance of adnexa was the result of ovarian engorgement secondary to venous stasis, which did not produce a complete arterial obstruction in most cases [13] [14]. Ovarian tissue contains angiogenic factors that stimulate endothelial cell migration [15] [16].…”

Section: Discussionmentioning

confidence: 99%

Effects of Melatonin on Ischemia-Reperfusion Injury in Rat Ovary: Histopathologic and Immunohistochemical Study

Balsak¹,

Toğrul²,

Seçkin³

et al. 2015

OJOG

View full text Add to dashboard Cite

Aim: To investigate the effect of melatonin on ischemia-reperfusion (I/R) injury in rat ovary. Material and Method: A total of 24 Wistar rats were divided into four groups. The rats were first numbered randomly and then randomly divided into four equal groups: sham, torsion, detorsion and melatonin groups. In group I (n = 6) sham, as well as in group II ovary torsion was not performed and no drug was administered. In group III, 1 hour of ischemia and 2 hours of reperfusion were performed and no drug was given. In group IV, melatonin was dissolved in 1% ethanol just before use. Melatonin was injected 1 hour before torsion to the torsion plus melatonin group. Right ovaries were surgically removed in all groups. Result: Malondialdehyde (MDA) levels were measured. We suggested that administration of melatonin would be in treating ovaries from torsion/detorsion induced damage in humans. The histopathological changes such as vascular con-* Corresponding author. D. Balsak et al. 640gestion, edema, hemorrhage, and follicular degeneration were found to be decreased in the melatonin + ischemia-reperfusion group. Ischemia-reperfusion group: PECAM-I expression is positive in vessel of the stromal area. The follicles and interfolicular area infiltrated with CD68 positive cells were increased in a time of ischemia-reperfusion exposure dependent manner. Conclusions: Melatonin after ischemia-reperfusion CD31 and CD68 expressions is weak, due to the reduction of the inflammatory effects and hemorrhage is thought that melatonin is effective.

show abstract

Long-term follow-up of the twisted ischemic adnexa managed by detorsion

Cited by 223 publications

References 2 publications

Clinical indices and histological changes over time in ovarian torsion related to ovarian tumors

Clinical indices and histological changes over time in ovarian torsion related to ovarian tumors

Management of adnexal torsion by laparoscopic approach

Effects of Melatonin on Ischemia-Reperfusion Injury in Rat Ovary: Histopathologic and Immunohistochemical Study

Contact Info

Product

Resources

About