Abstract
Purpose: Ovarian torsion, a condition requiring surgical intervention because it causes acute abdomen, is often treated by pediatric surgeons. Although ovarian preservation is the preferred approach, many institutions still opt for oophorectomy in cases of ovarian torsion. In this study, we retrospectively examined ovarian surgeries at our institution to assess the potential for ovarian preservation in cases of ovarian torsion.
Methods: We retrospectively reviewed 68 cases of ovarian surgery in patients under 20 years old between 2002 and March 2021, excluding seven neonates. The patients were categorized into those with ovarian torsion (T+ group) and those without torsion (T− group).
Results: Seventy-four surgeries were performed on 68 patients (T+ 30, T− 44). Emergency surgeries for suspected torsion were conducted in 31 patients (T+ 23, T− 8), whereas seven non-emergent cases were also identified in the T+ group. In the T+ group, one patient had detorsion, none of the patients had oophoropexy, 14 had enucleation, and none of the patients underwent two-step ovarian preservation surgery. Fifteen patients in the T+ group who underwent oophorectomy included nine with benign tumors without complete necrosis, suggesting the potential for ovarian preservation. In the T− group, oophorectomy was performed on nine patients, including three with benign tumors, although all of which were suspected to be malignant,
Conclusion: In ovarian torsion cases where malignancy cannot be ruled out preoperatively, a strategy prioritizing ovarian preservation, including two-step surgery, can increase the number of cases where preservation is possible.
