Pediatric Ovarian Torsion and its Recurrence: A Multicenter Study

Mirko Bertozzi, Ciro Esposito, Claudio Vella, Vito Briganti, Nicola Zampieri, Daniela Codrich, Michele Ubertazzi, Alessandro Trucchi, Elisa Magrini, Sonia Battaglia, Vittorio Bini, Maria Luisa Conighi, Caterina Gulia, Alessandra Farina, Francesco Saverio Camoglio, Waifro Rigamonti, Piergiorgio Gamba, Giovanna Riccipetitoni, Salvatore Fabio Chiarenza, Alessandro InserraAntonino Appignani

Research output: Contribution to journalArticle

Abstract

STUDY OBJECTIVE: To report results of a retrospective multicentric Italian survey concerning the management of pediatric ovarian torsion (OT) and its recurrence.

DESIGN: Multicenter retrospective cohort study.

SETTING: Italian Units of Pediatric Surgery.

PARTICIPANTS: Participants were female aged 1-14 years of age with surgically diagnosed OT between 2004 and 2014.

INTERVENTIONS: Adnexal detorsion, adnexectomy, mass excision using laparoscopy or laparotomy. Different kinds of oophoropexy (OPY) for OT or recurrence, respectively.

MAIN OUTCOME MEASURES: A total of 124 questionnaires were returned and analyzed to understand the current management of pediatric OT and its recurrence. The questionnaires concerned patient age, presence of menarche, OT site, presence and type of mass, performed procedure, OPY technique adopted, intra- and postoperative complications, recurrence and site, procedure performed for recurrence, OPY technique for recurrence, and 1 year follow-up of detorsed ovaries.

RESULTS: Mean age at surgery was 9.79 ± 3.54 years. Performed procedures were open adnexectomy (52 of 125; 41.6%), laparoscopic adnexectomy (25 of 125; 20%), open detorsion (10 of 125; 8%), and laparoscopic detorsion (38 of 125; 30.4%). Recurrence occurred in 15 of 125 cases (12%) and resulted as significant (P = .012) if associated with a normal ovary at the first episode of torsion. Recurrence occurred only in 1 of 19 cases after OPY (5.2%). Ultrasonographic results of detorsed ovaries were not significant whether an OPY was performed or not (P = 1.00).

CONCLUSION: Unfortunately, oophorectomy and open technique are still widely adopted even if not advised. Recurrence is not rare and the risk is greater in patients without ovarian masses. OPY does not adversely affect ultrasonographic results at 1 year. When possible OPY should be performed at the first episode of OT.

Original languageEnglish
JournalJournal of Pediatric and Adolescent Gynecology
DOIs
Publication statusE-pub ahead of print - Nov 26 2016

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Multicenter Studies
Pediatrics
Recurrence
Ovary
Menarche
Intraoperative Complications
Ovariectomy
Laparoscopy
Laparotomy
Cohort Studies
Retrospective Studies
Surveys and Questionnaires

Keywords

  • Journal Article

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Pediatric Ovarian Torsion and its Recurrence : A Multicenter Study. / Bertozzi, Mirko; Esposito, Ciro; Vella, Claudio; Briganti, Vito; Zampieri, Nicola; Codrich, Daniela; Ubertazzi, Michele; Trucchi, Alessandro; Magrini, Elisa; Battaglia, Sonia; Bini, Vittorio; Conighi, Maria Luisa; Gulia, Caterina; Farina, Alessandra; Camoglio, Francesco Saverio; Rigamonti, Waifro; Gamba, Piergiorgio; Riccipetitoni, Giovanna; Chiarenza, Salvatore Fabio; Inserra, Alessandro; Appignani, Antonino.

In: Journal of Pediatric and Adolescent Gynecology, 26.11.2016.

Research output: Contribution to journalArticle

Bertozzi, M, Esposito, C, Vella, C, Briganti, V, Zampieri, N, Codrich, D, Ubertazzi, M, Trucchi, A, Magrini, E, Battaglia, S, Bini, V, Conighi, ML, Gulia, C, Farina, A, Camoglio, FS, Rigamonti, W, Gamba, P, Riccipetitoni, G, Chiarenza, SF, Inserra, A & Appignani, A 2016, 'Pediatric Ovarian Torsion and its Recurrence: A Multicenter Study', Journal of Pediatric and Adolescent Gynecology. https://doi.org/10.1016/j.jpag.2016.11.008
Bertozzi, Mirko ; Esposito, Ciro ; Vella, Claudio ; Briganti, Vito ; Zampieri, Nicola ; Codrich, Daniela ; Ubertazzi, Michele ; Trucchi, Alessandro ; Magrini, Elisa ; Battaglia, Sonia ; Bini, Vittorio ; Conighi, Maria Luisa ; Gulia, Caterina ; Farina, Alessandra ; Camoglio, Francesco Saverio ; Rigamonti, Waifro ; Gamba, Piergiorgio ; Riccipetitoni, Giovanna ; Chiarenza, Salvatore Fabio ; Inserra, Alessandro ; Appignani, Antonino. / Pediatric Ovarian Torsion and its Recurrence : A Multicenter Study. In: Journal of Pediatric and Adolescent Gynecology. 2016.
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abstract = "STUDY OBJECTIVE: To report results of a retrospective multicentric Italian survey concerning the management of pediatric ovarian torsion (OT) and its recurrence.DESIGN: Multicenter retrospective cohort study.SETTING: Italian Units of Pediatric Surgery.PARTICIPANTS: Participants were female aged 1-14 years of age with surgically diagnosed OT between 2004 and 2014.INTERVENTIONS: Adnexal detorsion, adnexectomy, mass excision using laparoscopy or laparotomy. Different kinds of oophoropexy (OPY) for OT or recurrence, respectively.MAIN OUTCOME MEASURES: A total of 124 questionnaires were returned and analyzed to understand the current management of pediatric OT and its recurrence. The questionnaires concerned patient age, presence of menarche, OT site, presence and type of mass, performed procedure, OPY technique adopted, intra- and postoperative complications, recurrence and site, procedure performed for recurrence, OPY technique for recurrence, and 1 year follow-up of detorsed ovaries.RESULTS: Mean age at surgery was 9.79 ± 3.54 years. Performed procedures were open adnexectomy (52 of 125; 41.6{\%}), laparoscopic adnexectomy (25 of 125; 20{\%}), open detorsion (10 of 125; 8{\%}), and laparoscopic detorsion (38 of 125; 30.4{\%}). Recurrence occurred in 15 of 125 cases (12{\%}) and resulted as significant (P = .012) if associated with a normal ovary at the first episode of torsion. Recurrence occurred only in 1 of 19 cases after OPY (5.2{\%}). Ultrasonographic results of detorsed ovaries were not significant whether an OPY was performed or not (P = 1.00).CONCLUSION: Unfortunately, oophorectomy and open technique are still widely adopted even if not advised. Recurrence is not rare and the risk is greater in patients without ovarian masses. OPY does not adversely affect ultrasonographic results at 1 year. When possible OPY should be performed at the first episode of OT.",
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T1 - Pediatric Ovarian Torsion and its Recurrence

T2 - A Multicenter Study

AU - Bertozzi, Mirko

AU - Esposito, Ciro

AU - Vella, Claudio

AU - Briganti, Vito

AU - Zampieri, Nicola

AU - Codrich, Daniela

AU - Ubertazzi, Michele

AU - Trucchi, Alessandro

AU - Magrini, Elisa

AU - Battaglia, Sonia

AU - Bini, Vittorio

AU - Conighi, Maria Luisa

AU - Gulia, Caterina

AU - Farina, Alessandra

AU - Camoglio, Francesco Saverio

AU - Rigamonti, Waifro

AU - Gamba, Piergiorgio

AU - Riccipetitoni, Giovanna

AU - Chiarenza, Salvatore Fabio

AU - Inserra, Alessandro

AU - Appignani, Antonino

N1 - Copyright © 2016. Published by Elsevier Inc.

PY - 2016/11/26

Y1 - 2016/11/26

N2 - STUDY OBJECTIVE: To report results of a retrospective multicentric Italian survey concerning the management of pediatric ovarian torsion (OT) and its recurrence.DESIGN: Multicenter retrospective cohort study.SETTING: Italian Units of Pediatric Surgery.PARTICIPANTS: Participants were female aged 1-14 years of age with surgically diagnosed OT between 2004 and 2014.INTERVENTIONS: Adnexal detorsion, adnexectomy, mass excision using laparoscopy or laparotomy. Different kinds of oophoropexy (OPY) for OT or recurrence, respectively.MAIN OUTCOME MEASURES: A total of 124 questionnaires were returned and analyzed to understand the current management of pediatric OT and its recurrence. The questionnaires concerned patient age, presence of menarche, OT site, presence and type of mass, performed procedure, OPY technique adopted, intra- and postoperative complications, recurrence and site, procedure performed for recurrence, OPY technique for recurrence, and 1 year follow-up of detorsed ovaries.RESULTS: Mean age at surgery was 9.79 ± 3.54 years. Performed procedures were open adnexectomy (52 of 125; 41.6%), laparoscopic adnexectomy (25 of 125; 20%), open detorsion (10 of 125; 8%), and laparoscopic detorsion (38 of 125; 30.4%). Recurrence occurred in 15 of 125 cases (12%) and resulted as significant (P = .012) if associated with a normal ovary at the first episode of torsion. Recurrence occurred only in 1 of 19 cases after OPY (5.2%). Ultrasonographic results of detorsed ovaries were not significant whether an OPY was performed or not (P = 1.00).CONCLUSION: Unfortunately, oophorectomy and open technique are still widely adopted even if not advised. Recurrence is not rare and the risk is greater in patients without ovarian masses. OPY does not adversely affect ultrasonographic results at 1 year. When possible OPY should be performed at the first episode of OT.

AB - STUDY OBJECTIVE: To report results of a retrospective multicentric Italian survey concerning the management of pediatric ovarian torsion (OT) and its recurrence.DESIGN: Multicenter retrospective cohort study.SETTING: Italian Units of Pediatric Surgery.PARTICIPANTS: Participants were female aged 1-14 years of age with surgically diagnosed OT between 2004 and 2014.INTERVENTIONS: Adnexal detorsion, adnexectomy, mass excision using laparoscopy or laparotomy. Different kinds of oophoropexy (OPY) for OT or recurrence, respectively.MAIN OUTCOME MEASURES: A total of 124 questionnaires were returned and analyzed to understand the current management of pediatric OT and its recurrence. The questionnaires concerned patient age, presence of menarche, OT site, presence and type of mass, performed procedure, OPY technique adopted, intra- and postoperative complications, recurrence and site, procedure performed for recurrence, OPY technique for recurrence, and 1 year follow-up of detorsed ovaries.RESULTS: Mean age at surgery was 9.79 ± 3.54 years. Performed procedures were open adnexectomy (52 of 125; 41.6%), laparoscopic adnexectomy (25 of 125; 20%), open detorsion (10 of 125; 8%), and laparoscopic detorsion (38 of 125; 30.4%). Recurrence occurred in 15 of 125 cases (12%) and resulted as significant (P = .012) if associated with a normal ovary at the first episode of torsion. Recurrence occurred only in 1 of 19 cases after OPY (5.2%). Ultrasonographic results of detorsed ovaries were not significant whether an OPY was performed or not (P = 1.00).CONCLUSION: Unfortunately, oophorectomy and open technique are still widely adopted even if not advised. Recurrence is not rare and the risk is greater in patients without ovarian masses. OPY does not adversely affect ultrasonographic results at 1 year. When possible OPY should be performed at the first episode of OT.

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DO - 10.1016/j.jpag.2016.11.008

M3 - Article

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JO - Journal of Pediatric and Adolescent Gynecology

JF - Journal of Pediatric and Adolescent Gynecology

SN - 1083-3188

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