E-ISSN: 1309-0380
    Conservative laparoscopic management of adnexal torsion
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    Original Investigation
    VOLUME: 12 ISSUE: 1
    P: 4-8
    March 2011

    Conservative laparoscopic management of adnexal torsion

    J Turk Ger Gynecol Assoc 2011;12(1):4-8
    DOI: 10.5152/jtgga.2011.02
    Rana Karayalçin 1
    Sarp Özcan 1
    Sebnem Özyer 2
    Turgut Var 1
    Hüseyin Yesilyurt 1
    Hüseyin Dumanli 3
    Sunullah Soysal 1
    Leyla Mollamahmutoglu 4
    Sertaç Batioglu 5
    1. Department Of Obstetrics And Gynecology, Zekai Tahir Burak Women’S Health Education And Research Hospital, Ankara, Turkey
    2. Zekai Tahir Burak Women’S Health Education And Research Hospital, Ivf Unit, Ankara, Turkey
    3. Department Of Radiology, Zekai Tahir Burak Women’S Health Education And Research Hospital, Ankara, Turkey
    4. Zekai Tahir Burak Women’S Health Education And Research Hospital, Cebeci, Ankara, Turkey
    5. Baskent Üniversitesi Tip Faku¨Ltesi, Kadin Hastaliklari Ve Dogum Anabilim Dali
    No information available.
    No information available
    Received Date: 20.11.2010
    Accepted Date: 17.12.2010
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    ABSTRACT

    Objective:

    To evaluate our experience with adnexal torsion (AT) in 36 patients and the outcomes of the patients who were managed conservatively via laparoscopy.

    Material and Methods:

    A prospective study was conducted on 36 patients who underwent operations for AT via laparoscopy between January 2008 and December 2009. Data including age, previous history, time of onset of symptoms, time of admission to hospital, gray-scale and color Doppler US findings, time interval between hospital admission and surgery, type of intervention, operative findings and postoperative gray-scale and Doppler US findings were recorded.

    Results:

    In 29 (80.5%) patients, a preoperative diagnosis of AT was confirmed clinically. The mean age of the patients was 26.5, with a range of 11 to 44. Ovarian blood flow was assessed by color Doppler US ultrasonography in 30 patients preoperatively. In 11 (36.6%) patients, this was found to be normal. In 19 (63.3%) patients, ovarian blood flow was found to be pathological or absent. Laparoscopic conservative treatment was performed in 34 patients. In two patients, salpingo-oophorectomy was performed. No thromboembolic complications were seen. Postoperative ultrasonographic examinations confirmed normal ovarian morphology and Doppler blood flow in all patients with no recurrence.

    Conclusion:

    Early diagnosis and treatment are key factors in managing AT. According to the results of the present study, given its demonstrated safety and benefits, in women of reproductive age, a conservative approach of untwisting the adnexa and salvaging the ovary via laparoscopy should be considered in AT cases in which the time from the onset of symptoms to surgery does not exceed 44 hours, regardless of the color and number of twists.

    Keywords: Adnexal torsion, laparoscopy, detorsion, conservative management, ultrasonography

    References

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