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Ovarian Salvage With Prompt Surgical Intervention for Adnexal Torsion: Does Timing Matter?
Azalia Avila1, Monique Motta1, David Schechter1
1Memorial Healthcare System, Division of Pediatric General Surgery, Joe DiMaggio Children's Hospital, Hollywood, FL, USA.
Background:
Adnexal torsion requires treatment to limit ischemic injury and tissue loss. Optimal time to surgical intervention has not been established. We compared outcomes of ovarian loss amongst pediatric patients.
Methods:
We conducted a retrospective review of 88 patients with adnexal torsion from March 2014 through April 2021. Rates of ovarian loss were compared for patients who underwent surgery within and beyond 60 minutes from diagnosis.
Results:
Most patients underwent surgery more than 60 minutes from the time of diagnosis (83%; median time 116 minutes). Comparing patients with and without ovarian loss, there was no statistically significant difference in time to surgery from time of diagnosis (P = .618). Patients with ovarian loss had a longer duration of symptoms (24 vs 96 hours; P = .017).
Conclusions:
While surgical repair of adnexal torsion may be urgent, this study suggests that duration of symptoms should be considered when assessing a patient's likelihood of ovarian loss.
