Preservation vs. Resection? Pediatric and Non-Pediatric Management Patterns in Ovarian Torsion

Area of Science:

• Pediatric Surgery
• Gynecology
• Healthcare Management

Background:

• Ovarian torsion (OT) is a critical surgical emergency in pediatric and adolescent populations.
• Limited data exists on how OT management differs between pediatric (PD) and non-pediatric (Non-PD) departments in Germany.

Purpose of the Study:

• To analyze and compare the management strategies and outcomes of ovarian torsion in children and adolescents treated in pediatric versus non-pediatric departments in Germany.
• To identify variations in surgical approaches, hospital types, and patient outcomes based on the treating department.

Main Methods:

• Retrospective cohort study utilizing anonymized claims data from German statutory health insurance funds (2010-2019).
• Analysis included 293 patients ≤18 years diagnosed with ovarian torsion (ICD-10-GM N83.5).
• Key variables assessed: demographics, department type (PD vs. Non-PD), hospital type (university/maximum care [UM] vs. non-university/maximum care [Non-UM]), surgical procedures, and outcomes.

Main Results:

• Adolescents (71%) were primarily treated in Non-PD, while younger children were more often in PD (50%).
• Non-PD and Non-UM departments more frequently utilized laparoscopy (85%) and ovary-sparing procedures (77%).
• PD and UM departments performed oophorectomies more often, with longer mean hospital stays in PD (6.7 days vs. 4.9 days).

Conclusions:

• Significant variations exist in OT management in Germany based on department and hospital type.
• Pediatric and university hospitals manage younger patients but have higher oophorectomy rates.
• Non-pediatric and non-university hospitals tend to favor laparoscopic, ovary-sparing approaches, highlighting a need for standardized protocols.