Conservative surgery for ovarian torsion in young women: perioperative complications and national trends.
Adnexal Diseases
/ epidemiology
Adolescent
Adult
Conservative Treatment
/ statistics & numerical data
Female
Fertility Preservation
Humans
Intraoperative Complications
/ epidemiology
Middle Aged
Ovariectomy
/ statistics & numerical data
Practice Patterns, Physicians'
/ trends
Propensity Score
Retrospective Studies
Torsion Abnormality
/ epidemiology
Treatment Outcome
United States
/ epidemiology
Young Adult
Conservative surgery
fertility preservation
ovarian conservation
ovarian torsion
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
accepted:
13
02
2020
pubmed:
23
2
2020
medline:
1
7
2020
entrez:
23
2
2020
Statut:
ppublish
Résumé
To analyse populational trends and perioperative complications following conservative surgery versus oophorectomy in women <50 years of age with ovarian torsion. Population-based retrospective observational study. Nationwide Inpatient Sample in the USA (2001-2015). In all, 89 177 ovarian torsions including 20 597 (23.1%) conservative surgeries and 68 580 (76.9%) oophorectomies. (1) Trend analysis to assess utilisation of conservative surgery over time, (2) multivariable binary logistic regression to identify independent factors associated with conservative surgery and (3) inverse probability of treatment weighting with a generalised estimating equation to analyze perioperative complications. Trends, characteristics and complications related to conservative surgery. Performance of conservative surgery increased from 18.9 to 25.1% between 2001 and 2015 (32.8% relative increase, P = 0.001) but decreased steadily after age 15, and sharply declined after age 35 (P < 0.001). On multivariable analysis, younger age exhibited the largest effect size for conservative surgery among the independent factors (adjusted odds ratios 3.39-7.96, P < 0.001). In the weighted model, conservative surgery was associated with an approximately 30% decreased risk of perioperative complications overall (10.0% versus 13.6%, odds ratio 0.73, 95% confidence interval 0.62-0.85, P < 0.001) and was not associated with venous thromboembolism (0.2 versus 0.3%, P = 0.457) or sepsis (0.4 versus 0.3%, P = 0.638). There has been an increasing utilisation of conservative surgery for ovarian torsion in the USA in recent years. Our study suggests that conservative surgery for ovarian torsion may not be associated with increased perioperative complications. Conservative surgery for ovarian torsion may not be associated with increased perioperative complications.
Identifiants
pubmed: 32086987
doi: 10.1111/1471-0528.16179
pmc: PMC7772940
mid: NIHMS1653854
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
957-965Subventions
Organisme : NCI NIH HHS
ID : P30 CA014089
Pays : United States
Organisme : Ensign Endowment for Gynecologic Cancer Research
Informations de copyright
© 2020 Royal College of Obstetricians and Gynaecologists.
Références
J Pediatr Surg. 2004 May;39(5):750-3
pubmed: 15137012
J Am Assoc Gynecol Laparosc. 1999 May;6(2):139-43
pubmed: 10226121
Blood Rev. 2009 Sep;23(5):225-9
pubmed: 19683659
J Pediatr Surg. 2009 Sep;44(9):1759-65
pubmed: 19735822
Obstet Gynecol Surv. 1999 Sep;54(9):601-8
pubmed: 10481857
Gynecol Oncol. 2019 May;153(2):368-375
pubmed: 30792003
Lancet. 1946 Jul 13;2(6411):47
pubmed: 20991453
Int J Surg. 2014 Dec;12(12):1495-9
pubmed: 25046131
Am Surg. 2015 Sep;81(9):844-8
pubmed: 26350658
Acta Obstet Gynecol Scand. 2015 Mar;94(3):236-44
pubmed: 25412114
Gynecol Endocrinol. 2013 Jan;29(1):54-8
pubmed: 22817767
Am J Obstet Gynecol. 1993 Jun;168(6 Pt 1):1791-5
pubmed: 8317522
Clin Obstet Gynecol. 1985 Jun;28(2):375-80
pubmed: 4017325
Eur J Obstet Gynecol Reprod Biol. 2010 May;150(1):8-12
pubmed: 20189289
J Pediatr Surg. 2018 Jul;53(7):1387-1391
pubmed: 29153467
J Natl Cancer Inst. 2010 Dec 1;102(23):1780-93
pubmed: 20944078
JSLS. 2003 Oct-Dec;7(4):295-9
pubmed: 14626393
Pediatrics. 2010 Mar;125(3):532-8
pubmed: 20123766
J Gynecol Obstet Biol Reprod (Paris). 2003 Oct;32(6):535-40
pubmed: 14593299
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
J Pediatr Adolesc Gynecol. 2008 Aug;21(4):201-6
pubmed: 18656074
J Pediatr Surg. 2005 Apr;40(4):704-8
pubmed: 15852284
Am J Obstet Gynecol. 1994 Dec;171(6):1506-10; discussion 1510-1
pubmed: 7802059
Stat Med. 2015 Dec 10;34(28):3661-79
pubmed: 26238958
J Pediatr Adolesc Gynecol. 2015 Jun;28(3):136-8
pubmed: 26046601
J Pediatr Surg. 2015 Aug;50(8):1374-7
pubmed: 26026345
Ci Ji Yi Xue Za Zhi. 2017 Jul-Sep;29(3):143-147
pubmed: 28974907
J Minim Invasive Gynecol. 2007 May-Jun;14(3):270
pubmed: 17478353
J Reprod Med. 1990 Aug;35(8):833-4
pubmed: 2213749
J Int Med Res. 2018 Apr;46(4):1685-1689
pubmed: 29486636
Hum Reprod. 1998 Oct;13(1O):2823-7
pubmed: 9804239
Gynecol Oncol. 2019 Jul;154(1):169-176
pubmed: 31130286
Obstet Gynecol. 2019 Aug;134(2):e56-e63
pubmed: 31348225
Fertil Steril. 1993 Dec;60(6):976-9
pubmed: 8243702
J Turk Ger Gynecol Assoc. 2011 Mar 01;12(1):4-8
pubmed: 24591949
Am J Obstet Gynecol. 1985 Jun 15;152(4):456-61
pubmed: 4014339
Gynecol Oncol. 2019 Jul;154(1):45-52
pubmed: 31036348
Stat Med. 2010 Sep 10;29(20):2137-48
pubmed: 20108233
Eur J Obstet Gynecol Reprod Biol. 2002 Feb 10;101(1):83-6
pubmed: 11803106
Obstet Gynecol. 1954 May;3(5):523-6
pubmed: 13154798
J Pediatr Surg. 2014 Mar;49(3):465-8
pubmed: 24650479