Variations in the management of adolescent adnexal torsion at a single institution and the creation of a unified care pathway.
Adnexal disease
Adolescent
General surgery
Gynecology
Ovarian torsion
Journal
Pediatric surgery international
ISSN: 1437-9813
Titre abrégé: Pediatr Surg Int
Pays: Germany
ID NLM: 8609169
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
accepted:
09
11
2020
pubmed:
27
11
2020
medline:
22
6
2021
entrez:
26
11
2020
Statut:
ppublish
Résumé
Adnexal torsion is a gynecologic emergency, requiring intervention for tissue preservation. At our institution, torsion is managed by pediatric surgeons or gynecologists. We evaluated differences between specialties to streamline evaluation for children with gynecological emergencies, develop a clinical pathway, and prevent care delays. A retrospective review of adolescents undergoing intervention for adnexal torsion from 2004-2018 was performed. Differences in time to intervention, operation duration, the procedure performed, and length of stay (LOS) between the specialties were analyzed. Eighty-six patients underwent 94 operations for presumed adnexal torsion with 87 positive cases. Pediatric surgeons performed 60 operations and 34 cases were performed by gynecologists. Preservation of fertility was the goal in both cohorts and the rate of oophoropexy, cystectomy, and oophorectomy were similar between the cohorts (p = 0.14, p = 1.0, p = 0.39, respectively). There was no difference in intra-operative time (p = 0.69). LOS was shorter in the gynecology cohort (median 1 day [1-2] vs. 2 days [2-3], p > 0.001). Adnexal torsion is a time-sensitive diagnosis requiring prompt intervention for ovarian or fallopian tube preservation. A multidisciplinary institutional care pathway should be developed and implemented.
Identifiants
pubmed: 33242170
doi: 10.1007/s00383-020-04782-1
pii: 10.1007/s00383-020-04782-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
129-135Subventions
Organisme : NIH HHS
ID : Z1A HD008985
Pays : United States
Organisme : NIH HHS
ID : Z1A HD008985
Pays : United States
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