Piergiorgio Gamba, Waifro Rigamonti, Nicola Zampieri, Maria Luisa Conighi, Claudio Vella, Alessandra Farina, Alessandro Inserra, Mirko Bertozzi, Antonino Appignani, A. Trucchi, Vittorio Bini, Giovanna Riccipetitoni, Caterina Gulia, Francesco Saverio Camoglio, Sonia Battaglia, Vito Briganti, Salvatore Fabio Chiarenza, Ciro Esposito, Elisa Magrini, Michele Ubertazzi, Daniela Codrich, Bertozzi, Mirko, Esposito, Ciro, Vella, Claudio, Briganti, Vito, Zampieri, Nicola, Codrich, Daniela, Ubertazzi, Michele, Trucchi, Alessandro, Magrini, Elisa, Battaglia, Sonia, Bini, Vittorio, Conighi, Maria Luisa, Gulia, Caterina, Farina, Alessandra, Camoglio, Francesco Saverio, Rigamonti, Waifro, Gamba, Piergiorgio, Riccipetitoni, Giovanna, Chiarenza, Salvatore Fabio, Inserra, Alessandro, and Appignani, Antonino
Study Objective To report results of a retrospective multicentric Italian survey concerning the management of pediatric ovarian torsion (OT) and its recurrence. Design Multicenter retrospective cohort study. Setting Italian Units of Pediatric Surgery. Participants Participants were female aged 1-14 years of age with surgically diagnosed OT between 2004 and 2014. Interventions Adnexal detorsion, adnexectomy, mass excision using laparoscopy or laparotomy. Different kinds of oophoropexy (OPY) for OT or recurrence, respectively. Main Outcome Measures A total of 124 questionnaires were returned and analyzed to understand the current management of pediatric OT and its recurrence. The questionnaires concerned patient age, presence of menarche, OT site, presence and type of mass, performed procedure, OPY technique adopted, intra- and postoperative complications, recurrence and site, procedure performed for recurrence, OPY technique for recurrence, and 1 year follow-up of detorsed ovaries. Results Mean age at surgery was 9.79 ± 3.54 years. Performed procedures were open adnexectomy (52 of 125; 41.6%), laparoscopic adnexectomy (25 of 125; 20%), open detorsion (10 of 125; 8%), and laparoscopic detorsion (38 of 125; 30.4%). Recurrence occurred in 15 of 125 cases (12%) and resulted as significant ( P = .012) if associated with a normal ovary at the first episode of torsion. Recurrence occurred only in 1 of 19 cases after OPY (5.2%). Ultrasonographic results of detorsed ovaries were not significant whether an OPY was performed or not ( P = 1.00). Conclusion Unfortunately, oophorectomy and open technique are still widely adopted even if not advised. Recurrence is not rare and the risk is greater in patients without ovarian masses. OPY does not adversely affect ultrasonographic results at 1 year. When possible OPY should be performed at the first episode of OT.