AI Summary & Key Takeaways
AI InsightPatients who had laparoscopy have a short duration of hospital stay with a high rate of detorsion.
📌 3 Key Takeaways
Abstract
Objective: To determine the surgical results of laparoscopy and laparatomy in patients with adnexal torsion. Material and Methods: Twenty-eight patients with diagnosis of adnexal torsion in a period of two years were included in this retrospective analysis. Data regarding age, gravida, parity, size of the adnexal mass, delay between the first symptoms and the surgical procedure, the outcome of the operation and the duration of hospitalization were recorded and compared between the patients who had laparoscopy and those who had laparotomy. Results: Ten of the patients were managed by laparoscopy while 18 patients had laparotomy. The most frequent presenting symptom was pelvic pain. In 58.1% of the cases pain was located at the right side. The mean age of the patients was 21.1±5.9 years at the laparoscopy group and 28.2±9.1 years at the laparotomy group (p<0.05). The mean duration of hospital stay was shorter in the laparoscopy group [1.9±1.2 versus 2.9±1.2 days respectively] (p<0.05). Median delay between the first symptoms and the surgical procedure were 6.3±2.5 hours and 11.7±4.1 hours at the laparoscopy and the laparotomy groups respectively (p<0.05). Velocity loss in Doppler ultrasonography was noted in 46.4% of the patients. Salpingo-oophorectomy was performed in 11 (39.3%) of the cases and detorsion in 16 (57.1%) of cases. Detorsion of the ovaries were successful at 9 cases with laparoscopy and 7 cases with laparotomy. There was one case of isolated fallopian tube torsion managed by laparoscopic salpingectomy. The total number of pregnant cases was four. Detorsion was successful in two of the cases (one by laparoscopy) at first and second trimester. Conclusion: When adnexal torsion is suspected, the diagnosis can only be achieved by surgery. Arrangements should be made for laparoscopy as soon as possible. Treatment is essentially based on detorsion of the adnexa; even it has a necrosed appearance. Patients who had laparoscopy have a short duration of hospital stay with a high rate of detorsion.
Özet
Amaç: Adneksial torsiyon olgularında laparoskopi ve laparatomi olgularının değerlendirilmesi Gereç ve Yöntem: İki yıl içerisinde adneksiyel torsiyon tanısı ile opere edilen hastalar retrospektif olarak değerlendirildi. Yaş, gravida, parite, adneksial kitlenin boyutu, semptomların başlamasından operasyona kadar geçen süre, uygulanan cerrahi yöntem ve hastanede kalış süreleri laparoskopi ve laparotomi uygulanan olgularda karşılaştırıldı. Bulgular: Hastalardan on tanesine laparoskopi diğer 18 hastaya laparotomi uygulandı. Pelvik ağrı en sık gözlenen semptomdu. Hastalardan %58.1’inde pelvik ağrı sağda lokalizeydi. Hastaların yaş ortalaması laparoskopi grubunda 21.1±5.9 laparatomi grubunda 28.2±9.1 yıl olarak tespit edildi (p<0.05). Hastanede kalış süresi laparoskopi grubunda daha kısaydı (laparoskopi grubunda 1.9±1.2 gün, laparatomi grubunda 2.9±1.2gün), (p<0.05). Semptomların başlangıcından operasyona kadar geçen süre laparoskopi grubunda 6.3±2.5 saat, laparatomi grubunda ise11.7±4.1 saat olarak gözlendi (p<0.05). Dopplerde akım kaybı hastaların %46.4’ünde tespit edilebildi. Onbir hastaya salpingo-ooforektomi (%39.3), 16 (%57.1) hastaya ise detorsiyon uygulandı. Detorsiyon işlemi laparoskopi grubunda 9, laparatomi grubunda ise 7 hastada başarılı oldu. Bir olguda saptanan izole tuba torsiyonuna salpenjektomi yapıldı. Dört olguda gebelik mevcuttu. Detorsiyon bu hastalardan birinci ve ikinci trimester gebelikleri olmak üzere iki tanesinde (bir olguda laparoskopi ile) uygulanabildi. Sonuç: Adneksiyel torsiyondan şüphelenildiğinde kesin tanı ancak cerrahi olarak konulabilir. Laparoskopi için hazırlıklar hızla yapılmalıdır. Tedavi adneksin nekroze görünümde bile olsa detorsiye edilmesi üzerine dayanmalıdır. Laparoskopi uygulanan hastalarda hastanede kalış süresi daha kısa olup detorsiyon oranı yüksektir.