Contemporary Trends in Laparoscopy and Ovarian Sparing Surgery for Ovarian Torsion in the Pediatric Population | Retrospective Comparative Study | 3,161 Ovarian Torsion Patients | < 21 years old | National Database 2016-2018 | Total Oophorectomy (TO) vs. Ovarian Sparing Surgery (OSS) | Results | Open (52%) vs. laparoscopic approach (48%) | Ovarian resection performed in 87% of patients (48% TO vs. 39% OSS) | Differences in: | Overall readmissions (7% OSS vs. 8% TO) | Readmissions for recurrent torsion (<1% both) | Ovarian masses observed (both groups <1%; p=0.612) | Conclusion: Laparoscopy ovarian sparing surgery should be favored as the primary method of treatment for pediatric ovarian torsion in the majority of cases | https://doi.org/10.1016/j.jpedsurg.2023.10.042 | Source: Huerta, C. et al; | DeWitt Daughtry Family Department of Surgery Division of Pediatric Surgery, Florida, USA | @StayCurrentMD | @Kim_p_rn | Cincinnati Children's | Journal of Pediatric Surgery
Contemporary Trends in Laparoscopy and Ovarian Sparing Surgery for Ovarian Torsion in the Pediatric Population
Infographic · Apr 2024 · 1 min read
In brief
In brief
National database study of 3,161 pediatric ovarian torsion cases found ovarian sparing surgery achieved equivalent readmission rates to total oophorectomy while preserving fertility. Laparoscopy was underutilized in oophorectomy cases despite similar malignancy rates, supporting current guidelines favoring ovarian preservation.
- Ovarian sparing surgery (OSS) achieves equivalent outcomes to total oophorectomy with fertility preservation benefits in pediatric ovarian torsion
- Laparoscopy was used in only 48% of cases despite being more commonly paired with ovarian-sparing approaches (60% vs 40%)
- Recurrent torsion rates were extremely low (<1%) regardless of whether ovarian sparing or oophorectomy was performed
- Total oophorectomy was performed more often via open approach (59%) even when malignancy rates were similar between groups
- Current evidence supports OSS as preferred treatment for most pediatric ovarian torsion cases per practice guidelines
Written by the GCMD Library team from the infographic.
The infographic uses a teal header, dark background for results, and yellow footer. It includes illustrations of a pediatric patient, anatomical diagram of female reproductive system, and a research icon. Key statistics are highlighted in red and white text with bullet points and icons organizing the findings.
New Infographic by Kim Priban
Contemporary Trends in Laparoscopy and Ovarian Sparing Surgery for Ovarian Torsion in the Pediatric Population
Authors: Carlos Theodore Huerta, Cindy Rodriguez, Joshua Parreco, Chad M. Thorson, Juan E. Sola,Eduardo A. Perez
Full Article: https://doi.org/10.1016/j.jpedsurg.2023.10.042
Abstract
Purpose
Although total oophorectomy (TO) was historically performed in cases of nonviable-appearing ovaries, considerable evidence has demonstrated equivalent outcomes after ovarian sparing surgery (OSS) as well as long-term fertility preservation benefits. This study sought to compare outcomes of OSS and TO for patients with ovarian torsion.
Methods
Females <21 years old admitted for ovarian torsion were identified from the Nationwide Readmissions Database (2016–2018) and stratified by OSS or TO. Propensity score-matched analysis (PSMA) utilizing >50 covariates (demographics, medical comorbidities, ovarian diagnoses, etc.) was constructed between those receiving TO and OSS.
Results
There were 3,161 females (median 15 [12–18] years) with ovarian torsion, and concomitant pathologies included cysts (42%), benign masses (25%), and malignant masses (<1%). Open approaches were more common (52% vs. 48% laparoscopic), and ovarian resection (OSS or TO) was performed in 87% (39% OSS and 48% TO). OSS was more commonly performed with laparoscopic detorsions (60% vs. 40% TO), while TO was more frequent in open operations (59% vs. 41% TO; both p < 0.001). No differences in overall readmissions (7% OSS vs. 8% TO) or readmissions for recurrent torsion (<1% overall) and ovarian masses (<1%) were observed (both groups <1%; p = 0.612). After PSMA, laparoscopy was still utilized less frequently with TO (39% vs. 53%; p < 0.001) despite similar rates of malignant masses.
Conclusions
Overall, these data offer additional support for the current practice guidelines that give preference to OSS as the primary method of treatment for pediatric ovarian torsion in the majority of cases.
Level of Evidence
III.
Type of Study
Retrospective Comparative Study.