Adnexal torsion is defined by the existence of a partial or complete torsion of the ovary and a tubal portion around its vascular pedicle. It is a rare gynecological emergency. We report the case of adnexal torsion on...Adnexal torsion is defined by the existence of a partial or complete torsion of the ovary and a tubal portion around its vascular pedicle. It is a rare gynecological emergency. We report the case of adnexal torsion on a large postpartum ovarian cyst in a 40-year-old patient. The diagnosis was suspected based on clinical and ultrasound signs and confirmed by exploratory laparotomy. The appearance of the cyst was suggestive of a mucinous cystadenoma of the ovary. The treatment was radical by performing an adnexectomy. The surgical piece weighed 5.2 kg. The postoperative course was simple. Anatomopathological examination had not been carried out;the parents had buried the operating piece.展开更多
Objectives:To evaluate the safety and efficacy of conservative laparoscopic surgery for adnexal torsion and the feasibility of secondary operation.Methods:This is a retrospective study that consists of 17 patients wit...Objectives:To evaluate the safety and efficacy of conservative laparoscopic surgery for adnexal torsion and the feasibility of secondary operation.Methods:This is a retrospective study that consists of 17 patients with clinically diagnosed adnexal torsion who have a desire for pregnancy in the future.We performed conservative laparoscopic adnexal detorsion operations from January 2014 to June 2016 in Sir Run Run Shaw Hospital.The collected data,including age,onset time,maximum diameter of adnexal lesion,local blood flow signal,torsion degree,and recovery of local blood supply after detorsions,were analyzed.The blood flow of the lesion side,the antral follicles development,the basal endocrine hormone levels and the menstrual cycle were examined one-month and three-month post operation.Future fertility was investigated postoperatively.Results:All cases had no obvious clinical postoperative complications.There were no significant changes on menstrual cycle and ovarian function during the follow-up period.Conclusions:Adnexal torsion in young patients should be carefully treated and fertility reservation should be thoroughly considered.The decision to remove adnexa needs careful consideration.Conservative laparoscopic surgery is safe and does not increase the occurrence of serious complications.There is a higher possibility of a long delay between surgery and onset necrosis,but this is not always the case.Even if there is adnex thromboembolic infarction it does not result in serious complications such as pulmonary infarction.Conservative laparoscopic surgery can be performed first unless the clinician is certain it is already necrotic.We should do our best to reserve patients’fertility as much as possible.If necessary,a secondary surgery can be performed.展开更多
文摘Adnexal torsion is defined by the existence of a partial or complete torsion of the ovary and a tubal portion around its vascular pedicle. It is a rare gynecological emergency. We report the case of adnexal torsion on a large postpartum ovarian cyst in a 40-year-old patient. The diagnosis was suspected based on clinical and ultrasound signs and confirmed by exploratory laparotomy. The appearance of the cyst was suggestive of a mucinous cystadenoma of the ovary. The treatment was radical by performing an adnexectomy. The surgical piece weighed 5.2 kg. The postoperative course was simple. Anatomopathological examination had not been carried out;the parents had buried the operating piece.
基金All the co-authors have made great contributions to this article.The author appreciates the support from Lingxiu Huang for assisting with data collection and Guanghui Song for technical support.This work was supported by the following foundation:Project of Soft Science Research Project of Primary Health Care in Zhejiang Province(2015jc11)Project of Hangzhou Health Planning Scientific Research Program(2015A55).
文摘Objectives:To evaluate the safety and efficacy of conservative laparoscopic surgery for adnexal torsion and the feasibility of secondary operation.Methods:This is a retrospective study that consists of 17 patients with clinically diagnosed adnexal torsion who have a desire for pregnancy in the future.We performed conservative laparoscopic adnexal detorsion operations from January 2014 to June 2016 in Sir Run Run Shaw Hospital.The collected data,including age,onset time,maximum diameter of adnexal lesion,local blood flow signal,torsion degree,and recovery of local blood supply after detorsions,were analyzed.The blood flow of the lesion side,the antral follicles development,the basal endocrine hormone levels and the menstrual cycle were examined one-month and three-month post operation.Future fertility was investigated postoperatively.Results:All cases had no obvious clinical postoperative complications.There were no significant changes on menstrual cycle and ovarian function during the follow-up period.Conclusions:Adnexal torsion in young patients should be carefully treated and fertility reservation should be thoroughly considered.The decision to remove adnexa needs careful consideration.Conservative laparoscopic surgery is safe and does not increase the occurrence of serious complications.There is a higher possibility of a long delay between surgery and onset necrosis,but this is not always the case.Even if there is adnex thromboembolic infarction it does not result in serious complications such as pulmonary infarction.Conservative laparoscopic surgery can be performed first unless the clinician is certain it is already necrotic.We should do our best to reserve patients’fertility as much as possible.If necessary,a secondary surgery can be performed.
