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26.11.2020 | Original Article

Variations in the management of adolescent adnexal torsion at a single institution and the creation of a unified care pathway

verfasst von: Emily C. Alberto, Jun Tashiro, Yinan Zheng, Anthony Sandler, Timothy Kane, Veronica Gomez-Lobo, Mikael Petrosyan

Erschienen in: Pediatric Surgery International | Ausgabe 1/2021

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Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

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Titel: Variations in the management of adolescent adnexal torsion at a single institution and the creation of a unified care pathway
verfasst von: Emily C. Alberto
Jun Tashiro
Yinan Zheng
Anthony Sandler
Timothy Kane
Veronica Gomez-Lobo
Mikael Petrosyan
Publikationsdatum: 26.11.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 1/2021
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-020-04782-1

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Variations in the management of adolescent adnexal torsion at a single institution and the creation of a unified care pathway