Conservative laparoscopic management of adnexal torsion through a 1-stage or 2-stage operation Daisuke NAKAYAMA 1 , Akira FUJISHITA 1 1Department of Gynecology, Saiseikai Nagasaki Hospital Keyword: 腹腔鏡下手術 , 卵巣腫瘍茎捻転 , 保存手術 pp.695-699
Published Date 2012/10/15
DOI https://doi.org/10.11477/mf.4426100848
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 Adnexectomy has long been the standard treatment option for adnexal torsion. However, conservative management with gentle untwisting of the pedicle and possible cystectomy is now becoming increasingly common to preserve future fertility. We report the effectiveness of conservative surgery by reviewing our experience with 20 patients. Between December 2005 and April 2011, we performed 39 laparoscopic procedures for unilateral adnexal torsion. We tried to untwist and conserve the adnexa in 20 patients who were under the age of 45. We excluded the cases where malignancy was suspected, the patient was pregnant, or the patient did not request the conservative operation. We evaluated and compared the patients' medical charts for laparoscopic findings, histological features of the mass causing adnexal torsion, and operative methods. Adnexal torsion was caused by ovarian masses in 17 patients (85%) and parovarian cysts in 3 patients (15%). Among the 20 patients, the adnexa could be conserved in 100% (3/3) of the patients with parovarian cysts and could be salvaged in 65% (11/17) of the patients with ovarian masses through 1-stage or 2-stage conservative surgery. In conclusion, conservative laparoscopic management of adnexal torsion was effective in all patients caused by parovarian cysts, and in more than 60% of the patients with ovarian masses. We did not observe any adverse effect such as pulmonary embolism from the management.

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