De-torsion without oophoropexy for torsion of normal ovary in children: a report of 10 cases

Study objective Torsion of normal ovary is rare in children. There is no consensus on the optimal method. A preliminary study of the clinical features of normal ovarian torsion and the efficacy and feasibility of de-torsion without oophoropexy in children. Design Retrospective analysis of the clinical data of 10 girls with normal ovarian torsion treated in the Department of General Surgery,Hebei Provincial Children's Hospital from May 2018 to December 2023.According to whether the ovaries have atrophied and disappeared during follow-up,they were categorized into atrophy group(4 cases) and non-atrophy group(5 cases).The age,affected side, nausea and vomiting,fever,onset-operation time,degree of torsion,color of ovary,preoperative and postoperative neutrophil(NE),C-reaction protein(CRP) and white blood cell(WBC) were compared between the two groups.The surgical procedure was laparoscopic de-torsion without oophoropexy.Hematoma removal in 5 cases of severely congested ovaries.Follow up the children for recurrent torsion and recovery of ovarian function. Participants Childrenwith a diagnosis of normal ovarian torsion intraoperatively confirmed and surgically treated in our department. Results There was statistical differences in onset-operation time, color of ovary,preoperative CRP and nausea and vomiting(P<0.05).No statistical difference was found in age,affected side,fever,torsion degree, preoperative WBC and NE,postoperative WBC,NE and CRP(P>0.05). No recurrent torsion after laparoscopic de-torsion without oophoropexy.Normal ovarian morphology and functional recovery in the non-atrophy group. Conclusions High incidence of atrophy after de-torsion of normal ovarian torsion in children.There was no recurrent torsion without oophoropexy.Children with longer onset, darker ovaries and higher preoperative CRP are more likely to develop ovarian atrophy postoperatively, but those with nausea and vomiting are less likely to develop ovarian atrophy.