Testis Torsiyonlu Olgularda 4.5 Yıllık Deneyimlerimiz
ÖZET:
Giriş: Testisin vasküler pedikülü etrafında dönmesi sonucu meydana
gelen testis torsiyonu, akut skrotumun sonuçları açısından en önemli
nedenlerinden biridir. Bu çalışmada kliniğimizde opere edilen testis torsiyonu
olgularının özellikleri ve sonuçları literatür eşliğinde tartışıldı.
Materyal ve Metod: Ocak 2006 Temmuz 2010 tarihleri arasında testis
torsiyonu nedeni ile kliniğimizde opere edilen olgular yaş, yakınma, öykü,
taraf, muayene bulguları, tanı yöntemleri, ameliyat bulguları ve ameliyat
sonrası takipleri açısından değerlendirildi.
Bulgular: Dört buçuk yılda kliniğimizde opere edilen testis
torsiyonlu 24 olgudan birinde bilateral torsiyon olması nedeniyle toplam 25
testis opere edilmişti. Çocukların 3’ünde şüpheli travma öyküsü mevcut olup, fizik
muayenelerinde şişlik, ağrı, kızarıklık gibi nonspesifik bulgular vardı.
Olguların 9’u yenidoğan (%37.5), 3’ü adolesan (%12.5), diğer 12 olgu 1 ay-10
yaş aralığında idi (%50). 25 testiste torsiyonların 16’sı sol (%64), 9’u sağda
(%36) idi. Olgularımızın yaşları bir saatlik yenidoğan ile 16 yaş arasında
değişmekte idi. 14 tetiste (%56) orşiektomi; 10 olgudaki 11 testiste (%44)
orşiopeksi uygulandı.
9 yenidoğandan 7’si doğumundan
itibaren birici gün içinde opere edildi. Yenidoğan torsiyonlarının hepsi
ekstravajinal idi. Torsiyonlar 360-720 derece arasında değişmekte idi; çoğunda 540
dereceden fazlaydı. Sadece iki yenidoğanda orşiopeksi yapıldı; diğerlerinde
orşiektomi gerekti. Orşidektomi materyallerinin histopatolojik incelemelerinde
tüm testislerde hemorajik infarktüs saptandı. İki
yenidoğanda yapılan üç orşiopeksi den ikisi geç dönemde atrofiye gitti. Sonuçta
torsiyone olmuş 25 testisten 9’unda testis viabilitesi korunmuş oldu.
Sonuç: Testis torsiyonu, gelişen teknolojiye rağmen gerek tanı,
gerek operasyon endikasyonu açısından halen aileler ve çocuk cerrahları için
stres kaynağı olmaya devam etmektedir.
Anahtar Kelimeler: Testis, Torsiyon, Çocuk, Yenidoğan, Orşiektomi.
4.5 Years’ Experiences In Cases With Testicular Torsion
ABSTRACT:
Introduction and Aim: Testicular torsion occurring as
a result of the rotation of the
vasculer pedicle is the most important cause of acute scrotum results
in terms of. In this study, cases with testicular torsion who had operated at our department and it’s
outcomes were discussed.
Material and Method: Clinical records of all cases with testicular
torsion who had operated at our department between January 2006 and July 2010 were
evaluated as retrospectively in regard to age, history, side, symptoms, examination
findings, surgical indications, operatively findings, histopathological results
and outcome.
Results: 25 testes torsion in 24 cases were operated at our
department during 4.5 years period. Ages of patients ranged an 1 hour’s newborn
to a 16 years old boy. 9 of patients (37.5%) were newborn; and 3 were adolescent
(12.5%); the other 12 patients remained between 0ne and 11 years old (50%) one
of these newborns had bilateral testes torsion. 14 testes underwent orchiectomy
(44%) and 11 testes of 10 patients underwent orchidopexy (56%). 16 of testes
torsion were on left side (64%), and 9 were on right side (36%). One patient
aged 7 years old had torsion of appendix testes on left side. Torsion degree
was changed between 360-720 degree; and bigger than 540 degree in most patients.
All newborn torsions were extravaginal. Orchidopexy was created in elder boys;
three of them had a suspicious of trauma, and findings of the phisical examination
were unspesific for the torsion. In histopathologıc examinations of all
orchidectomic testes were determined hemoragic infarctus. Two of the three testis with orchiopexy
in two neonates went to atrophy in the late period. Overall, testicular viability
of 9 testes in 25 testes was preserved.
Conclusion: Despite emerging technologies, testicular torsion
is still continues to be a source of stress for families and pediatric surgeons both in terms of operation indication
and recognize.
Key Words: Testes, Torsion, Child, Newborn, Orchidectomy..
Introduction and Aim: Testicular torsion occurring as
a result of the rotation of the
vasculer pedicle is the most important cause of acute scrotum results
in terms of. In this study, cases with testicular torsion who had operated at our department and it’s
outcomes were discussed.
Material and Method: Clinical records of all cases with testicular
torsion who had operated at our department between January 2006 and July 2010 were
evaluated as retrospectively in regard to age, history, side, symptoms, examination
findings, surgical indications, operatively findings, histopathological results
and outcome.
Results: 25 testes torsion in 24 cases were operated at our
department during 4.5 years period. Ages of patients ranged an 1 hour’s newborn
to a 16 years old boy. 9 of patients (37.5%) were newborn; and 3 were adolescent
(12.5%); the other 12 patients remained between 0ne and 11 years old (50%) one
of these newborns had bilateral testes torsion. 14 testes underwent orchiectomy
(44%) and 11 testes of 10 patients underwent orchidopexy (56%). 16 of testes
torsion were on left side (64%), and 9 were on right side (36%). One patient
aged 7 years old had torsion of appendix testes on left side. Torsion degree
was changed between 360-720 degree; and bigger than 540 degree in most patients.
All newborn torsions were extravaginal. Orchidopexy was created in elder boys;
three of them had a suspicious of trauma, and findings of the phisical examination
were unspesific for the torsion. In histopathologıc examinations of all
orchidectomic testes were determined hemoragic infarctus. Two of the three testis with orchiopexy
in two neonates went to atrophy in the late period. Overall, testicular viability
of 9 testes in 25 testes was preserved.
Conclusion: Despite emerging technologies, testicular torsion
is still continues to be a source of stress for families and pediatric surgeons both in terms of operation indication
and recognize
Subjects | Health Care Administration |
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Journal Section | Original Research |
Authors | |
Publication Date | September 8, 2017 |
Published in Issue | Year 2017 |