Management of Ovarian Tumors and Adnexal Torsion in Children; How to Save?

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Abstract

Background/Aims: Although rare, torsion and malignancy of the uterine adnexa, are a common concern of differential diagnosis while dealing with abdominal pain in girls

Methods:Forty-seven patients  who were operated for adnexal torsion or ovarian tumor between March 2004 and December 2010 are enrolled in the study. 

Results:Twenty one patients had torsion of the uterine adnexa, 18 had ovarian tumors and 8 had an ovarian tumor with torsion. The rate of radical surgery was 47% in torsion which was elevated to 72% in tumor and 100% in tumors with torsion. In ovarian torsion, the rate of radical surgery and adnexal sparing were not different between early versus late presenting cases. 

Conclusions: Despite encouraging data in the literature favor ovarian sparing, radical surgery still seems to remain high in girls with adnexal torsion and tumors. Ovarian sparing seems possible in tumors but further studies are needed to determine the best management strategy. 

Anahtar Kelimeler

• ovary,tumor,torsion,child

Çocuklarda Over Tümörlerinin Ve Adneks Torsiyonlarının Sağaltımı; Nasıl Kurtarabiliriz?

Öz

Öz

Amaç:Nadir görülmekle birlikte, uterin adnekslerin malignite ve torsiyonları, karın ağrısı ile başvuran kız çocuklarının değerlendirilmesinde önemli bir sorun oluşturmaktadır

Gereç ve Yöntem: Kliniğimizde, Mart 2004 ile Aralık 2010 tarihleri arasında adneks torsiyonu veya tümörü tanısı almış 47 hasta çalışmaya dahil edildi.

Bulgular:Yirmi bir hasta uterin adnekslerin torsiyonu, 18 hasta over tümörü ve 8 hastanın ise tümör ile birlikte torsiyon nedeniyle ameliyat edilmişti. Radikal cerrahi oranı torsiyonlarda %47, tümörlerde %72 iken, hem torsiyon hemde tümör varlığında %100’e ulaşmaktaydı. Over torsiyonlarında radikal cerrahi ve over kurtarılma oranları açısından, erken ve geç başvuran vakalar arasında fark yoktu.

Tartışma:Overlerin korunabileceğini destekleyen verilerin giderek artmasına rağmen, kız çocuklarında adneks torsiyonu ve tümörlerinin tedavisinde radikal cerrahi oranları halen yüksek gözükmektedir. Over tümörlerinde koruyucu cerrahi mümkün gözükmekle beraber en uygun yolunu bulmak için daha ileri çalışmalara ihtiyaç vardır. 

Anahtar Kelimeler

• over,tümör,torsiyon,çocuk

Kaynakça

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