Taner GÜNAY, Oğuz Devrim YARDIMCI, Meryem HOCAOĞLU, Ergül DEMİRÇİVİ BÖR, Gamze ERDEM

Over Torsiyonu ve Cerrahi Tedavisi: Tersiyer bir merkezin 5 yıllık deneyimi

Amaç: Çalışmamızda son 5 yılda hastanemizde over torsiyonu tanısı ile opere ettiğimiz hastaların klinik ve laboratuvar bulguları ile uygulanan cerrahi tedavi yöntemlerinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Elektronik ortamda arşiv taraması yapılarak Ocak 2013 ile Ocak 2018 tarihleri arasında hastanemizin acil servis servisine başvuran ve over torsiyonu tanısı ile opere edilen hastaların demografik özelliklerinin yanı sıra klinik ve laboratuvar bulguları ile uygulanan cerrahi tedavi yaklaşımları kaydedildi ve bulguların analizi yapıldı. Bulgular: Kayıtlarına ulaşılan toplam 32 hastanın yaş ortalaması 27.2±10.5 olarak bulundu ve 9(%28.1) hasta virgo idi. Acil servise başvuran bütün hastalarda abdominal ve/veya pelvik ağrı mevcut olup, 15(%46.8) hastada bulantı, 7(%21.8) hastada kusma ve 2(%6.2) hastada ateş görüldü. Over torsiyonu saptanan 2 hastada gebelik mevcuttu. Olguların 19(%59.3)’unda torsiyon sağ tarafta iken 13(%40.7) olguda sol taraftaydı. Torsiyone olan kitlenin boyutu ortalama 92.5±46.3 mm olup olguların 15(%46.8)’inde ultrasonografik incelemede ovaryen akım saptanmadı. Hastaların 23(%71.9)’ünde laparoskopik yaklaşım uygulanırken 9(%28.1) hastada laparatomi tercih edildi. Sonuç: Over torsiyonu jinekolojik acil bir durum olup hastanın fizik muayene bulguları başta olmak üzere laboratuvar ve görüntüleme sonuçları ile değerlendirilerek erken müdahalesi torsiyone olmuş organların korunabilmesi ve fonksiyonlarını devam ettirebilmesi için kritik önemdedir. Cerrahi yaklaşımda da laparoskopi ön planda tercih edilmeli ve organ koruyucu yaklaşımlar tedavide ilk seçenek olmalıdır.

Anahtar Kelimeler:

over torsiyonu, laparoskopik cerrahi, ultrason

Ovarian Torsion and Surgical Treatment: Five-year’s experience of a tertiary center

Objective: In current study, we aimed to evaluate the clinical and laboratory findings and surgical methods in patients treated with a surgical approach for ovarian torsion in a period of five years in our institute.Materials and Methods: The demographic characteristics, clinical and laboratory findings of patients who admitted to emergeny unit of our hospital and underwent a surgery for a diagnosis of ovarian torsion in between January 2013 and January 2018 and surgical methods used were collected via digital patient database. The relevant data was assessed.Results: The mean age of the patient 32 patients who had eligible medical records was 27.2±10.5. Nine (28.1%) of 32 patients was virgo. All the patients had abdominal or pelvic pain. 15 (46.7%) patients had nausea, 7 (6.2%) had vomitting and 2 (6.2%) had fever. Two of patients were pregnant during diagnosis. 19 (59.35) patients had righ-sided ovarian torsion and 13(40.7) had left-sided. The mean average diameter of the torsioned ovary was 92.5±46.3 mm. Ovarian blood flow was compromised in 15 (46.8%) patients in color doppler sonographic evaluation. Laparoscopic surgery was preferred for 23 (71.9%) patients and laparotomy for 9.Conclusion: The early intervention of a torsioned ovary, a gynecologic emergency, has a critical role to secure the affected organ and to preserve its functions with the evaluation of the patient’s physical examination findings, laboratory and imaging findings. Organ-sparing surgery should be the first choice preferably with a laparoscopic approach.

Keywords:

ovarian torsion, laparoscopic surgery, ultrasound,

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