The tactics of managing children and adolescents when twisting the uterine appendages from the position of international standards

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Abstract


Background. Adnexal torsion (AT) takes fifth place among all emergency gynecological conditions. Suspicion of AT requires immediate diagnosis and urgent surgical treatment. The most common causes of AT are various volumetric formations, such as functional or dermoid ovarian cysts, contributing to an increase in its volume and/or anomalies in the development of the ligamentous apparatus. Timely diagnosis and detorsion contributes to the full restoration of impaired venous outflow and lymphatic drainage of the ovarian tissue, preventing the development of severe ischemia and necrosis. Over the past few decades, a surgical organ-preserving approach in managing patients with AT has been the “gold standard” of care.

Materials and methods. The article describes the results of a retrospective study of cases of AT in children and adolescents treated at the Department of Pediatric and adolescent gynecology Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology with an assessment of the clinical and anamnestic features of this cohort of patients and the choice of therapeutic tactics.

Conclusion. A multidisciplinary approach is critical to optimizing the delivery of care in cases of AT, including minimally invasive detorsion and preserving the functionality of the ovary as a treatment standard that should be used in the management of children and adolescents.


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About the authors

Zalina K. Batyrova

Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Author for correspondence.
Email: linadoctor@mail.ru
ORCID iD: 0000-0003-4997-6090

Russian Federation, Moscow

канд. мед. наук, ст. науч. сотр. 2-го гинекологического отд-ния (гинекологии детского и юношеского возраста)

Zaira K. Kumykova

Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: zai-kumykova@yandex.ru
ORCID iD: 0000-0001-7511-1432

Russian Federation, Moscow

канд. мед. наук, ст. науч. сотр. 2-го гинекологического отд-ния (гинекологии детского и юношеского возраста)

Elena V. Uvarova

Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: elena-uvarova@yandex.ru
ORCID iD: 0000-0002-3105-5640

Russian Federation, Moscow

чл.-кор. РАН, д-р мед. наук, проф., зав. 2-м гинекологическим отд-нием (гинекологии детского и юношеского возраста)

Vladimir D. Chuprynin

Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: v_chuprynin@oparina4.ru

Russian Federation, Moscow

канд. мед. наук, зав. хирургическим отд-нием

Natalya A. Buralkina

Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: n_buralkina@oparina4.ru
ORCID iD: 0000-0001-5109-6725

Russian Federation, Moscow

д-р мед. наук, зав. приемным отд-нием, ст. науч. сотр. хирургического отд-ния

Irina A. Kiseleva

Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: i_kiseleva@oparina4.ru

Russian Federation, Moscow

канд. мед. наук, зав. по клинической работе 2-го гинекологического отд-ния

Fatima Sh. Mamedova

Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: fmamedova@yandex.ru

Russian Federation, Moscow

канд. мед. наук, врач ультразвуковой диагностики отд. ультразвуковой диагностики в неонатологии и педиатрии

Madina A. Chundokova

Pirogov Russian National Research Medical University; Filatov Children’s City Clinical Hospital №13

Email: cmadina@yandex.ru

Russian Federation, Moscow

D. Sci. (Med.), Prof.

References

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  2. Ripatti L, Taskinen M, Koivusalo A, Taskinen S. Surgically treated ovarian lesions in preadolescent girls. Acta Obstet Gynecol Scand 2019. doi: 10.1111/aogs.13717
  3. Geimanaite L, Trainavicius K. Pediatric ovarian torsion: Follow- up after preservation of ovarian tissue. J Pediatr Surg 2019; 54 (7): 1453–6. doi: 10.1016/j.jpedsurg.2019.02.004
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