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

Year 2018, Volume: 13 Issue: 2, 33 - 42, 15.07.2018

Taner Günay , Oğuz Devrim Yardımcı Meryem Hocaoğlu , Ergül Demirçivi Bör Gamze Erdem

https://doi.org/10.17517/ksutfd.423102

Cited By: 2

Abstract

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.

Keywords

over torsiyonu, laparoskopik cerrahi, ultrason

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

Abstract

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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