The Study Of Conservative Surgical Treatment Of Adnexal Torsion

Objective:To investigate the value of conservative ovarian surgery in adnexal torsion and provide clinical basis for young female patients to retain ovarian fertility and physiological function.Methods:A retrospective analysis was performed on 82 patients with adnexal torsion treated from January 2012 to December 2019 in our hospital.They were divided into two groups according to the surgical method.The patients underwent the detorsion with or without cystectomy were the experimental group(40 cases).The patients underwent direct appendectomy were the control group(42 cases).And then follow-up for half-year.The surgical status,length of hospital stays,postoperative pain,infection,anti-Muller hormone(AMH),follicular estrogen(FSH),the affected ovarian size,ovarian blood flow,antralfolliclecount(AFC),postoperative thrombotic events,postoperative pregnancy were counted.And the above data was statistically analyzed with SPSS 20.0 software.Results:(1)Basic operation situation and complications:The average operation time of the experimental group was 53.20±15.88 minutes,and that was 31.52±11.39 minutes in the control group.The operation time of the experimental group was longer than that of the control group,and there was a statistical difference in comparison.The average intraoperative bleeding volume and hospital stay in the experimental group was 32.93± 14.66 ml and 3.68 ± 1.62 days.In the control group,the average intraoperative bleeding volume and hospital stay was 29.79±10.98 ml and 3.50±2.64 days.There was no statistical difference between the two groups of these two data.The postoperative infection rate,secondary operation rate,and postoperative thrombosis rate in both groups were 0.(2)The recovery of ovarian function:After 3 months of operation,the recovery of ovarian blood supply was confirmed by transvaginal color doppler ultrasound examination in 35 patients from the experimental group,and some patients showed dominant follicles.Among them,5 patients did not detect the affected ovarian tissue after ultrasound examination,and no obvious ovarian blood supply was seen.Three months after surgery,the AFC was monitored by ultrasound.The experimental group was 7.05 + 2.88 and the control group was 4.31 + 2.05.The difference between the two groups was statistically significant.FSH and AMH in two groups were monitored after 3 months of operation.FSH was 6.36±1.27 m IU/ml in the experimental group and 7.064 ± 2.96 m IU/ml in the control group,the difference between the two groups was not statistically significant.AMH was 3.72±3.13ug/L in the experimental group,that was significantly higher than 1.744 ± 1.18ug/L in the control group,the difference was statistically significant.Conclusion:For patients with adnexal torsion,the conservative surgery group had no statistically significant differences in surgical bleeding volume,postoperative infection,postoperative pain,thrombosis,and secondary operation rate with the accessory resection group.The surgical time was longer than that of the accessory resection group.The recovery of ovarian function and postoperative pregnancy were better than those of the accessory resection group.Therefore,in the treatment of adnexal torsion for young women,conservative ovarian surgery are worthy of clinical application and promotion.