title: Does gradual detorsion protect the ovary against ischemia-reperfusion injury in rats?
abstract: OBJECTIVE
  Adnexal torsion is an infrequent and serious gynecologic surgical emergency. Adnexal torsion may result from pre-existing tubal or ovarian pathology or hyperstimulation of the ovary during ovulation. Early diagnosis and emergency surgical treatment (detorsion) are important to preserve fertility and to prevent peritonitis or loss of the adnexa. However, during reperfusion, tissue damage is more severe than during ischemia because of oxygen-derived radicals. The present study aimed to investigate the protective effect of gradual detorsion on adnexal torsion.
  
  
  METHODS
  Twenty-one adult female rats were divided into three groups as sham-operated (Sh group, n = 7); torsion + detorsion (TD group, n = 7); and torsion + gradual detorsion (TGD group, n = 7). A midline laparotomy was performed under anesthesia. In the TD and TGD groups, the left adnexa along with tubal and ovarian vessels were twisted three times in a clockwise direction and fixed to the abdominal wall. After 30 h, detorsion was performed on the mesenteries of both TD and TGD groups. In the TGD group, however, detorsion was performed gradually: the ovarian mesentery was detorsioned 360°, followed by a 5-min pause, then a repeat of the cycle until full detorsion was achieved. Rats were killed 1 week later. Left ovaries were removed and evaluated histopathologically.
  
  
  RESULTS
  The histopathological mean grade was significantly higher in the TD than in the TGD group (p < 0.05).
  
  
  CONCLUSIONS
  Gradual detorsion can reduce reperfusion injury in a rat model of ovarian torsion. This method is easily applicable and may be a useful method for human patients with ovarian torsion.
authors: Department of Pediatric Surgery, Adnan Menderes University Faculty of Medicine, Aydin, Turkey, sozkisacik@adu.edu.tr.
authors: Sezen
authors: S
authors: Ozkisacik
authors: Mesut
authors: M
authors: Yazici
authors: Harun
authors: H
authors: Gursoy
authors: Nil
authors: N
authors: Culhaci
mesh_terms: D000291:Adnexal Diseases / Q000150:complications / Q000628:therapy*; D000818:Animals; D005260:Female; D010053:Ovary / Q000098:blood supply*; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000209:etiology / Q000517:prevention & control*; D014102:Torsion Abnormality / Q000150:complications / Q000628:therapy*