title: Pediatric Ovarian Torsion and its Recurrence: A Multicenter Study.
abstract: OBJECTIVE
  To report results of a retrospective multicentric Italian survey concerning the management of pediatric ovarian torsion (OT) and its recurrence.
  
  
  METHODS
  Multicenter retrospective cohort study.
  
  
  METHODS
  Italian Units of Pediatric Surgery.
  
  
  METHODS
  Participants were female aged 1-14 years of age with surgically diagnosed OT between 2004 and 2014.
  
  
  METHODS
  Adnexal detorsion, adnexectomy, mass excision using laparoscopy or laparotomy. Different kinds of oophoropexy (OPY) for OT or recurrence, respectively.
  
  
  METHODS
  A total of 124 questionnaires were returned and analyzed to understand the current management of pediatric OT and its recurrence. The questionnaires concerned patient age, presence of menarche, OT site, presence and type of mass, performed procedure, OPY technique adopted, intra- and postoperative complications, recurrence and site, procedure performed for recurrence, OPY technique for recurrence, and 1 year follow-up of detorsed ovaries.
  
  
  RESULTS
  Mean age at surgery was 9.79 ± 3.54 years. Performed procedures were open adnexectomy (52 of 125; 41.6%), laparoscopic adnexectomy (25 of 125; 20%), open detorsion (10 of 125; 8%), and laparoscopic detorsion (38 of 125; 30.4%). Recurrence occurred in 15 of 125 cases (12%) and resulted as significant (P = .012) if associated with a normal ovary at the first episode of torsion. Recurrence occurred only in 1 of 19 cases after OPY (5.2%). Ultrasonographic results of detorsed ovaries were not significant whether an OPY was performed or not (P = 1.00).
  
  
  CONCLUSIONS
  Unfortunately, oophorectomy and open technique are still widely adopted even if not advised. Recurrence is not rare and the risk is greater in patients without ovarian masses. OPY does not adversely affect ultrasonographic results at 1 year. When possible OPY should be performed at the first episode of OT.
authors.affiliation: S.C. di Clinica Chirurgica Pediatrica, Università degli Studi di Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy. Electronic address: mirkobertozzi@hotmail.com.
authors.forename: Mirko
authors.initials: M
authors.lastname: Bertozzi
authors.affiliation: Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.
authors.forename: Ciro
authors.initials: C
authors.lastname: Esposito
authors.affiliation: S.C. di Chirurgia Pediatrica, Ospedale dei Bambini "V. Buzzi," Milano, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Vella
authors.affiliation: U.O.C. di Chirurgia e Urologia Pediatrica Azienda Ospedaliera S. Camillo Forlanini, Roma, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Briganti
authors.affiliation: Pediatric Surgical Unit, Department of Surgical Sciences, G.B. Rossi Hospital, Verona, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Zampieri
authors.affiliation: Institute for Maternal and Child Health, IRCCS "Burlo Garofolo" Via dell'Istria, Trieste, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Codrich
authors.affiliation: U.O. di Chirurgia Pediatrica, Azienda Ospedaliero, Universitaria di Sassari Viale S. Pietro, Sassari, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Ubertazzi
authors.affiliation: U.O.C. Chirurgia Generale e Toracica Ospedale Pediatrico Bambino Gesù, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Trucchi
authors.affiliation: S.C. di Clinica Chirurgica Pediatrica, Università degli Studi di Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Magrini
authors.affiliation: Pediatric Surgery, Department of Woman and Child Health, University Hospital, Padua, Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Battaglia
authors.affiliation: Department of Medicine, Section of Internal Medicine and Endocrine and Metabolic Sciences, University of Perugia, Perugia, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Bini
authors.affiliation: U.O di Chirurgia Pediatrica, Ospedale S. Bortolo, Vicenza, Italy.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Conighi
authors.affiliation: U.O.C. di Chirurgia e Urologia Pediatrica Azienda Ospedaliera S. Camillo Forlanini, Roma, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Gulia
authors.affiliation: Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Farina
authors.affiliation: Pediatric Surgical Unit, Department of Surgical Sciences, G.B. Rossi Hospital, Verona, Italy.
authors.forename: Francesco Saverio
authors.initials: FS
authors.lastname: Camoglio
authors.affiliation: Institute for Maternal and Child Health IRCCS "Burlo Garofolo," University of Trieste, Trieste, Italy.
authors.forename: Waifro
authors.initials: W
authors.lastname: Rigamonti
authors.affiliation: Pediatric Surgery, Department of Woman and Child Health, University Hospital, Padua, Italy.
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Gamba
authors.affiliation: S.C. di Chirurgia Pediatrica, Ospedale dei Bambini "V. Buzzi," Milano, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Riccipetitoni
authors.affiliation: U.O di Chirurgia Pediatrica, Ospedale S. Bortolo, Vicenza, Italy.
authors.forename: Salvatore Fabio
authors.initials: SF
authors.lastname: Chiarenza
authors.affiliation: U.O.C. Chirurgia Generale e Toracica Ospedale Pediatrico Bambino Gesù, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Inserra
authors.affiliation: S.C. di Clinica Chirurgica Pediatrica, Università degli Studi di Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Appignani
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007558:Italy; D010535:Laparoscopy / Q000379:methods / Q000706:statistics & numerical data; D007813:Laparotomy / Q000379:methods / Q000706:statistics & numerical data; D008572:Menarche; D010049:Ovarian Diseases / Q000601:surgery*; D010052:Ovariectomy / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014102:Torsion Abnormality / Q000601:surgery*
keywords: Children; Oophoropexy; Ovarian torsion; Recurrence