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THE PROPORTION OF CONSERVATIVE SURGERY OF OVARIAN TORSION AND RELATED FACTORS AT HUNG VUONG HOSPITAL
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Abstract
Background: Ovarian torsion is a gynecological emergency. The two main surgical treatment methods are ovarian conservation and adnexectomy. The ACOG 2019 recommends a minimally invasive surgical approach with detorsion and preservation of the adnexal structures regardless of the appearance of the ovary. A surgeon should not remove a torsed ovary unless oophorectomy is unavoidable, such as when a severely necrotic ovary falls apart. Objectives: Determine the rate of ovarian conservation surgery in the treatment of ovarian torsion at Hung Vuong Hospital from January 2020 to March 2023. Determine the relationship between the rate of ovarian preservation surgery in the treatment of ovarian torsion with: age, obstetric and gynecological characteristics, clinical symptoms and paraclinical tests (leukemia, ultrasound) and ovarian tumor characteristics at surgery. Methods: Retrospective cross-sectional study on 355 patients with ovarian torsion at Hung Vuong hospital from January 2020 to March 2023. Results: The proportion of ovarian preservation surgery was 67% with 95% CI [59.3% - 71.3%]. Related factors that increase the rate of ovarian preservation surgery include: the age group under 18 years old is 12.5 times higher than the group over 45 years old, 95% CI [1.9-82.1], the 18 - 45 year olds are 2.1 times higher than those over 45 years old, 95% CI [1.7-6.3]. Time from the patient's onset of abdominal pain to admission to the hospital: 24 - 48 hours is 3.6 times higher than pain duration over 48 hours 95% CI [1,3-10]. Without symptoms of vomiting, nausea is 7.2 times higher than the 95% CI [3.1-16.9]. Number of twists: 1 twist has a higher conservation rate than 3 twists or more, 6.6 times 95% CI [2.6-17.2] and 2 twists is 3.8 times higher than 3 twists or more than 95% CI [1.6-8.7]. Conclusions: The rate of ovarian preservation surgery at Hung Vuong hospital is 67%. Related factors that increase the rate of ovarian preservation surgery include: younger patient age, shorter time from abdominal pain onset to hospitalization, no symptoms of vomiting or nausea, and number of ovarian twists less than.
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Keywords
ovarian torsion, ovarian conservation
References
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