Does gradual detorsion protect the ovary against ischemia–reperfusion injury in rats?

Aim 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...

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Bibliographic Details
Published in:Pediatric surgery international 2014-04, Vol.30 (4), p.437-440
Main Authors: Ozkisacik, Sezen, Yazici, Mesut, Gursoy, Harun, Culhaci, Nil
Format: Article
Language:English
Subjects:
Adnexal Diseases - complications
Adnexal Diseases - therapy
Animals
Female
Medicine
Medicine & Public Health
Original Article
Ovary - blood supply
Pediatric Surgery
Pediatrics
Rats
Rats, Wistar
Reperfusion Injury - etiology
Reperfusion Injury - prevention & control
Surgery
Torsion Abnormality - complications
Torsion Abnormality - therapy
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Summary:Aim 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. Materials and 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  
ISSN:0179-0358
1437-9813
DOI:10.1007/s00383-014-3480-3