Current trends in the surgical treatment of pediatric ovarian torsion: we can do better

IntroductionCurrent literature strongly recommends ovarian preservation for pediatric patients with ovarian torsion. The purpose of this study was to evaluate national trends in the surgical management of pediatric ovarian torsion and to compare outcomes between pediatric surgeons (PED) and gynecologists (GYN).MethodsWe queried Pediatric Health Information System (PHIS) data from 2007 to 2011 for patients < 18 years old with a diagnosis of ovarian torsion who underwent a surgical procedure. Patients with malignant disease were excluded. Outcomes were compared between pediatric surgeons and gynecologists.ResultsA total of 1151 patients were identified with a mean age of 10.7 ± 4.1 years with a bimodal distribution. Pediatric surgeons performed the majority of procedures (81%) and were more likely to use a laparoscopic approach (PED 27% vs. GYN 17%, p < .05). Pediatric surgeons were more likely to perform an oophorectomy (PED 38% vs. GYN 27%, p < .01), and more likely to administer antibiotics for this clean procedure (PED 61% vs. GYN 29%, p < .001). The overall reoperation rate was 5.1% and did not differ significantly by subspecialty (PED 4.4% vs. GYN 7.8%, p > .05).ConclusionsThese data demonstrate a significant opportunity for pediatric surgeons and gynecologists to improve ovarian salvage rates and to reduce unnecessary antibiotic utilization for children with ovarian torsion.