İskemik Torsiyone Overin Detorsiyon Sonrası Omentuma Sarılarak Korunması

Abstract

There is not any reliable criterion to evaluate the viability of torsed ovary. The treatment of ovarian torsion is based on detorsion and preservation of ovary even it appears as purple-black necrotic tissue. Omentum is known to be effective in tissue healing. The aim of this study is to investigate whether wrapping of the ischemic ovary with omentum would be beneficial in improving perfusion and prevention of ischemia-reperfusion injury or not. After approval of the ethics committee, 15 SD rats were randomly divided into 3 groups (n=5). The rats in the sham group underwent laparotomy and the abdominal wall was closed without any further intervention. After the rats in the control group underwent laparotomy, left ovary was twisted 720 degrees on clockwise direction and fixed on the anterior abdominal wall and omentectomy was performed. Twenty-four hours later, the rats were again subjected to laparotomy and detorsion of the ovary. The rats in the experimental group underwent laparotomy, left ovary was twisted 720 degrees on clockwise direction and fixed on the anterior abdominal wall. Twenty-four hours later, laparotomy and detorsion were performed and ovary was wrapped with omentum. Oophorectomy was performed in all rats in all three groups 21 days after the first operation. After oophorectomy, total tissue damage was calculated by examining the rat ovaries in terms of congestion, interstitial edema, neutrophilic infiltration and necrosis. The total tissue damage in the sham, control and study group were; 9, 51 and 28 respectively. In the control group, tissue damage was significantly higher than sham and experimental group (Kruskal Wallis p<0.05). While healthy follicles were observed in only 2 of the rats in the control group, healthy follicles were observed in all rats in the study group. The current data indicate that, omentum is effective in tissue healing, and wrapping torsed ovary with omentum following detortion may be useful in maintaining ovarian vitality and healthy follicle production.