Is the management of isolated tubal torsion in pediatric surgery appropriate? A multicenter european study and insights into clinical practice

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PURPOSE: The aim of the study was to describe the current surgical practices in managing isolated fallopian tubal torsion (IFTT) in children, identify the most appropriate surgical procedure, and assess the associated postoperative complications and recurrence rates. METHODS: A retrospective European multicentric study was conducted, included all patients aged 18 years or younger who underwent IFTT between 2006 and 2021. A detailed descriptive analysis based on a case series presentation was conducted. RESULTS: Sixty-four girls aged 6-17 years who underwent surgery for IFTT across eight European paediatric centers were included. Surgical procedures included: tubal detorsion (87%), partial salpingectomy (6%), total salpingectomy (44%), and salpingotomy (5%). Histopathological analysis identified tubal cysts and hydrosalpinx (HSX) as common causes of torsion. HSX was found in 15% of cases, and neosalpingostomy was performed in two patients with recurrent abdominal pain after initial surgery. Overall, 12% of patients required more than one surgical intervention due to persistent abdominal pain. CONCLUSION: IFTT alone, in the absence of tubal malformation, provides a favourable prognosis with a straightforward detorsion procedure. If a tubal malformation is detected during the surgery, an ablation of malformation is advised in order to avoid recurrences. In the event of HSX being present, the option of a neosalpingostomy can be proposed. Our results emphasize the importance of timely diagnosis and appropriate surgical management to reduce complications and improve outcomes in paediatric IFTT.

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