Laparoscopic-Assisted Ovary-Sparing Surgery for Ovarian Torsion in Children and Adolescents: A Single-Center 6.4-Year Retrospective Analysis

Objectives: To explore the surgical experience and clinical value of laparoscopic exploration with one-stage ovarian tumor enucleation and oophoroplasty for ovarian tumor pedicle torsion in children and adolescents. Methods: A retrospective analysis was conducted on the clinical data of 105 cases of ovarian torsion managed at the Department of Oncological Surgery, Children’s Hospital, Zhejiang University School of Medicine from 1 January 2019 to 1 June 2025. All patients underwent emergency laparoscopic exploration with one-stage ovarian tumor enucleation and oophoroplasty. Postoperative ovarian Doppler ultrasound follow-up was performed at 1–3 months, 3–6 months, 6–12 months, and over 12 months, comparing the ovarian volume of the affected side with that of the contralateral ovary. Results: This study included 105 cases of ovarian tumor pedicle torsion. The patients ranged in age from 11 months to 14 years, with a median age of 8 years. The surgery was successfully completed in all 105 cases. Ovarian survival was achieved in 103 cases (98.09%), postoperative ovarian necrosis occurred in 1 case (0.95%), and the affected ovary and fallopian tube were removed due to malignant tumor in 1 case (0.95%); the overall complication rate was 13.3% (14/105). Comparison of ovarian volume between the affected side and the contralateral ovary at each postoperative follow-up time point: at 1–3 months postoperatively, the volume was 3.28 (1.33, 7.71) cm3 vs. 3.43 (1.38, 5.92) cm3 (p = 0.301); at 3–6 months postoperatively, the volume was 1.28 (0.76, 6.09) cm3 vs. 2.67 (1.23, 6.24) cm3 (p = 0.169); at 6–12 months postoperatively, the volume was 3.37 (2.04, 6.66) cm3 vs. 4.37 (2.02, 6.28) cm3 (p = 0.092); at more than 12 months postoperatively, the volume was 4.07 (1.10, 5.04) cm3 vs. 5.60 (1.02, 9.85) cm3 (p = 0.090). At all follow-up time points, the comparison of ovarian volume between the affected side and the contralateral ovary showed no statistically significant difference (all p > 0.05). Conclusions: Emergency laparoscopic exploration with concurrent tumor enucleation and oophoroplasty for ovarian tumor pedicle torsion in children and adolescents is safe and feasible. It reduces the need for a second surgery and effectively preserves ovarian tissue on the affected side.