Understanding delayed surgery for paediatric testicular torsion-Analysis of GIRFT report

3^rd World Congress on Surgery, Surgeons & Anesthesia

March 27-28, 2023 | Webinar

Pia Borgas*, Jayaram Sivaraj, Aleksandra Lasica, Pavandeep Virdee and Gopal Nair

North Middlesex University Hospital, United Kingdom

Scientific Tracks Abstracts: Surgery

Abstract :

Introduction: The Paediatric Surgery GIRFT report suggested that delayed surgery in testicular torsion due to unclear treatment pathways were the primary cause of a high orchidectomy rate. Our aim was to determine the cause of delayed surgery in paediatric testicular torsion at our institution. Patients and Methods: Paediatric patients with testicular torsion between January 2018 and December 2020 were retrospectively reviewed. Patients who underwent orchidectomy were compared with patients who did not undergo orchidectomy. Outcomes reviewed included time from symptom onset to Presentation to hospital (TP), Time to first Assessment (TA), Time to Urology assessment (TU) and Time to arrival in Theatre (TT). Results: 62 patients underwent scrotal exploration during our study period. Of these, 35 (56%) had torsion. The orchidectomy rate for patients undergoing explorations is 13% (8/62 patients). In the orchidectomy group, median TP (IQR) was 24 (11.31) hours compared to 3.25 (4.63) hours in the non-orchidectomy group (p<0.0001). In the orchidectomy group, median TA (IQR) was 0.26 (0.28) hours compared to 0.13 (0.08) hours in the nonorchidectomy group (p=0.06). In the orchidectomy group, median TU (IQR) was 1.42 (0.66) hours compared to 1.12 (0.75) hours in the non-orchidectomy group (p=0.23). In the orchidectomy group, median TT (IQR) was 1.1 (0.18) hours compared to 1.25 (0.73) hours in the non-orchidectomy group (p=0.38). No patients were transferred out for surgery. Conclusions: In our institution, delayed presentation appears to be the primary cause for orchidectomies in patients with testicular torsion. Appropriate education in the community is required to address this.

Biography :

Pia Borgas trained at University College London, where she obtained her MBBS degree in 2021. She then commenced her foundation training at North Middlesex University Hospital and is currently completing the second year at University College London Hospital undergoing a mix of medical and surgical rotations. She hopes to enter core surgical training in the UK next year, with an aim of becoming a general surgeon in the future.