Abstract：
BACKGROUND: Literature on paediatric surgical conditions in low- and middle-income countries (LMICs) remains limited. As a common emergency, timely treatment of testicular torsion acts as a benchmark of adequate emergency service delivery in paediatric surgery. This scoping study aims to synthesise all existing literature on paediatric testicular torsion in LMICs.
METHODS: A database search was conducted by the OxPLORE global paediatric surgery research group to identify studies containing the terms \'testicular torsion\' or \'acute scrotum\' originating from LMICs. A thematic analysis was applied to the results of the search and the quality of evidence was appraised for all included articles.
RESULTS: This review included 17 studies with 1798 patients. All studies originated from middle-income countries and the majority (76%) had sample sizes smaller than 100 patients. All studies were appraised as providing less than adequate evidence. Included studies identified long delays to treatment and highlighted ongoing debates on the value of scoring systems and Doppler ultrasonography in diagnosing torsion. Major heterogeneity in surgical approaches to treatment of testicular torsion in children was also observed.
CONCLUSIONS: Literature on paediatric testicular torsion in LMICs is scarce and heterogeneous. Prospective, multi-centre research on the management of this common paediatric surgical emergency is urgently required.
METHODS: A database search was conducted by the OxPLORE global paediatric surgery research group to identify studies containing the terms \'testicular torsion\' or \'acute scrotum\' originating from LMICs. A thematic analysis was applied to the results of the search and the quality of evidence was appraised for all included articles.
RESULTS: This review included 17 studies with 1798 patients. All studies originated from middle-income countries and the majority (76%) had sample sizes smaller than 100 patients. All studies were appraised as providing less than adequate evidence. Included studies identified long delays to treatment and highlighted ongoing debates on the value of scoring systems and Doppler ultrasonography in diagnosing torsion. Major heterogeneity in surgical approaches to treatment of testicular torsion in children was also observed.
CONCLUSIONS: Literature on paediatric testicular torsion in LMICs is scarce and heterogeneous. Prospective, multi-centre research on the management of this common paediatric surgical emergency is urgently required.
摘要：
背景：关于低收入和中等收入国家（LMICs）儿科手术状况的文献仍然有限。作为一种常见的紧急情况，睾丸扭转的及时治疗是儿科手术中提供足够紧急服务的基准。这项范围研究旨在综合所有有关LMICs小儿睾丸扭转的现有文献。
方法：OxPLORE全球儿科外科研究小组进行了数据库搜索，以确定包含源自LMIC的术语“睾丸扭转”或“急性阴囊”的研究。对搜索结果进行了专题分析，并对所有纳入的文章进行了证据质量评估。
结果：本综述包括17项研究，共1798例患者。所有研究都来自中等收入国家，大多数（76％）的样本量小于100名患者。所有研究均被评估为提供的证据不足。纳入的研究确定了治疗的长期延误，并强调了关于评分系统和多普勒超声检查在诊断扭转中的价值的持续辩论。还观察到了治疗儿童睾丸扭转的手术方法的主要异质性。
结论：关于LMICs患儿睾丸扭转的文献很少且不均匀。前瞻性,迫切需要多中心研究这种常见的儿科外科紧急情况的管理。
方法：OxPLORE全球儿科外科研究小组进行了数据库搜索，以确定包含源自LMIC的术语“睾丸扭转”或“急性阴囊”的研究。对搜索结果进行了专题分析，并对所有纳入的文章进行了证据质量评估。
结果：本综述包括17项研究，共1798例患者。所有研究都来自中等收入国家，大多数（76％）的样本量小于100名患者。所有研究均被评估为提供的证据不足。纳入的研究确定了治疗的长期延误，并强调了关于评分系统和多普勒超声检查在诊断扭转中的价值的持续辩论。还观察到了治疗儿童睾丸扭转的手术方法的主要异质性。
结论：关于LMICs患儿睾丸扭转的文献很少且不均匀。前瞻性,迫切需要多中心研究这种常见的儿科外科紧急情况的管理。
