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儿童性腺毒性治疗中卵巢和睾丸组织冷冻保存的评估。

Evaluation of ovarian and testicular tissue cryopreservation in children undergoing gonadotoxic therapies.

机构信息

Department of Obstetrics and Gynecology, New York Medical College, Valhalla, NY, USA.

出版信息

J Assist Reprod Genet. 2013 Jan;30(1):3-9. doi: 10.1007/s10815-012-9909-5. Epub 2012 Dec 15.

Abstract

OBJECTIVE

Ovarian and testicular tissue cryopreservation are the only fertility preservation options for sexually immature individuals. Because of their experimental nature, it is important to determine safety and possible bundling with other medicallyindicated procedures.

STUDY DESIGN

Prospective observational.

RESULTS

Cryopreservation indications included cancer in 75 % of females and 50 % of males, while non-cancer indications included various hematological conditions. Similar numbers of females (12/28) and males (3/9) underwent prior chemotherapy. Females underwent laparoscopic (27/28) or robotic (1/28) approaches while incisional biopsy was used in males. Bundling of ovarian and testicular harvesting with other medicallyindicated procedures was performed in 42 % and 22 %, respectively. The operative time inclusive of bundled procedures was similar (1.6 ± 0.1 vs. 0.9 ± 0.3 h) but the discharge time was significantly longer for females than males (10.4 ± 0.6 vs. 4.6 ± 0.6 h, p<0.05) due to frequent bundling of medically-indicated procedures in females. All procedures were successfully completed without complications or significant blood loss.

CONCLUSIONS

Pediatric gonadal tissue cryopreservation can be combined with other medically-indicated procedures to minimize the potential inconvenience, additional anesthetic risks, and costs.

摘要

目的

卵巢和睾丸组织冷冻保存是唯一适用于未成熟个体的生育力保存选择。由于其具有实验性质,因此确定安全性并可能与其他医学上需要的程序相结合非常重要。

研究设计

前瞻性观察性研究。

结果

冷冻保存的适应证包括女性 75%和男性 50%的癌症,而非癌症的适应证包括各种血液疾病。女性(12/28)和男性(3/9)接受过类似数量的化疗。女性接受腹腔镜(27/28)或机器人(1/28)手术,而男性则采用切开活检。卵巢和睾丸采集与其他医学上需要的程序相结合的比例分别为 42%和 22%。包括捆绑程序在内的手术时间相似(1.6±0.1 与 0.9±0.3 小时),但由于女性经常捆绑医学上需要的程序,女性的出院时间明显长于男性(10.4±0.6 与 4.6±0.6 小时,p<0.05)。所有手术均成功完成,无并发症或明显失血。

结论

儿科性腺组织冷冻保存可以与其他医学上需要的程序相结合,以最小化潜在的不便、额外的麻醉风险和成本。

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