Raźnikiewicz Aleksandra, Korlacki Wojciech, Grabowski Andrzej
Department of Children's Developmental Defects Surgery and Traumatology, Medical University of Silesia in Katowice, Zabrze, Poland.
Wideochir Inne Tech Maloinwazyjne. 2020 Jun;15(2):366-376. doi: 10.5114/wiitm.2020.93998. Epub 2020 Mar 28.
The current trend in adnexal surgery in children is to minimize the invasiveness of diagnostic and therapeutic procedures, reduce the number of complications and reduce the risk of infertility.
Evaluation of the usefulness and effectiveness of laparoscopy in diagnostics and treatment of pathological lesions of adnexa in the pediatric population and evaluation of the correlation of imaging with the intraoperative diagnosis during laparoscopy.
The study included 89 patients aged 0-18 years (mean: 12.62) who underwent an emergency or elective laparoscopic procedure due to the suspicion of adnexa pathology in the imaging tests or in which intraoperative pathology of the adnexa was found without previous suspicion of these changes in the imaging tests. Patients were divided into 2 groups according to the procedure (emergency or elective) and into 4 age groups.
The most frequent postoperative diagnosis was an adnexal cyst and ovarian tumor. The ratio of malignant to benign lesions was 0.087. In 32.58% of patients appendix pathology was found. Coexistence of adnexa and appendix pathology was statistically significantly more frequent in patients undergoing emergency surgery (p = 0.013). There was no correlation between the size of the tumor or ovarian cyst and the occurrence of adnexal torsion, and no correlation between the size of the tumor and the degree of torsion of the adnexa. Three conversions were performed. The average operation time was 63.7 min.
Laparoscopic diagnosis and treatment of adnexal pathology seems to be safe due to the low percentage of perioperative complications. It shows high sensitivity in recognizing adnexal pathologies and other defects.
儿童附件手术的当前趋势是尽量减少诊断和治疗程序的侵入性，减少并发症数量并降低不孕风险。
评估腹腔镜检查在儿科人群附件病理病变诊断和治疗中的实用性和有效性，以及评估腹腔镜检查期间影像学与术中诊断的相关性。
该研究纳入了89例年龄在0至18岁（平均：12.62岁）的患者，这些患者因影像学检查怀疑附件病变而接受了急诊或择期腹腔镜手术，或者在术中发现附件病理情况但术前影像学检查未怀疑有这些变化。根据手术类型（急诊或择期）将患者分为2组，并分为4个年龄组。
最常见的术后诊断是附件囊肿和卵巢肿瘤。恶性与良性病变的比例为0.087。在32.58%的患者中发现了阑尾病理情况。在接受急诊手术的患者中，附件和阑尾病理共存的情况在统计学上更为常见（p = 0.013）。肿瘤或卵巢囊肿的大小与附件扭转的发生之间没有相关性，肿瘤大小与附件扭转程度之间也没有相关性。进行了3次中转手术。平均手术时间为63.7分钟。
由于围手术期并发症发生率低，腹腔镜诊断和治疗附件病变似乎是安全的。它在识别附件病变和其他缺陷方面显示出高敏感性。
