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儿童卵巢肿瘤保留卵巢肿瘤切除术的腹腔镜治疗:一项临床回顾性分析。

Laparoscopy for Ovary-Sparing Tumorectomy in Children with Ovarian Tumors: A Clinical Retrospective Analysis.

机构信息

Department of Gynaecology, Weihai Municipal Hospital, Shandong, China.

Department of Pediatric Surgery, Weihai Municipal Hospital, Shandong, China.

出版信息

J Laparoendosc Adv Surg Tech A. 2023 Mar;33(3):296-302. doi: 10.1089/lap.2022.0372. Epub 2023 Jan 30.

DOI:10.1089/lap.2022.0372
PMID:36716193
Abstract

The aim of this study is to analyze the characteristics of pediatric ovarian tumors (OTs) and evaluate treatment strategies for ovary-sparing tumorectomy (OST). Medical records of children from October 2011 to December 2021 were reviewed. Data regarding clinical characteristics, pathological type, and management of OST were analyzed. In total, 61 patients with OTs were screened. The median age was 14.8 ± 3.0 years. The median length and volume of borderline and malignant OTs were larger than those of benign OTs ( < .001 and  = .05, respectively). There was a significant difference in the median OT volume between torsion and nontorsion OTs ( = .04). The overall OST rate was 91.8% (67/73). A total of 53.4% (39/73) lesions were treated with laparoscopic OST. The OT volume was smaller in patients who underwent laparoscopy than in those who underwent laparotomy ( = .04). The probability of intraoperative tumor rupture or spillage was higher during laparoscopy than during laparotomy ( = .02). No significant differences were observed in OT recurrence. Seven patients had borderline and malignant tumors, 3 of whom had stage IA tumors and underwent OST. None of the patients experienced relapse. OT size is a useful reference factor for differential diagnosis and choosing laparoscopic surgery. Intraoperative tumor rupture and spillage of benign tumors during laparoscopy and laparotomy did not seem to be associated with recurrence, and laparoscopic OST was considered safe. Further prospective studies are required to confirm these conclusions.

摘要

本研究旨在分析小儿卵巢肿瘤(OT)的特征,并评估保留卵巢肿瘤切除术(OST)的治疗策略。回顾了 2011 年 10 月至 2021 年 12 月期间的儿童病历。分析了 OT 的临床特征、病理类型和 OST 管理的数据。共筛选出 61 例 OT 患儿。中位年龄为 14.8±3.0 岁。交界性和恶性 OT 的中位长度和体积均大于良性 OT( < .001 和  = .05)。扭转和非扭转 OT 的中位 OT 体积有显著差异( = .04)。总体 OST 率为 91.8%(67/73)。腹腔镜 OST 治疗的病变共有 53.4%(39/73)。与开腹手术相比,腹腔镜手术患者的 OT 体积更小( = .04)。腹腔镜手术中肿瘤破裂或溢出的概率高于开腹手术( = .02)。OT 复发率无显著差异。7 例患者为交界性和恶性肿瘤,其中 3 例为 IA 期肿瘤,行 OST。所有患者均无复发。OT 大小是鉴别诊断和选择腹腔镜手术的有用参考因素。良性肿瘤在腹腔镜和开腹手术中肿瘤破裂和溢出似乎与复发无关,腹腔镜 OST 被认为是安全的。需要进一步的前瞻性研究来证实这些结论。

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