Piotrowska-Gall Aneta, Strzelecka Agnieszka, Wróbel Joanna, Salamon Aleksandra, Urbaniak-Wąsik Sławka, Cierniak Piotr, Wolak Przemysław
Collegium Medicum, Jan Kochanowski University of Kielce, Kielce, Poland; Department of Pediatric Surgery, Urology and Traumatology, Voivodship Hospital, Kielce, Poland.
Collegium Medicum, Jan Kochanowski University of Kielce, Kielce, Poland.
J Pediatr Surg. 2024 Mar;59(3):400-406. doi: 10.1016/j.jpedsurg.2023.10.057. Epub 2023 Oct 28.
Laparoscopic ovarian-sparing surgery (OSS) is safe and effective management approach for benign ovarian lesions in pediatric patients. This study evaluates the outcomes of females younger than 18 years who underwent the OSS procedure between December 2013 and November 2022 at a single institution.
We conducted a retrospective analysis of records from 82 females who underwent OSS for ovarian lesions. OSS was performed based on diagnostic imaging that suggested the benign nature of the lesion.
Of the 82 patients studied, 78 had unilateral lesions and 4 had bilateral synchronous lesions. The mean age was 14 years. The majority (62 cases) of the surgeries were laparoscopic, with 20 requiring conversion to open surgery due to factors such as indistinguishable edges and large size of the lesion. We identified 8 cases of ovarian torsion. The surgical specimens revealed that 46 were ovarian teratomas, 2 were granulosa cell tumors, 15 were cystadenomas, and 23 were functional cysts. There were no intraoperative complications. Two recurrences were observed in patients who were initially treated for bilateral ovarian teratomas. One patient developed a pelvic abscess. Additionally, three patients had metachronous ovarian tumors during the follow-up period. In patients followed with ultrasound imaging, the viable ovary was visualized in 83.6% of the cases (61 out of 73).
Our findings demonstrate the effectiveness of laparoscopic OSS in preserving ovarian function and providing clinical benefits in patients with benign ovarian lesions. We recommend regular follow-up with ultrasound to exclude metachronous lesions or recurrence.
III.
腹腔镜保留卵巢手术（OSS）是治疗儿科患者良性卵巢病变的一种安全有效的方法。本研究评估了2013年12月至2022年11月期间在单一机构接受OSS手术的18岁以下女性的手术结果。
我们对82例因卵巢病变接受OSS手术的女性患者的记录进行了回顾性分析。OSS手术基于诊断成像显示病变为良性。
在研究的82例患者中，78例为单侧病变，4例为双侧同步病变。平均年龄为14岁。大多数手术（62例）为腹腔镜手术，20例因病变边缘不清、体积大等因素需要转为开放手术。我们发现8例卵巢扭转。手术标本显示，46例为卵巢畸胎瘤，2例为颗粒细胞瘤，15例为囊腺瘤，23例为功能性囊肿。术中无并发症。最初接受双侧卵巢畸胎瘤治疗的患者中有2例复发。1例患者发生盆腔脓肿。此外，3例患者在随访期间出现异时性卵巢肿瘤。在接受超声成像随访的患者中，83.6%（73例中的61例）可见存活的卵巢。
我们的研究结果表明，腹腔镜OSS在保留卵巢功能和为良性卵巢病变患者提供临床益处方面是有效的。我们建议定期进行超声随访，以排除异时性病变或复发。
III级。
