Ceccanti Silvia, Morini Francesco, Manganaro Lucia, Masselli Gabriele, Stranieri Giuseppe, Cozzi Denis A
Pediatric Surgery Unit, AOU Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, RM, Italy.
Department of Radiological, Oncological and Pathological Sciences, AOU Policlinico Umberto I Hospital, 00161, Rome, RM, Italy.
Pediatr Surg Int. 2025 Apr 12;41(1):115. doi: 10.1007/s00383-025-06002-0.
Large ovarian tumors with a predominantly cystic pattern are uncommon in adolescents. This study evaluates the effectiveness of a decompression technique utilizing a balloon trocar to facilitate ovarian-sparing surgery, while preserving oncologic principles, in adolescent patients presenting with such lesions METHODS: A retrospective review of four consecutive cases managed by a single surgeon over a 7-year period ending December 2024. We describe the surgical technique of this innovative approach, and provide patient-specific clinical data including histopathologic findings and follow-up outcomes.
The median patient age was 13 years (range, 10-17), and the median maximum tumor diameter was 17 cm (range, 10-28). The balloon trocar technique enabled a tight seal and closed suction drainage of the tumor cyst fluid, facilitating safe decompression and exteriorization of the mass. All surgeries were completed with negligible morbidity. Histological examination revealed three mature cystic teratomas and one serous cystadenoma. At clinical and ultrasonographic follow-up ranging 8 months to 7 years (median, 6,5 years), all patients remained free of recurrence, maintained regular menstrual cycles with normal-sized preserved ovaries, and expressed high satisfaction with their cosmetic outcomes.
Large predominantly cystic ovarian tumors are generally associated with a favorable prognosis. Preemptive in situ decompression using a balloon trocar represents a simple, effective, and rapid technique to minimize the risk of tumor spillage. This approach facilitates safe ovary-sparing surgery for these large tumors, while also providing excellent cosmetic outcomes.
以囊性为主的大型卵巢肿瘤在青少年中并不常见。本研究评估了一种利用球囊套管针的减压技术在患有此类病变的青少年患者中促进保留卵巢手术的有效性，同时遵循肿瘤学原则。方法：回顾性分析一位外科医生在截至2024年12月的7年期间连续处理的4例病例。我们描述了这种创新方法的手术技术，并提供了患者特异性临床数据，包括组织病理学结果和随访结果。
患者中位年龄为13岁（范围10 - 17岁），肿瘤最大直径中位值为17 cm（范围10 - 28 cm）。球囊套管针技术实现了肿瘤囊液的紧密密封和闭式吸引引流，便于肿物安全减压和取出。所有手术的发病率可忽略不计。组织学检查显示3例成熟囊性畸胎瘤和1例浆液性囊腺瘤。在8个月至7年（中位值6.5年）的临床和超声随访中，所有患者均无复发，保留的卵巢大小正常，月经周期规律，患者对美容效果高度满意。
以囊性为主的大型卵巢肿瘤通常预后良好。使用球囊套管针进行预防性原位减压是一种简单、有效且快速的技术，可将肿瘤破裂风险降至最低。这种方法便于对这些大型肿瘤进行安全的保留卵巢手术，同时也能提供出色的美容效果。
