Management of Large Pediatric and Adolescent Ovarian Neoplasms with a Leak-Proof Extracorporeal Drainage Technique: Our Experience Using a Hybrid Minimally Invasive Approach.
J Pediatr Adolesc Gynecol
; 34(3): 394-399, 2021 Jun.
Article
de En
| MEDLINE
| ID: mdl-32828966
ABSTRACT
STUDY OBJECTIVE:
In a pediatric setting, laparoscopic management of large cystic ovarian neoplasms with low malignancy probability is not suitable, because of the mass size; nevertheless, an effort should be made to be as minimally invasive as possible, without violating the principles of oncologic surgery. We describe our experience in managing these neoplasms with leak-proof extracorporeal drainage through mini laparotomy, followed by cyst excision or oophorectomy.DESIGN:
Case series study, describing interventions and outcomes.SETTING:
Department of pediatric surgery in a tertiary pediatric and adult university hospital.PARTICIPANTS:
Pediatric patients affected by large cystic ovarian mass.INTERVENTIONS:
Hybrid minimally invasive approach using leak-proof extracorporeal drainage. MAIN OUTCOMEMEASURES:
Data on demographic characteristics, tumor marker values, and imaging findings were collected and analyzed. Outcome of surgical technique was evaluated and reported.RESULTS:
Between 2011 and 2018, 17 patients (mean age, 10.2 years; range, 2-14 years) affected by large cystic ovarian mass, were eligible for this technique. All patients had negative preoperative tumor markers. Of the seventeen subjects, 13/17 girls (76%) underwent pelvic magnetic resonance imaging. No sign of lymphadenopathy or metastasis was found. Surgery was successful in all patients, with ovarian preservation in 5/17 cases (29.4%). Mean surgical time was 98 minutes; no intra-abdominal leakage of neoplasm content or postoperative complications occurred. Mature cystic teratoma was the most frequent histopathological diagnosis (71%).CONCLUSION:
After a thorough patient selection, the management of large cystic ovarian neoplasms with leak-proof extracorporeal drainage performed through a mini laparotomy is a feasible and safe approach, with excellent cosmetic results. When achievable, ovarian-sparing surgery has to be considered.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Kystes de l'ovaire
/
Tumeurs de l'ovaire
/
Interventions chirurgicales mini-invasives
Type d'étude:
Observational_studies
Limites:
Adolescent
/
Adult
/
Child
/
Female
/
Humans
Langue:
En
Journal:
J Pediatr Adolesc Gynecol
Sujet du journal:
GINECOLOGIA
/
PEDIATRIA
Année:
2021
Type de document:
Article