Management of Large Pediatric and Adolescent Ovarian Neoplasms with a Leak-Proof Extracorporeal Drainage Technique: Our Experience Using a Hybrid Minimally Invasive Approach - 30/04/21
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 Outcome Measures |
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.
El texto completo de este artículo está disponible en PDF.Key Words : Cystic ovarian neoplasm, Pediatric, Minimally invasive, Leak-proof drainage, Cyanoacrylates, Ovarian sparing, Oophorectomy, Benign, Patient selection
Esquema
The authors indicate no conflicts of interest. |
Vol 34 - N° 3
P. 394-399 - juin 2021 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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