Takaharu Oue1, Shuichiro Uehara2, Takashi Sasaki3, Satoko Nose3, Ryuta Saka3, Hiroaki Yamanaka2, Takehisa Ueno2, Yuko Tazuke2, Hiroomi Okuyama2. 1. Department of Pediatric Surgery, Hyogo College of Medicine, Nishinomiya-shi, Hyogo, Japan. Electronic address: ta-oue@hyo-med.ac.jp. 2. Department of Surgery, Division of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. 3. Department of Pediatric Surgery, Hyogo College of Medicine, Nishinomiya-shi, Hyogo, Japan.
Abstract
BACKGROUND/ PURPOSE: Ovarian preservation is desirable in children with ovarian tumors. However, the diagnostic and treatment strategies are heterogeneous. The aim of this study was to investigate the management and preservation of ovarian tissue in order to identify the factors associated with ovarian preservation. METHODS: Thirty-seven patients (41 ovaries) were surgically treated for ovarian tumors. Four cases were bilateral. The data on the patient symptoms at presentation, imaging, treatment, outcome, pathology, and status of ovarian preservation were retrospectively analyzed for each patient. RESULTS: Histological examinations revealed 25 mature teratomas, 5 immature teratomas, 5 cystadenomas, 2 dysgerminomas, and other tumors. Ovarian torsion occurred in 16 ovaries (39%). Ovary-sparing surgery was performed in 22 ovaries (53.7%). Successful ovarian preservation was significantly associated with a smaller tumor size, benign pathology, and a lower degree of torsion (P<0.01). CONCLUSIONS: Because the prognosis was favorable in most cases, the preservation of fertility and gonadal function should be a goal in the surgical treatment of ovarian tumors. We recommend ovary-sparing surgery as the first-line treatment for all pediatric ovarian tumors other than those that are preoperatively diagnosed as being malignant and those in which emergent surgical intervention is indicated owing to the suspicion of ovarian torsion.
BACKGROUND/ PURPOSE: Ovarian preservation is desirable in children with ovarian tumors. However, the diagnostic and treatment strategies are heterogeneous. The aim of this study was to investigate the management and preservation of ovarian tissue in order to identify the factors associated with ovarian preservation. METHODS: Thirty-seven patients (41 ovaries) were surgically treated for ovarian tumors. Four cases were bilateral. The data on the patient symptoms at presentation, imaging, treatment, outcome, pathology, and status of ovarian preservation were retrospectively analyzed for each patient. RESULTS: Histological examinations revealed 25 mature teratomas, 5 immature teratomas, 5 cystadenomas, 2 dysgerminomas, and other tumors. Ovarian torsion occurred in 16 ovaries (39%). Ovary-sparing surgery was performed in 22 ovaries (53.7%). Successful ovarian preservation was significantly associated with a smaller tumor size, benign pathology, and a lower degree of torsion (P<0.01). CONCLUSIONS: Because the prognosis was favorable in most cases, the preservation of fertility and gonadal function should be a goal in the surgical treatment of ovarian tumors. We recommend ovary-sparing surgery as the first-line treatment for all pediatric ovarian tumors other than those that are preoperatively diagnosed as being malignant and those in which emergent surgical intervention is indicated owing to the suspicion of ovarian torsion.
Authors: Aleksandra Raźnikiewicz; Wojciech Korlacki; Andrzej Grabowski Journal: Wideochir Inne Tech Maloinwazyjne Date: 2020-03-28 Impact factor: 1.195