Paulette I Abbas1, Jennifer E Dietrich2, Jessica A Francis2, Mary L Brandt1, Darrell L Cass1, Monica E Lopez3. 1. Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas. 2. Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas. 3. Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas. Electronic address: melopez@texaschildrens.org.
Abstract
STUDY OBJECTIVE: To evaluate outcomes of children after ovarian-sparing surgery (OSS) for non-neoplastic and benign neoplastic ovarian lesions. DESIGN: Retrospective cohort study from January 2003 to January 2012. SETTING: Single, high-volume, tertiary care hospital. PARTICIPANTS: Children 18 years of age and younger. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Postoperative complications and tumor recurrence after OSS. RESULTS: One hundred nine patients underwent OSS with a median age of 13.3 years (interquartile range [IQR], 11.4-15.1 years). Eighty-two patients were treated laparoscopically with 4 conversions to an open procedure. Postoperative complications included surgical site infections in 7 patients (6%). Pathology most commonly revealed functional ovarian cysts (n = 57) and mature teratomas (n = 37). Ninety-four patients (86%) were followed for a median of 10.4 months (IQR, 0.72-30.8 months). Fifty-five patients (60%) had subsequent imaging surveillance a median of 7.6 months postoperatively (IQR, 3.9-13 months). Ten patients (10%) developed a second ipsilateral lesion within a median time of 11 months (IQR, 7.7-24 months), of whom 5 girls had repeated surgery for mass enlargement or persistent abdominal pain at a median time of 10.5 months (IQR, 8.0-12.65 months). Fifty-eight patients (63%) began or resumed menses at their most recent follow-up. Three girls became pregnant after OSS at a median follow-up of 5 years (range, 2.4-6.7 years). CONCLUSION: Benign ovarian lesions in children can be treated successfully with OSS with low recurrence and repeat surgery rates.
STUDY OBJECTIVE: To evaluate outcomes of children after ovarian-sparing surgery (OSS) for non-neoplastic and benign neoplastic ovarian lesions. DESIGN: Retrospective cohort study from January 2003 to January 2012. SETTING: Single, high-volume, tertiary care hospital. PARTICIPANTS: Children 18 years of age and younger. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Postoperative complications and tumor recurrence after OSS. RESULTS: One hundred nine patients underwent OSS with a median age of 13.3 years (interquartile range [IQR], 11.4-15.1 years). Eighty-two patients were treated laparoscopically with 4 conversions to an open procedure. Postoperative complications included surgical site infections in 7 patients (6%). Pathology most commonly revealed functional ovarian cysts (n = 57) and mature teratomas (n = 37). Ninety-four patients (86%) were followed for a median of 10.4 months (IQR, 0.72-30.8 months). Fifty-five patients (60%) had subsequent imaging surveillance a median of 7.6 months postoperatively (IQR, 3.9-13 months). Ten patients (10%) developed a second ipsilateral lesion within a median time of 11 months (IQR, 7.7-24 months), of whom 5 girls had repeated surgery for mass enlargement or persistent abdominal pain at a median time of 10.5 months (IQR, 8.0-12.65 months). Fifty-eight patients (63%) began or resumed menses at their most recent follow-up. Three girls became pregnant after OSS at a median follow-up of 5 years (range, 2.4-6.7 years). CONCLUSION:Benign ovarian lesions in children can be treated successfully with OSS with low recurrence and repeat surgery rates.
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