Surgical management of ovarian masses in children and adolescents: experience of an academic institution in France
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In brief
In brief
This 8-year retrospective study of 88 pediatric patients demonstrates that laparoscopic management of ovarian masses offers significant advantages over open surgery, including smaller incisions, shorter operative times, and reduced hospital stays. Laparoscopy is recommended for benign lesions and torsion, with selective conversion to open surgery for suspected malignancy.
- Laparoscopy is safe and effective for benign ovarian masses in pediatric patients, with shorter operative time and hospital stay versus open surgery.
- Laparoscopic approach is appropriate for smaller tumors (mean 54mm) and ovarian torsion, with minimal complications and low recurrence (5.7%).
- For suspected malignant ovarian masses, laparoscopy aids diagnosis and staging but conversion to open surgery is warranted if malignancy confirmed.
- Tumor size is a key factor: laparoscopy suited for lesions <120mm; larger masses may require open approach for safe resection.
- Conservative ovarian-sparing surgery via laparoscopy preserves fertility in adolescents with benign lesions and acceptable long-term outcomes.
Written by the GCMD Library team from the article.
Abstract
Purpose
Surgical management of ovarian masses in girls still challenging. The aim of the study is to report an 8-year experience in managing children with ovarian masses, and to demonstrate the advantages and the limitations of laparoscopy for such lesions.
Methods
Data of girls aged less than 18 years operated because of an ovarian mass between January 2015 and February 2023 were retrospectively reviewed. Patients were divided into two groups: group A including children operated by laparoscopy, and Group B of patients who underwent open surgery.
Results
Eighty-eight children were enrolled. Laparoscopy was performed in 56 patients (63.6%). Group A patients had smaller tumor size (53.6±38.5 vs. 122.2±75.4 mm, P<0.0001), shorter operative time (50.4±20.3 vs. 71.5±36.5 min, P = 0.004), reduced length of hospital stay (1.4±1.1 vs. 3±2.3 days, P<0.0001), and absence of postoperative complications. Only 3 cases (5.7%) of recurrence were seen exclusively within patients followed for benign tumors during a mean follow-up period of 4.6±3 years.
Conclusion
Laparoscopy should be done in benign ovarian lesions or/and if a torsion is seen. For tumors at high risk of malignancy, laparoscopy can be performed to establish a clear macroscopic diagnosis, for staging of the disease, and resection of small tumors. Conversion to open surgery is indicated in case of doubt.