Laparoscopy versus laparotomy for pediatric ovarian dermoids

AUTHORS

Knaus ME , Onwuka AJ , Afrazi A , Breech L , Corkum KS , Dillon PA , Ehrlich PF , Fallat ME , Fraser JD , Gadepalli SK , Grabowski JE , Hertweck SP , Kabre R , Lal DR , Landman MP , Lawrence AE , Leys CM , Mak GZ , Markel TA , Merchant N , Elliott Overman R , Rademacher BL , Raiji MT , Rymeski B , Sato TT , Scannell M , Schikler AG , Sujka JA , Wright T , Aldrink JH , Hewitt GD , Minneci PC , Deans KJ , , . Journal of pediatric surgery. 2022 2 12; ().

PMID: 35292164 [PubMed].

ABSTRACT

Background With increased surgeon comfort using laparoscopy, we hypothesized resection of pediatric ovarian dermoids using laparoscopy would yield a shorter length of stay and no increase in morbidity or recurrence compared to laparotomy. Methods A retrospective review was performed amongst eleven pediatric hospitals. Patients aged 2 to 21 who underwent resection of an ovarian dermoid from 2010 to 2020 were included. Patient characteristics, operative details, and outcomes by approach were evaluated using Chi-squared and Wilcoxon-Mann tests. Results 466 patients were included, with a median age of 14.4 and median follow-up of 4.0 months. 279 patients underwent laparoscopy (60%), 139 laparotomy (30%), and 48 laparoscopy converted to laparotomy (10%). There were no differences in rates of tumor spillage by approach (p = 0.15). 65% underwent ovarian-sparing surgery and 35% underwent oophorectomy. Length of stay was significantly shorter amongst patients who underwent laparoscopy (1 day versus 2 days for laparotomy and converted, p<0.0001). There were no differences in rates of suspected recurrence or reoperation (p = 0.19 and p = 0.57, respectively). Conclusion Patients who underwent laparoscopy experienced no differences in the rates of tumor spillage, recurrence, or reoperation and had a shorter length of stay compared to laparotomy. Laparoscopy is an acceptable approach for resection of pediatric ovarian dermoids.

Tags: alumni publications 2022