Laparoscopy versus laparotomy for pediatric ovarian dermoids.

Autor: Knaus ME; Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, United States., Onwuka AJ; Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, United States., Afrazi A; American Family Children's Hospital, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States., Breech L; Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States., Corkum KS; Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, United States., Dillon PA; St. Louis Children's Hospital, Washington University School of Medicine in St. Louis, St. Louis, MO, United States., Ehrlich PF; C.S. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor, MI, United States., Fallat ME; Norton Children's Hospital, University of Louisville School of Medicine, Louisville, KY, United States., Fraser JD; Children's Mercy Kansas City, University of Missouri Kansas City School of Medicine, Kansas City, MO, United States., Gadepalli SK; C.S. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor, MI, United States., Grabowski JE; Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, United States., Hertweck SP; Norton Children's Hospital, University of Louisville School of Medicine, Louisville, KY, United States., Kabre R; Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, United States., Lal DR; Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, United States., Landman MP; Riley Hospital for Children, Indiana University Health, Indianapolis, IN, United States., Lawrence AE; Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, United States., Leys CM; American Family Children's Hospital, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States., Mak GZ; Comer Children's Hospital, The University of Chicago Medicine, Chicago, IL, United States., Markel TA; Riley Hospital for Children, Indiana University Health, Indianapolis, IN, United States., Merchant N; Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States., Elliott Overman R; C.S. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor, MI, United States., Rademacher BL; American Family Children's Hospital, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States., Raiji MT; Comer Children's Hospital, The University of Chicago Medicine, Chicago, IL, United States., Rymeski B; Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States., Sato TT; Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, United States., Scannell M; St. Louis Children's Hospital, Washington University School of Medicine in St. Louis, St. Louis, MO, United States., Schikler AG; Norton Children's Hospital, University of Louisville School of Medicine, Louisville, KY, United States., Sujka JA; Children's Mercy Kansas City, University of Missouri Kansas City School of Medicine, Kansas City, MO, United States., Wright T; Norton Children's Hospital, University of Louisville School of Medicine, Louisville, KY, United States., Aldrink JH; Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, United States., Hewitt GD; Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, United States., Minneci PC; Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, United States. Electronic address: peter.minneci@nationwidechildrens.org., Deans KJ; Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, United States.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2022 Jun; Vol. 57 (6), pp. 1008-1012. Date of Electronic Publication: 2022 Feb 12.
DOI: 10.1016/j.jpedsurg.2022.01.053
Abstrakt: 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.
(Copyright © 2022. Published by Elsevier Inc.)
Databáze: MEDLINE
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