Laparoscopic treatment of ovarian cysts in children and adolescents

Abstract

Introduction: Ovarian cysts in children and adolescents are rare and mostly benign. The aim of this study was to evaluate the laparoscopic management of the ovarian cysts in this age group. Laparoscopic surgery has been accepted as the gold standard in the management of ovarian cysts. Materials & Methods: During the last 15 years were performed 201 surgeries to children, all related to ovarian cysts in the age group between 8 and 18 years (15.62 ± 0.15). The surgical approach was the laparotomy in 138 cases (68.7%) and the laparoscopy in 63 patients (31.3%). Results: A total of 63 patients with average age of 15.8 ± 0.25 years (ranged from 9 to 18) were treated by laparoscopy. There was registered a significantly higher rate of unilateral mass compared to the bilateral ovarian lesions (93.7% vs. 6.3%, p<0.001). According to the ultrasound and radiology data the maximum diameter of the cyst was of 8.07±0.4 cm (95% CI:7.2-8.8) and the min was 6.6±0.3 cm (95% CI:5.9-7.3). By means of the laparoscopic approach was performed: cystectomy in 44 cases (67.7%), partial resection of the ovary in 13 cases (20%), adnexectomy in 7 cases (10.8%) and ovarectomy one case (1.5%). The ovarian-preserving surgery was a significantly predominant procedure (57/65 (87.7 %) vs. 8/65 (12.3 %). Inr 19 (31.7%) cases was used the combined laparoscopic technique and extracorporeal enucleare of the cysts. Histopathological report revealed: simple cyst (n=45, 69.2%), ovarian dermoid cyst (n=5, 7.7%) cystadenoma (n=13, 20 %), endometrioma (n=2, 3.1%). There were no operative or postoperative complications.Conclusion: This study has demonstrated that the laparoscopic ovary-preserving surgery and the use of the expracorporeal enucleare of the cyst is a safe and easy method of treatment of ovarian cysts in children and adolescents with short-term hospitalization, the minimum of analgesic dose and a good cosmetic result.