Ovarian-Sparing Surgery in Pediatric Benign Ovarian Tumors

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.

Keywords: Adolescent gynecology; Fertility; Ovarian-sparing surgery; Pediatric ovarian tumors; Pediatric surgery.