Laparoscopy versus laparotomy for pediatric ovarian dermoids

Authors

Maria E. Knaus, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, United States.
Amanda J. Onwuka, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, United States.
Amin Afrazi, American Family Children's Hospital, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.Follow
Lesley Breech, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States.Follow
Kristine S. Corkum, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.Follow
Patrick A. Dillon, St. Louis Children's Hospital, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.
Peter F. Ehrlich, C.S. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor, MI, United States.
Mary E. Fallat, Norton Children's Hospital, University of Louisville School of Medicine, Louisville, KY, United States.
Jason D. Fraser, Children's Mercy Kansas City, University of Missouri Kansas City School of Medicine, Kansas City, MO, United States.
Samir K. Gadepalli, C.S. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor, MI, United States.
Julia E. Grabowski, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
S Paige Hertweck, Norton Children's Hospital, University of Louisville School of Medicine, Louisville, KY, United States.
Rashmi Kabre, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Dave R. Lal, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, United States.
Matthew P. Landman, Riley Hospital for Children, Indiana University Health, Indianapolis, IN, United States.
Amy E. Lawrence, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, United States.
Charles M. Leys, American Family Children's Hospital, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
Grace Z. Mak, Advocate Aurora Health
Troy A. Markel, Riley Hospital for Children, Indiana University Health, Indianapolis, IN, United States.
Naila Merchant, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
R Elliott Overman, C.S. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor, MI, United States.
Brooks L. Rademacher, American Family Children's Hospital, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
Manish T. Raiji, Advocate Aurora HealthFollow
Beth Rymeski, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
Thomas T. Sato, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, United States.
Madeline Scannell, St. Louis Children's Hospital, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.
Allegra G. Schikler, Norton Children's Hospital, University of Louisville School of Medicine, Louisville, KY, United States.
Joseph A. Sujka, Children's Mercy Kansas City, University of Missouri Kansas City School of Medicine, Kansas City, MO, United States.
Tiffany Wright, Norton Children's Hospital, University of Louisville School of Medicine, Louisville, KY, United States.
Jennifer H. Aldrink, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, United States.Follow
et al

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.

Type

Article

PubMed ID

35292164


 

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