当前位置: X-MOL 学术J. Pediatr. Adolesc. Gynecol. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Management of Large Pediatric and Adolescent Ovarian Neoplasms with a Leak-Proof Extracorporeal Drainage Technique: Our Experience Using a Hybrid Minimally Invasive Approach
Journal of Pediatric and Adolescent Gynecology ( IF 1.8 ) Pub Date : 2020-08-21 , DOI: 10.1016/j.jpag.2020.08.009
Silvia Pecorelli 1 , Uca Giacomo Tonegatti 1 , Maria Vittoria Stern 1 , Anna Lavinia Bulotta 1 , Francesco Laffranchi 2 , Claudia Stegher 3 , Franco Odicino 3 , Daniele Alberti 4
Affiliation  

Study Objective

In a pediatric setting, laparoscopic management of large cystic ovarian neoplasms with low malignancy probability is not suitable, because of the mass size; nevertheless, an effort should be made to be as minimally invasive as possible, without violating the principles of oncologic surgery. We describe our experience in managing these neoplasms with leak-proof extracorporeal drainage through mini laparotomy, followed by cyst excision or oophorectomy.

Design

Case series study, describing interventions and outcomes.

Setting

Department of pediatric surgery in a tertiary pediatric and adult university hospital.

Participants

Pediatric patients affected by large cystic ovarian mass.

Interventions

Hybrid minimally invasive approach using leak-proof extracorporeal drainage.

Main Outcome Measures

Data on demographic characteristics, tumor marker values, and imaging findings were collected and analyzed. Outcome of surgical technique was evaluated and reported.

Results

Between 2011 and 2018, 17 patients (mean age, 10.2 years; range, 2-14 years) affected by large cystic ovarian mass, were eligible for this technique. All patients had negative preoperative tumor markers. Of the seventeen subjects, 13/17 girls (76%) underwent pelvic magnetic resonance imaging. No sign of lymphadenopathy or metastasis was found. Surgery was successful in all patients, with ovarian preservation in 5/17 cases (29.4%). Mean surgical time was 98 minutes; no intra-abdominal leakage of neoplasm content or postoperative complications occurred. Mature cystic teratoma was the most frequent histopathological diagnosis (71%).

Conclusion

After a thorough patient selection, the management of large cystic ovarian neoplasms with leak-proof extracorporeal drainage performed through a mini laparotomy is a feasible and safe approach, with excellent cosmetic results. When achievable, ovarian-sparing surgery has to be considered.



中文翻译:

防渗漏体外引流技术管理大型儿科和青春期卵巢肿瘤:我们的使用混合微创方法的经验

研究目的

在儿科环境中,由于肿块的大小,腹腔镜处理恶性可能性低的大型囊性卵巢肿瘤是不合适的。但是,在不违反肿瘤外科手术原则的情况下,应努力做到尽可能做到微创。我们描述了通过微型剖腹术,然后进行囊肿切除或卵巢切除术,通过防漏体外引流处理这些肿瘤的经验。

设计

案例研究,描述干预措施和结果。

环境

三级儿科和成人大学医院儿科外科。

参加者

小儿患者受大囊性卵巢肿块的影响。

干预措施

使用防漏体外引流的混合微创方法。

主要观察指标

收集并分析有关人口统计学特征,肿瘤标志物值和影像学发现的数据。评估并报告了手术技术的结果。

结果

在2011年至2018年之间,有17名患者(平均年龄10.2岁;范围2-14岁)受了大的囊性卵巢肿块的影响,符合这项技术的条件。所有患者术前肿瘤标志物均为阴性。在17名受试者中,有13/17名女孩(占76%)接受了骨盆磁共振成像。没有发现淋巴结肿大或转移的迹象。所有患者均手术成功,保留卵巢的比例为5/17例(29.4%)。平均手术时间为98分钟;腹腔内无肿瘤内容物渗漏或术后并发症发生。成熟的囊性畸胎瘤是最常见的组织病理学诊断(71%)。

结论

经过彻底的患者选择后,通过微型剖腹术进行防漏性体外引流的大囊性卵巢肿瘤治疗是一种可行且安全的方法,具有出色的美容效果。在可行的情况下,必须考虑保留卵巢的手术。

更新日期:2020-08-21
down
wechat
bug