Laparoscopic Outcomes for Pelvic Pathology in Children and Adolescents among Patients Presenting to the Pediatric and Adolescent Gynecology Service

Rieger, Mary; Santos, Xiomara M.; Sangi‐Haghpeykar, Haleh; Bercaw, Jennifer L.; Dietrich, Jennifer E.

doi:10.1016/j.jpag.2014.06.008

Cited by 12 publications

(5 citation statements)

References 20 publications

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“…Laparoscopy is now commonly utilized as both a diagnostic and therapeutic tool and has a broad range of indications within pediatric and adolescent gynecology. The literature has found gynecologic laparoscopy to be equally well tolerated in younger premenarcheal females as well as in older adolescents [17][18][19] . In our study, among the 212 patients, 179 (84.4%) underwent laparoscopic surgery, and there were no intraoperative or postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

The Clinicopathological Features And Surgical Procedure of Adnexal Mass With Abdominal Pain In Pediatric And Adolescent Patients

Liu

Zhou

Cao

et al. 2021

Preprint

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Objective: To investigate the clinicopathological features and surgical procedures of adnexal masses with abdominal pain in pediatric and adolescent patients.Methods: A total of 212 pediatric and adolescent adnexal masses with abdominal pain who underwent surgery were retrospectively reviewed. The patients were divided into two groups, namely, the emergency surgery (EMS, n=96) group and the elective surgery (ELS, n=116) group, according to whether they had been surgically diagnosed with emergency conditions. EMS group refers to patients who had been surgically diagnosed with emergency conditions including adnexal masses torsion，corpus luteum rupture，and rupture of ectopic pregnancy. ELS group refers to patients with adnexal mass without emergency condition. The differences between the two groups were compared using the chi- squared test.Results: At the surgery evaluation, the median age was 14.5±3.6 years. A total of 175 patients (82.5%, 175/212) had menstruation, and 37 patients (17.5%, 37/212) had not yet begun menstruating. A total of 126 (59.4%, 126/212) patients presented with an abrupt onset of abdominal pain. Pelvic abdominal ultrasound was the first imaging modality used in all the patients (n = 212/212; 100%). Tumor markers were abnormally elevated in 26 patients.Compared with the ELS group, the proportion of patients with emergency onset of pain, pain duration less than 3 months, persistent and intense of pain were significantly higher than those in ELS group (P < 0.05). There were significantly more patients without menarche in the EMS group than in the ELS group (p<0.05). The average tumor size in the ELS group was larger than that in the EMS group (p<0.05). In the EMS group, 78 cases（ 81.3%,78/96）had adnexal mass torsion, 16 cases (16.7%，16/96) had mass rupture, and 2 cases (2.1%, 2/96）had ectopic pregnancy. Of the 78 patients with adnexal mass torsion, 49 cases (62.8%, 49/78）underwent ovary-preserving surgery, and 24 cases (30.8%，24/78）underwent adnexectomy. The most common pathologic types of adnexal torsion were mature teratoma cysts and simple cysts, accounting for 29% and 26%, respectively.Conclusions: Adnexal masses combined with abdominal pain in pediatric and adolescent patients, especially for patients presented as acute pain which characterized by emergency pain onset, persistent pain that cannot be relieved or recurrent pain，should be considered due to the possibility of adnexal mass combined with acute complications, and emergency surgery should be performed immediately. For patients with suspected malignant lesions, a comprehensive evaluation of the lesions should be conducted preoperatively to select the appropriate surgical method and strategy. After the discovery of an adnexal mass, evaluation should be performed quickly, and long-term management should be implemented.

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Section: Discussionmentioning

confidence: 99%

The Clinicopathological Features And Surgical Procedure of Adnexal Mass With Abdominal Pain In Pediatric And Adolescent Patients

Liu

Zhou

Cao

et al. 2021

Preprint

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“…It is considered that cysts larger than 5 cm not diminishing for a period of 3 months and not undergoing conservative treatment should be eligible for surgery in children. As mentioned above, a persistent large ovarian cyst increases the risk of its torsion, and can also have a destructive effect on the remaining ovarian parenchyma, disrupting its hormonal and reproductive function [5,42]. The size of the cyst or tumor at present is not a limitation for laparoscopy and there is no clear answer in the literature as to what size of ovarian cyst should be considered a contraindication for laparoscopic surgery [43].…”

Section: Discussionmentioning

confidence: 99%

“…Despite the availability of increasingly precise imaging methods (ultrasound, CT, MRI), in some cases laparoscopy is an excellent diagnostic tool. Moreover, it allows the diagnostic and therapeutic procedures to be carried out during the same surgical intervention [5].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the usefulness of laparoscopy in the diagnosis and treatment of adnexal pathologies in the pediatric population.

Raźnikiewicz¹,

Korlacki²,

Grabowski³

2020

Videosurgery and Other Miniinvasive Techniques

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Introduction:The current trend in adnexal surgery in children is to minimize the invasiveness of diagnostic and therapeutic procedures, reduce the number of complications and reduce the risk of infertility. Aim: Evaluation of the usefulness and effectiveness of laparoscopy in diagnostics and treatment of pathological lesions of adnexa in the pediatric population and evaluation of the correlation of imaging with the intraoperative diagnosis during laparoscopy. Material and methods: The study included 89 patients aged 0-18 years (mean: 12.62) who underwent an emergency or elective laparoscopic procedure due to the suspicion of adnexa pathology in the imaging tests or in which intraoperative pathology of the adnexa was found without previous suspicion of these changes in the imaging tests. Patients were divided into 2 groups according to the procedure (emergency or elective) and into 4 age groups. Results: The most frequent postoperative diagnosis was an adnexal cyst and ovarian tumor. The ratio of malignant to benign lesions was 0.087. In 32.58% of patients appendix pathology was found. Coexistence of adnexa and appendix pathology was statistically significantly more frequent in patients undergoing emergency surgery (p = 0.013). There was no correlation between the size of the tumor or ovarian cyst and the occurrence of adnexal torsion, and no correlation between the size of the tumor and the degree of torsion of the adnexa. Three conversions were performed. The average operation time was 63.7 min. Conclusions: Laparoscopic diagnosis and treatment of adnexal pathology seems to be safe due to the low percentage of perioperative complications. It shows high sensitivity in recognizing adnexal pathologies and other defects.

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“…Varios procedimientos, como la quistectomía, el drenaje del quiste, la detorsión, la ovariopexia y la ooforectomía, se realizaron con pocas complicaciones, que fueron menores. 13 Desde 2012, realizamos 16 cirugías laparoscópicas y casi todas fueron cirugías conservadoras de los ovarios. El motivo del alto porcentaje de laparotomías fue el poco tiempo transcurrido desde la introducción de la laparoscopía en nuestra institución en el período total del estudio.…”

Section: Discussionunclassified

¿Sirven los hallazgos prequirúrgicos para interpretar las lesiones ováricas neoplásicas y no neoplásicas e influir en las decisiones quirúrgicas en niñas y adolescentes?

2019

Arch Argent Pediat

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Laparoscopic Outcomes for Pelvic Pathology in Children and Adolescents among Patients Presenting to the Pediatric and Adolescent Gynecology Service

Cited by 12 publications

References 20 publications

The Clinicopathological Features And Surgical Procedure of Adnexal Mass With Abdominal Pain In Pediatric And Adolescent Patients

The Clinicopathological Features And Surgical Procedure of Adnexal Mass With Abdominal Pain In Pediatric And Adolescent Patients

Evaluation of the usefulness of laparoscopy in the diagnosis and treatment of adnexal pathologies in the pediatric population.

¿Sirven los hallazgos prequirúrgicos para interpretar las lesiones ováricas neoplásicas y no neoplásicas e influir en las decisiones quirúrgicas en niñas y adolescentes?

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