Treatment of Ovarian Lesions in Children and Adolescents: A Retrospective Study of 130 Cases
Treatment of Ovarian Lesions in Children and Adolescents: A Retrospective Study of 130 Cases
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DOI：
10.3109/08880018.2013.856050
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发表时间：
2015-04-01
影响因子：
1.7
通讯作者：
Messineo, Antonio
中科院分区：
文献类型：
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作者：
Spinelli, Claudio;Pucci, Valentina;Messineo, Antonio
在这项研究中，我们分析了130名儿童手术治疗的137个卵巢病变（7个双侧）的卵巢肿块的管理。最常见的症状是慢性腹痛（52.3%）和急性腹痛（25.4%）。组织学检查显示功能性病变64例（46.7%），良性肿瘤59例（43.1%），恶性肿瘤5例（3.7%），正常卵巢扭转7例（6.6%）。卵巢扭转36例（26.27%）。81例（59.1%）女孩接受保守治疗：61例（75.3%）在非急诊治疗，20例（24.7%）在急诊手术治疗; 35例（43.2%）采用腹腔镜手术; 46例（56.8%）采用开放手术。其余56例（40.9%）卵巢肿块行非保守性手术，其中非急诊手术40例（71.4%），急诊手术16例（28.6%），腹腔镜手术20例（35.7%），开放手术36例（64.3%）。保留生育能力应是手术治疗的目标。卵巢扭转的处理应包括附件复位和卵巢组织的恢复。对于良性肿瘤，腹腔镜肿瘤切除术应该是金标准;对于早期恶性肿瘤，保留生育能力的手术和准确的分期是首选。
In this study, we analyze the management of ovarian masses in a total of 130 children surgically treated for 137 ovarian lesions (7 bilateral). The most frequent symptoms were chronic (52.3%) and acute (25.4%) abdominal pain. Histological examination revealed 64(46.7%) functional lesions,59 (43.1%) benign neoplasms, 5 (3.7%) malignant ones, and 7 (6.6%) torsed normal ovaries. Ovarian torsion occurred in 36 cases (26.27%). A conservative treatment was performed in 81 (59.1%) girls: 61 (75.3%) treated in nonemergency and 20(24.7%) in emergency surgery; laparoscopic approach in 35 cases (43.2%); and open surgery in 46(56.8%). The remaining 56(40.9%) ovarian masses underwent nonconservative surgery: 40 cases (71.4%) nonemergency and 16 (28.6%) emergency; laparoscopy in 20 patients (35.7%); and open surgery in 36 (64.3%). Fertility preservation should be a goal in the surgical treatment. The management of ovarian torsion should include adnexal detorsion and recovery of the ovarian tissue. In case of benign neoplasms, laparoscopic tumorectomy should be the gold standard; in early stage malignant tumors, fertility-sparing surgery with accurate staging is preferred.