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Laparoscopy versus laparotomy for pediatric ovarian dermoids
Knaus, M. E., Onwuka, A. J., Afrazi, A., Breech, L., Corkum, K. S., Dillon, P. A., Ehrlich, P. F., Fallat, M. E., Fraser, J. D., Gadepalli, S. K., Grabowski, J. E., Hertweck, S. P., Kabre, R., Lal, D. R., Landman, M. P., Lawrence, A. E., Leys, C. M., Mak, G. Z., Markel, T. A., ... Deans, K. J. (2022). Laparoscopy versus laparotomy for pediatric ovarian dermoids. Journal of Pediatric Surgery, 57(6), 1008-1012. https://doi.org/10.1016/j.jpedsurg.2022.01.053
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 la-parotomy (10%). There were no differences in rates of tumor spillage by approach ( p = 0.15). 65% un-derwent 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 con-verted, p < 0.0 0 01). 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.(c) 2022 Elsevier Inc. All rights reserved.