학술논문
Analysis of Ovarian Pathology in Children: Ten-years Experience/Cocuklarda Over Patolojilerinin Analizi: On Yillik Deneyim
ORIGINAL RESEARCH
ORIGINAL RESEARCH
Document Type
Clinical report
Author
Source
Bagcilar Medical Bulletin. June 2023, Vol. 8 Issue 2, p135, 5 p.
Subject
Language
English
ISSN
2547-9431
Abstract
Introduction Ovarian pathologies can be cystic, complex, or solid. Ovarian cysts may be physiological, secondary to polycystic ovarian syndrome or infections. Most neoplasms in puberty or adolescence are benign. Many [...]
Objective: In this study, we aimed to analyze whether laparoscopy is a feasible and safe surgical option for ovarian pathologies in children. Method: Our study included 43 patients who were followed up and treated for ovarian pathology in our clinic between January 1, 2012, and January 1, 2022. The clinical information and data for the patients were reviewed retrospectively. The patients were divided into 2 groups: Laparoscopy and the laparotomy group. Demographic data of the patients, complaints at presentation, localization of the mass, laboratory hormone levels and surgical findings, histopathological diagnoses, treatment methods, and treatment results were evaluated. Results: In the study, 43 female patients with a mean age of 9.6 years (1 month-15 years) were evaluated. It was the most common on the right side (58%). The most common symptom was abdominal pain (70%). Thirteen (30%) patients had acute abdomen findings. For surgical intervention, laparoscopy was performed in 22 (51%) patients and laparotomy was performed in 19 (44%) patients. Unilateral oophorectomy or salpingo-oophorectomy was performed in 28 (65%) of the patients as surgical treatment. Twenty-three (53%) of the ovarian pathologies were neoplastic, and 20 (47%) patients were non-neoplastic. Pathological diagnoses of ovarian pathologies 19 (44%) patients had ovarian torsion and 14 (33%) patients had teratoma. The operation time was shorter in the laparoscopy group (p0.05). While 42 of 43 patients survived, one patient with immature teratoma died from tumor-associated metastasis. Conclusion: Although the majority of ovarian pathologies are benign, since malignant masses may occur, surgery should be performed as early as possible. In lesions that are thought to be benign, ovariansparing surgery should be performed as much as possible. Laparoscopy is a feasible and safe surgical option for ovarian pathologies even, in malignant patients. Keywords: Children, laparoscopy, ovary, pathology Amac: Bu calismada, cocuklarda over patolojilerinde laparoskopinin uygulanabilir ve guvenli bir cerrahi secenek olup olmadigini incelemeyi amacladik. Yontem: Calismamiza 1 Ocak 2012-1 Ocak 2022 tarihleri arasinda klinigimizde over patolojisi nedeniyle takip ve tedavi edilen 43 hasta dahil edildi. Hastalarin klinik bilgileri ve verileri retrospektif olarak incelendi. Hastalar laparoskopi ve acik grup olarak 2 gruba ayrildi. Hastalarin demografik verileri, basvuru yakinmalari, kitlenin lokalizasyonu, laboratuvar hormon duzeyleri ve cerrahi bulgulari, histopatolojik tanilari, tedavi yontemleri ve tedavi sonuclari degerlendirildi. Bulgular: Calismada yas ortalamasi 9,6 (1 ay-15 yas) olan 43 kadin hasta degerlendirildi. En sik sagda (%58) goruldu. En sik semptom karin agrisiydi (%70). On uc (%30) hastada akut karin bulgulari vardi. Cerrahi girisim icin 22 (%51) hastaya laparoskopi ve 19 (%44) hastaya laparotomi uygulandi. Hastalarin 28'ine (%65) cerrahi tedavi olarak unilateral ooferektomi veya salpingo-ooferektomi uygulandi. Over patolojilerinin 23'u (%53) neoplastik, 20 (%47) hasta neoplastik degildi. Over patolojilerinin patolojik tanilari 19 (%44) hastada over torsiyonu, 14 (%33) hastada teratom vardi. Ameliyat suresi laparoskopi grubunda daha kisaydi (p0,05). Kirk uc hastanin 42'si hayatta kalirken, immatur teratomlu bir hasta tumor iliskili metastaz nedeniyle kaybedildi. Sonuc: Over patolojilerinin buyuk cogunlugu benign olmasina ragmen malign kitleler olusabileceginden cerrahi mumkun oldugunca erken yapilmalidir. Iyi huylu oldugu dusunulen lezyonlarda mumkun oldugunca yumurtalik koruyucu cerrahi yapilmalidir. Laparoskopi, malign hastalarda bile over patolojileri icin uygulanabilir ve guvenli bir cerrahi secenektir. Anahtar kelimeler: Cocuklar, laparoskopi, over, patoloji
Objective: In this study, we aimed to analyze whether laparoscopy is a feasible and safe surgical option for ovarian pathologies in children. Method: Our study included 43 patients who were followed up and treated for ovarian pathology in our clinic between January 1, 2012, and January 1, 2022. The clinical information and data for the patients were reviewed retrospectively. The patients were divided into 2 groups: Laparoscopy and the laparotomy group. Demographic data of the patients, complaints at presentation, localization of the mass, laboratory hormone levels and surgical findings, histopathological diagnoses, treatment methods, and treatment results were evaluated. Results: In the study, 43 female patients with a mean age of 9.6 years (1 month-15 years) were evaluated. It was the most common on the right side (58%). The most common symptom was abdominal pain (70%). Thirteen (30%) patients had acute abdomen findings. For surgical intervention, laparoscopy was performed in 22 (51%) patients and laparotomy was performed in 19 (44%) patients. Unilateral oophorectomy or salpingo-oophorectomy was performed in 28 (65%) of the patients as surgical treatment. Twenty-three (53%) of the ovarian pathologies were neoplastic, and 20 (47%) patients were non-neoplastic. Pathological diagnoses of ovarian pathologies 19 (44%) patients had ovarian torsion and 14 (33%) patients had teratoma. The operation time was shorter in the laparoscopy group (p0.05). While 42 of 43 patients survived, one patient with immature teratoma died from tumor-associated metastasis. Conclusion: Although the majority of ovarian pathologies are benign, since malignant masses may occur, surgery should be performed as early as possible. In lesions that are thought to be benign, ovariansparing surgery should be performed as much as possible. Laparoscopy is a feasible and safe surgical option for ovarian pathologies even, in malignant patients. Keywords: Children, laparoscopy, ovary, pathology Amac: Bu calismada, cocuklarda over patolojilerinde laparoskopinin uygulanabilir ve guvenli bir cerrahi secenek olup olmadigini incelemeyi amacladik. Yontem: Calismamiza 1 Ocak 2012-1 Ocak 2022 tarihleri arasinda klinigimizde over patolojisi nedeniyle takip ve tedavi edilen 43 hasta dahil edildi. Hastalarin klinik bilgileri ve verileri retrospektif olarak incelendi. Hastalar laparoskopi ve acik grup olarak 2 gruba ayrildi. Hastalarin demografik verileri, basvuru yakinmalari, kitlenin lokalizasyonu, laboratuvar hormon duzeyleri ve cerrahi bulgulari, histopatolojik tanilari, tedavi yontemleri ve tedavi sonuclari degerlendirildi. Bulgular: Calismada yas ortalamasi 9,6 (1 ay-15 yas) olan 43 kadin hasta degerlendirildi. En sik sagda (%58) goruldu. En sik semptom karin agrisiydi (%70). On uc (%30) hastada akut karin bulgulari vardi. Cerrahi girisim icin 22 (%51) hastaya laparoskopi ve 19 (%44) hastaya laparotomi uygulandi. Hastalarin 28'ine (%65) cerrahi tedavi olarak unilateral ooferektomi veya salpingo-ooferektomi uygulandi. Over patolojilerinin 23'u (%53) neoplastik, 20 (%47) hasta neoplastik degildi. Over patolojilerinin patolojik tanilari 19 (%44) hastada over torsiyonu, 14 (%33) hastada teratom vardi. Ameliyat suresi laparoskopi grubunda daha kisaydi (p0,05). Kirk uc hastanin 42'si hayatta kalirken, immatur teratomlu bir hasta tumor iliskili metastaz nedeniyle kaybedildi. Sonuc: Over patolojilerinin buyuk cogunlugu benign olmasina ragmen malign kitleler olusabileceginden cerrahi mumkun oldugunca erken yapilmalidir. Iyi huylu oldugu dusunulen lezyonlarda mumkun oldugunca yumurtalik koruyucu cerrahi yapilmalidir. Laparoskopi, malign hastalarda bile over patolojileri icin uygulanabilir ve guvenli bir cerrahi secenektir. Anahtar kelimeler: Cocuklar, laparoskopi, over, patoloji