Laparoscopic Surgery is an Acceptable Alternative to Laparotomy for Pediatric Ovarian Dermoid Cysts

Published June 2022 | Journal of Pediatric Surgery

As surgeons have become more comfortable with laparoscopic surgery, these less-invasive procedures have become the standard for the treatment of many conditions. Many ovarian dermoid cysts are removed via more-invasive laparotomy procedures, but laparoscopic surgery is a safe and effective alternative for many children with ovarian dermoid cysts, according to research conducted by Lesley Breech, MD, director, Division of Pediatric and Adolescent Gynecology, and her colleagues.

This study relied on a review of 466 patients aged 2 to 21 who underwent ovarian dermoid resection over 10 years. Of these patients, 60% underwent laparoscopy, 30% laparotomy, and 10% laparoscopy converted to laparotomy.

In terms of efficacy, there were no differences between the two procedures in rates of tumor spillage. Importantly, especially for the pediatric population, those patients under-going laparoscopy had a one-day hospital stay compared to two for laparotomy.

The study ultimately concluded that patients who underwent laparoscopy rather than laparotomy had no differences in tumor spillage, recurrence, or the need for reoperation. Moreover, these patients had a shorter hospital stay compared to laparotomy. As a result, a less-invasive laparoscopy is an acceptable approach for the resection of pediatric ovarian dermoid cysts.

“These results seem to demonstrate that pediatric and adolescent patients, like adults, benefit from the use of a minimally invasive approach to the resection of ovarian dermoid lesions,” Breech says. “This paper validates the role of laparoscopy for this indication in this population, getting both kids and parents back to routine activities sooner.”

Citation

Knaus ME, Onwuka AJ, Afrazi A, Breech L, Corkum KS, Dillon PA, Ehrlich PF, Fallat ME, Fraser JD, Gadepalli SK, Grabowski JE, Hertweck SP, Kabre R, Lal DR, Landman MP, Lawrence AE, Leys CM, Mak GZ, Markel TA, Merchant N, Elliott Overman R, Rademacher BL, Raiji MT, Rymeski B, Sato TT, Scannell M, Schikler AG, Sujka JA, Wright T, Aldrink JH, Hewitt GD, Minneci PC, Deans KJ; Midwest Pediatric Surgery Consortium. Laparoscopy versus laparotomy for pediatric ovarian dermoids. J Pediatr Surg. 2022 Jun;57(6):1008-1012.