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Is the stripping technique a tissue-sparing procedure in large simple ovarian cysts in children?
Francesco Arena1, Carmelo Romeo, Marco Castagnetti
1Department of Medical and Surgical Pediatric Sciences-Unit of Minimally Invasive Pediatric Surgery, University of Messina, 98125 Messina, Italy.
Insights
The stripping technique for large ovarian cysts spares adjacent ovarian tissue in children. This gynecological procedure is tissue-sparing, even in young patients, preserving ovarian function.
Area of Science:
- Gynecologic Surgery
- Pediatric Surgery
- Pathology
Background:
- Large ovarian cysts are treated by stripping the cystic wall, a common gynecological procedure.
- Limited data exists on the efficacy of this technique in pediatric patients.
- This study prospectively evaluates the tissue-sparing nature of cyst wall stripping in children.
Purpose of the Study:
- To determine if the stripping technique for large ovarian cyst excision is tissue-sparing in pediatric patients.
- To assess the amount of normal ovarian tissue preserved during the procedure in this age group.
Main Methods:
- Prospective evaluation of 5 pediatric patients undergoing large ovarian cyst excision.
- Pathologic analysis of cystic wall specimens, including adjacent layers.
- Assessment of ovarian tissue presence and morphology.
- Pelvic ultrasound follow-up to confirm ovarian tissue integrity.
Main Results:
- Mean patient age was 4.5 years; all symptomatic cysts were removed.
- Mean cyst diameter was 86.6 mm; types included follicular, serous, and endometriotic.
- Adjacent ovarian tissue (1-2 mm thick) was present in one specimen.
- Pathology confirmed normal ovarian tissue adjacent to the cyst wall in all cases.
- Ultrasound follow-up demonstrated the presence of ovarian tissue.
Conclusions:
- The stripping procedure for large ovarian cyst excision effectively spares adjacent normal ovarian tissue in pediatric patients.
- Ovarian tissue is rarely excised with the cyst wall during this procedure in children.
- This technique is considered safe and tissue-sparing for pediatric ovarian cyst management.
Background:
Stripping of the cystic wall is performed by gynecologists to treat large ovarian cysts. Information in the pediatric population is poor. We prospectively evaluated the pathologic specimens of large ovarian cyst to determine whether the stripping technique is a tissue-sparing procedure even in this age.
Methods:
We evaluated 5 patients. Samples were taken from the intermediate part of the cystic wall and from the layer covering the cyst during excision. The presence of ovarian tissue adjacent to the cyst wall, and the morphological features of the surrounding tissue were both evaluated. Pelvic ultrasound follow-up was also performed.
Results:
Patients' mean age was 4.5 years (7 days to 12 years). All cysts were removed because all were symptomatic. The mean diameter was 86.6 mm (74-100 mm). Cysts were follicular in 2 cases, serous in other two, and endometriotic in 1 case. Adjacent ovarian tissue was present in 1 of 5 specimens and was approximately 1 to 2 mm in thickness. The layer adjacent to the cystic wall always appeared as normal ovarian tissue. Ultrasound scans at follow-up revealed presence of ovarian tissue.
Conclusion:
The stripping procedure for large ovarian cyst excision allows to spare the adjacent normal ovarian tissue even in pediatric age because ovarian tissue is rarely excised with the cyst wall during the procedure.
