Laparoscopic Outcomes of Adnexal Surgery in Older Children and Adolescents

To evaluate the outcomes of laparoscopic surgery for the treatment of adnexal pathology in older children and adolescents.

A retrospective cohort review.

A tertiary academic center in Istanbul, Turkey.

Pediatric and adolescent patients aged between 9 and 19 years (n = 69) who underwent laparoscopic surgery for adnexal pathology from January 2005 through September 2015. The patients who were pregnant or with non-gynecologic pathology detected during surgery were excluded from the study.

Patients were divided into 2 groups according to their age. Group 1 consisted of 31 patients aged between 9 and 16 years and group 2 included 38 patients aged between 17 and 19 years.

The indication for surgery, procedures performed, anesthesia time, length of hospital stay, pathology findings, and complication rates were evaluated.

Ovarian cystectomy and adnexal detorsion with or without cystectomy were the most frequently performed. Ovary-sparing conservative surgery was possible for all patients, except those with gonadal dysgenesis and testicular feminization (n = 6), who underwent laparoscopic gonadectomy. The most common pathologic finding was mature cystic teratoma (30.2%), followed by benign paratubal cyst, and simple cysts of the ovary. Anesthesia time was shorter in group 2 (P = .018). The procedures performed, length of hospital stay, complication rate, and pathology findings were not significantly different between the 2 groups.

Laparoscopic surgery can be successfully performed as an efficient, safe, and well tolerated procedure for treating a wide variety of adnexal pathology among children and young adolescents without any significant variation between different age groups.