Laparoscopy versus laparotomy for pediatric ovarian dermoids.

Area of Science:

• Pediatric Surgery
• Gynecologic Oncology
• Minimally Invasive Surgery

Background:

• Ovarian dermoid cysts are common in pediatric patients.
• Laparotomy has been the traditional surgical approach.
• Increasing surgeon proficiency with laparoscopy prompts reevaluation of surgical methods.

Purpose of the Study:

• To compare laparoscopic versus laparotomy approaches for pediatric ovarian dermoid resection.
• To assess differences in length of stay, morbidity, and recurrence rates.

Main Methods:

• Retrospective review of 466 pediatric patients (ages 2-21) undergoing ovarian dermoid resection across eleven hospitals (2010-2020).
• Comparison of outcomes between laparoscopic, laparotomy, and converted procedures.
• Statistical analysis using Chi-squared and Wilcoxon-Mann tests.

Main Results:

• Laparoscopic surgery was performed in 60% of cases.
• Significantly shorter length of stay for laparoscopy (1 day) versus laparotomy (2 days) (p<0.0001).
• No significant differences in tumor spillage (p=0.15), recurrence (p=0.19), or reoperation rates (p=0.57) between approaches.

Conclusions:

• Laparoscopy is a safe and effective surgical approach for pediatric ovarian dermoid resection.
• It leads to reduced hospital stays without compromising oncologic or surgical outcomes.
• Laparoscopy is an acceptable alternative to laparotomy for these tumors.