Laparoscopy versus laparotomy for surgical management of ovarian dermoid cysts in children: a systematic review and meta-analysis

Nicole Smith ¹, Justin Wei-Jia Lim ², Carolyn Ziegler ³

⁰Temerty Faculty of Medicine, University of Toronto.

Journal of Pediatric and Adolescent Gynecology +

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November 26, 2025

View abstract on PubMed

Summary

Laparoscopic ovarian dermoid cyst surgery in pediatric patients shows a higher risk of intraoperative rupture compared to laparotomy. However, recurrence rates and peritonitis were similar between both surgical approaches.

Area Of Science

Gynecologic Surgery
Pediatric Surgery
Oncology

Background

Ovarian dermoid cysts are common germ cell tumors in pediatric and adolescent females.
Surgical management aims to remove the cyst while preserving ovarian function.
Laparoscopy and laparotomy are the primary surgical approaches, each with potential benefits and risks.

Purpose Of The Study

To compare intraoperative cyst rupture, peritonitis, and cyst recurrence rates between laparoscopic and laparotomy approaches for ovarian dermoid cyst surgery in pediatric and adolescent patients.

Main Methods

A systematic review and meta-analysis adhering to PRISMA guidelines and Cochrane Handbook.
Searched five bibliographic databases and three clinical trial registries from inception to August 29, 2024.
Included quasi-/randomized trials and prospective/retrospective cohort studies comparing laparoscopy versus laparotomy for ovarian dermoid surgery.

Main Results

Included 6 studies with 893 patients (laparoscopy: 53.9%, laparotomy: 39.5%, converted: 6.6%).
Meta-analysis revealed a significantly higher risk of intraoperative cyst rupture with laparoscopy (RR 2.47, 95%CI 1.40-4.37).
No significant difference in cyst recurrence (RR 0.92, 95%CI 0.41-2.08) or observed cases of chemical peritonitis.

Conclusions

Laparoscopy for pediatric ovarian dermoid cysts may increase the risk of intraoperative rupture compared to laparotomy.
Post-operative peritonitis was not clinically observed, and recurrence rates were similar between the two surgical methods.

Keywords:

Dermoid Cyst Laparoscopy Laparotomy Ovarian Surgery Ovarian Teratoma