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小児患者の良性卵巣新生体に対する不必要な卵巣摘出の減少

Peter C Minneci ^1,2, Katherine C Bergus ¹, Carley Lutz ¹

¹Center for Surgical Outcomes Research, Abigail Wexner Research Institute and Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus.
²Now with Department of Surgery, Nemours Children's Hospital-Delaware Valley, Nemours Children's Health, Wilmington, Delaware.
³Division of Pediatric Surgery, Department of Surgery, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee.
⁴Division of Pediatric Surgery, Department of Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.
⁵Division of Pediatric Surgery, Department of Surgery, St Louis Children's Hospital, Washington University School of Medicine in Saint Louis, St Louis, Missouri.
⁶Division of Pediatric Surgery, Norton Children's Hospital, University of Louisville School of Medicine, Louisville, Kentucky.
⁷Section of Pediatric Surgery, Department of Surgery, C. S. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor.
⁸Division of Pediatric Surgery, Department of Surgery, Children's Mercy Kansas City, University of Missouri Kansas City School of Medicine, Kansas City.
⁹Division of Pediatric Surgery, Department of Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
¹⁰Division of Pediatric Surgery, Department of Surgery, Riley Hospital for Children, Indiana University Health, Indianapolis.
¹¹Division of Pediatric Surgery, Department of Surgery, American Family Children's Hospital, University of Wisconsin School of Medicine and Public Health, Madison.
¹²Section of Pediatric Surgery, Department of Surgery, Comer Children's Hospital, The University of Chicago Medicine, Chicago, Illinois.
¹³Center for Surgical Outcomes Research, Abigail Wexner Research Institute and Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio.
¹⁴Department of Surgery, Nemours Children's Hospital-Delaware Valley, Nemours Children's Health, Wilmington, Delaware.

⁰Center for Surgical Outcomes Research, Abigail Wexner Research Institute and Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus.

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2023年10月3日

PubMedで要約を見る

まとめ

新しいリスク分層アルゴリズムは,良性卵巣群を特定することで,不必要な卵巣摘出を減少させました. このアプローチは,健康な卵巣の摘出に伴う生涯にわたる健康上の影響を防ぐことを目的としています.

科学分野

小児手術
婦人腫瘍学
リスク評価

背景

子供と青年のほとんどの卵巣腫は良性です.
良性腫瘍の卵巣切除は生涯にわたる健康への悪影響をもたらす可能性があります.
不必要な卵巣切除は小児婦人科の懸念事項です.

研究の目的

合意に基づく手術前リスク分層アルゴリズムを評価する.
卵巣の良性病変と悪性病変を区別するアルゴリズムの能力を評価する.
小児患者の不必要な卵巣摘出手術の割合を減らすために

主な方法

介入前の/後の研究は,米国の11の小児病院で実施された.
6歳から21歳までの卵巣群の患者にリスク分層アルゴリズムを適用した.
データは18ヶ月間収集され,介入前と介入段階を分析した.

主要な成果

不必要な卵巣摘出手術の割合は,介入前の16.1%から介入中の8.4%に減少した.
このアルゴリズムは高感度 (91. 6%) と高特異性 (90. 0%) を示した.
卵巣保存手術で治療された悪性疾患の誤分類は低かった (0. 7%).

結論

術前のリスク分層アルゴリズムは,若者の不必要な卵巣摘出を効果的に減少させました.
このアルゴリズムは,卵巣保存手術に適した良性卵巣群を特定するのに役立ちます.
卵巣摘出手術に伴う長期的な健康問題を予防できるでしょう

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