WOFAPS 2025 8th World Congress of Pediatric Surgery

Ayoung Kang, Soo-Hong Kim

Division of Pediatric Surgery, Pusan National University Children's Hospital, Korea

Purpose

Ovarian lesions requiring surgery are relatively uncommon in pediatric patients. Their diverse clinical and pathological features often make diagnosis challenging. This study aimed to identify age group–specific risk factors for oophorectomy in pediatric ovarian surgery.

Method

We retrospectively reviewed patients aged 0–18 years who underwent ovarian surgery at our center from 2008 to 2024. Patients were categorized into three age groups: Group 1 (≤12 months), Group 2 (<12 years or premenarcheal), and Group 3 (>12 years or postmenarcheal). Clinical and surgical features were compared across groups.

Results

Among 116 patients, 65 (56.0%) underwent ovary-sparing surgery and 51 (44.0%) underwent oophorectomy. Ovary-sparing rates increased with age: 33.3% in Group 1, 49.1% in Group 2, and 76.6% in Group 3 (p = 0.001). In Group 1, although 83.3% had simple cysts, ovary preservation was lowest. Torsion occurred in 50.0% of cases. In Group 2, germ cell tumors were most common (81.8%), and 8 of 10 borderline or malignant tumors were found in this group, all requiring oophorectomy. Torsion occurred in 52.6% and was significantly associated with lower ovary preservation (p = 0.006). In Group 3, ovary-sparing surgery was most frequent (76.6%), with more diverse pathology and predominantly benign lesions. When all groups were analyzed together, younger age, ovarian torsion, malignant pathology, and larger tumor size were significantly associated with increased likelihood of oophorectomy.

Conclusion

The likelihood of oophorectomy in pediatric patients with ovarian lesions is strongly influenced by age-specific factors. Tailored surgical planning considering age, pathology, and torsion risk is essential to optimize ovary preservation.