WOFAPS 2025 8th World Congress of Pediatric Surgery

Aziz Mseddi, Yosra Ben Ahmed, Rim Ezzine, Mariem Marzouki, Faouzi Nouira, Said Jlidi

Children Hospital Bechir Hamza, Pediatric surgery department B. Tunis, Tunisia

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Introduction

Ovarian masses in pediatric population are the most common genital neoplasms. The treatment often involves surgical intervention. Both laparoscopy and laparotomy are commonly employed, each with distinct advantages and limits.

Aim

To compare the indications, clinical outcomes, complications, and recovery times rates between laparoscopic and open approaches in the surgical management of ovarian masses in children.

Methods

A monocentric retrospective study was conducted on children diagnosed with ovarian masses who underwent surgical intervention from 2008 to 2023. Data on demographics, surgical duration, postoperative recovery, and complications were collected and analyzed.

Results

Thirty-one patients with a mean age at diagnosis of 7.5 years (2 years- 13 years) were studied. In 58.1% [n=18] of our cases, the primary presenting symptom was acute abdominal pain, in 22.6% [n=7], it was chronic abdominal pain or abdominal/pelvic discomfort and in 38.7% [n=12] a palpable mass.The ultrasonographic appearance of the mass was complex in 51.6% [n=16] of the cases. Serum levels of tumoral markers were tested in 25 cases and resulted elevated in one of them. All patients underwent surgery: 45.2% [n=14] had oophorectomies and 54.8% [n=17] had ab ovary sparing surgeries. Laparotomy access was performed in 67.7% [n=21]. Ten patients were conducted via laparoscopy.

The mean size of the mass was 9.3 cm for the open surgery group vs 6cm for the laparoscopy group, measured by ultrasonography pre-operatively.

The average operating time was longer for the laparoscopy group [87.2min vs 128.3min, p<0.001 but the duration of hospital stay after surgery was shorter [4.69days vs 3.2 days] and the need for analgesic medication was lower [2.92 days vs 1.6 days].

Conclusion

Both laparoscopy and laparotomy are possible options for the management of ovarian masses in children. The seize of the ovarian mass remains the most decisive factor in choosing one technique over another.