Abstract

Ovarian cysts in childhood are not only clinically and histopathologically different from adults but they also have different surgical treatments. In this study, we aimed to present the clinical features and surgical methods in patients with ovarian cysts who were managed laparoscopically.

The clinical records of the patients who were diagnosed as ovarian cyst, and managed laparoscopically between January 2010 and April 2018 were reviewed retrospectively. Demographic data, clinical and imaging features, surgical findings and procedures, pathologic features, complications, and outcomes were retrospectively evaluated. Since they had different etiologies, and clinical characteristics, the patients were evaluated separately in preadolescent, and adolescent age groups.

Thirty six laparoscopic procedures were performed for a total of 36 patients with the indication of ovarian cyst (median age of the patients was 12.4 years. The main complaints of the cases were restlessness and abdominal pain at early ages, and acute abdominal pain and/or recurrent pelvic pain in adolescents. The most frequent surgical indication in preadolescent patients was the risk of torsion, on the other hand it was acute abdominal pain in puberty. Laparoscopy was performed in patients by three-port technique and ovarysparing surgery was aimed. The laparoscopic procedures applied included drilling and fenestration (n=13), cystectomy (n=15), detorsion (n=6) and salpingo-ophorectomy (n=2), and detorsion (n=5). In preadolescents most frequently cyst detorsion was performed, whereas cyst excision was the most frequently applied procedure in other groups. Average postoperative length of hospital stay was 3 days (range: 1 to 4 days). Histopatologically most often follicular cyst was detected in preadolescents, and hemorrhagic cyst was most frequently observed in adolescentS. Surgical complications or loss of ovary were not seen in our patients.

Ovarian cysts are frequently encountered in children, and, especially in adolescents. The management of the cysts described in adults has begun to be well standardized also in children.