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¿Sirven los hallazgos prequirúrgicos para interpretar las lesiones ováricas neoplásicas y no neoplásicas e influir en las decisiones quirúrgicas en niñas y adolescentes? / Can preoperative findings help to interpret neoplastic and non-neoplastic lesions of ovary and affect surgical decisions in children and adolescents?
User, Idil R; Karakus, Süleyman C; Özokutan, Bülent H; Akçaer, Vedat; Burulday, Bayram; Ceylan, Haluk.
  • User, Idil R; Gaziantep Üniversitesi. Facultad de Medicina. Departamento de Cirugía Pediátrica. Gaziantep. TR
  • Karakus, Süleyman C; Gaziantep Üniversitesi. Facultad de Medicina. Departamento de Cirugía Pediátrica. Gaziantep. TR
  • Özokutan, Bülent H; Gaziantep Üniversitesi. Facultad de Medicina. Departamento de Cirugía Pediátrica. Gaziantep. TR
  • Akçaer, Vedat; Gaziantep Üniversitesi. Facultad de Medicina. Departamento de Cirugía Pediátrica. Gaziantep. TR
  • Burulday, Bayram; Gaziantep Üniversitesi. Facultad de Medicina. Departamento de Cirugía Pediátrica. Gaziantep. TR
  • Ceylan, Haluk; Gaziantep Üniversitesi. Facultad de Medicina. Departamento de Cirugía Pediátrica. Gaziantep. TR
Arch. argent. pediatr ; 117(5): 294-300, oct. 2019. ilus, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1054955
RESUMEN
Antecedentes. Las masas ováricas son frecuentes en la población pediátrica. Suele realizarse cirugía conservadora de los ovarios porque la mayoría son quistes benignos o funcionales. Objetivo. Investigar quéhallazgos prequirúrgicos sirven para diferenciar la patología de las lesiones ováricas, influir en las decisiones quirúrgicas y predecir la posibilidad de conservar los ovarios. Método. Se incluyeron pacientes operadas con diagnóstico de masa ovárica. Revisión retrospectiva de edad, síntomas, examen físico, marcadores tumorales, características radiológicas y resultados anatomopatológicos. Resultados. Durante el estudio, se operaron 98 pacientes y se incluyeron 86. Media de edad 9,7 ± 5,62 años. Las patologías no neoplásicas representaron el 68,6 %, las neoplásicas, el 31,4 %, la tasa de malignidad, el 4,6 %. Las neoplasias incluyeron componente sólido, ausencia de torsión ovárica y diámetro >9 cm (p < 0,001;p < 0,001; p = 0,001).Se halló torsión anexial en el 34,9 %. El diámetro medio no difirió significativamente entre los grupos con o sin torsión; la incidencia de torsión fue mayor en las masas <6 cm (p = 0,019). Se realizó cirugía conservadora de los ovarios en 48 pacientes (55,8 %) y ooforectomía, en 38 (44,2 %). El tratamiento dependió de la naturaleza (p < 0,001) y del tamaño (p < 0,001) de la lesión pero no de la edad y la torsión. Conclusión. Una masa puramente quística <9 cm, con torsión y marcadores negativos indica masa no neoplásica. La presencia de un componente sólido y la ausencia de torsión están asociadas con riesgo de cáncer.
ABSTRACT

Background:

Ovarian masses are common in all pediatric age groups. Ovarian-sparing surgery is favored since most cases are benign or functional cysts. Detection of a few malignant cases prevents morbidity and mortality.

Objective:

to investigate which of the preoperative findings can help to distinguish the pathology of the ovarian lesions, affect the surgical decision and predict the possibility of ovarian preservation.

Method:

Patients operated with diagnosis of ovarian mass were enrolled in the study between 2000-2015. Age, symptoms, physical examination findings, tumor markers, radiologic features, operative notes, and pathology results were reviewed retrospectively.

Results:

During the study period, 98 patients were operated and 86 were included. Mean age was 9.7±5.62 years. Non-neoplastic pathologies constitute 68.6 % of cases; 31.4 % was neoplastic. Malignancy rate was 4.6 %. Solid component, absence of ovarian torsion and diameter >9 cm were more commonly seen in neoplastic cases (p<0.001, p<0.001, p=0.001). Adnexal torsion was found in 30 (34.9 %) patients. Mean diameter did not differ significantly between groups with or without torsion; incidence of torsion was greater in patients with masses <6 cm (p=0.019). Ovarian-sparing surgery was performed in 48 (55.8 %) and oopherectomy in 38 (44.2 %) patients. Surgical approach was affected by nature (p<0.001) and size (p<0.001) of the lesion; it was independent of age and presence of torsion.

Conclusion:

A purely cystic mass <9 cm, with torsion and negative markers, orients towards a non-neoplastic mass. The presence of solid component and absence of torsion are associated with increased risk of malignancy.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Ovary / General Surgery / Adolescent / Conservative Treatment / Genitalia Type of study: Diagnostic study / Prognostic study Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Infant, Newborn Language: English / Spanish Journal: Arch. argent. pediatr Journal subject: Pediatrics Year: 2019 Type: Article Affiliation country: Turkey Institution/Affiliation country: Gaziantep Üniversitesi/TR

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Full text: Available Index: LILACS (Americas) Main subject: Ovary / General Surgery / Adolescent / Conservative Treatment / Genitalia Type of study: Diagnostic study / Prognostic study Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Infant, Newborn Language: English / Spanish Journal: Arch. argent. pediatr Journal subject: Pediatrics Year: 2019 Type: Article Affiliation country: Turkey Institution/Affiliation country: Gaziantep Üniversitesi/TR