Highlights
- •Oophorectomy and ovarian detorsion are common operations performed in the female pediatric population. Few studies have directly compared outcomes after laparoscopic and open approaches in the pediatric population.
- •Despite fewer overall complications and readmissions, decreased cost, and shorter length of stay, laparoscopic approaches are underutilized for pediatric ovarian procedures.
Summary
Purpose
Oophorectomy and ovarian detorsion are some of the most frequent operations performed
in the female pediatric population. Despite the advent of laparoscopy, many surgeons
continue to utilize open surgical approaches in these patients. This study sought
to compare nationwide trends and postoperative outcomes in laparoscopic and open ovarian
operations in the pediatric population.
Methods
Females less than 21 years old who underwent ovarian operations (oophorectomy, detorsion,
and/or drainage) from 2016-2017 were identified from the Nationwide Readmissions Database.
Patients were stratified by surgical approach (laparoscopic or open). Hospital characteristics
and outcomes were compared using standard statistical tests.
Results
There were 13,202 females (age 17 [14-20] years) underwent open (59%) or laparoscopic
(41%) ovarian operations. The most common indications for surgery were ovarian mass
(48%), cyst (36%), and/or torsion (19%) for which oophorectomy (88%), detorsion (26%),
and drainage (13%) were performed most frequently. The open approach was utilized
more frequently for oophorectomy (95% vs. 77% laparoscopic) and detorsion (33% vs.
16% laparoscopic), both p<0.001. A greater proportion of laparoscopic procedures were
performed at large (67% vs. 61% open), teaching (82% vs. 76% open) hospitals in patients
with private insurance (47% vs. 42% open), all p<0.001. Patients undergoing open procedures
had significantly higher index length of stay (LOS) and rates of wound infections.
Thirty-day and overall readmission rates, as well as overall readmission costs, were
higher in patients who received open surgeries.
Conclusions
Despite fewer overall complications, decreased cost, fewer readmissions, and shorter
LOS, laparoscopic approaches are underutilized for pediatric ovarian procedures.
Type of Study
Retrospective Comparative.
Level of Evidence
Level III.
Keywords
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Article info
Publication history
Accepted:
January 2,
2023
Received:
December 15,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
