Laparoendoscopic single-site surgery for ovarian mature teratomas in children and adolescents: a retrospective cohort study.
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BACKGROUND: Ovarian mature teratoma (OMT) is a common benign gynecological tumor, with surgical resection being the primary treatment. Laparoendoscopic single-site surgery (LESS) has been widely used in various surgical procedures due to its advantages of minimal invasiveness and faster recovery. However, there is limited research on LESS for OMT in adolescents. This study aims to evaluate the safety and efficacy of LESS in children and adolescents aged 18 years or younger. METHODS: Patients who underwent LESS cystectomy or laparotomic cystectomy in West China Second Hospital, Sichuan University, from 01/01/2019 to 31/12/2023, were enrolled in this retrospective cohort study. They were divided into LESS group and open surgery group based on the surgical approaches. We collected surgical conditions, postoperative conditions and complications to evaluate the safety and efficacy. Patients were followed up one month and one year after surgery by phone-call and recurrence was recorded. A t-test or chi-square test was performed according to the data type characteristics. RESULTS: We included 169 pediatric and adolescent girls (151 LESS cases and 18 open cases) in this study. The average age, body mass index, and menstrual history were not statistically different (P=0.84, 0.93, 0.93, retrospectively). Compared with open group, the tumors in LESS group were smaller and the difference was statistically significant (6.5±0.2 vs. 18.9±1.0 cm, P<0.001). The surgical outcomes and recovery in LESS group were better and difference was statistically significant (surgical duration, P<0.001; estimated blood loss, P=0.02; complications, P<0.001; exhaust time, P<0.001; hospital stays, P<0.001). CONCLUSIONS: LESS is a safe and effective method for female children and adolescents with OMT. A tumor diameter <15 cm may serve as one of the factors favoring LESS, but the final surgical approach should be determined through comprehensive consideration of tumor characteristics, the patient's general condition, and fertility requirements.