Morphological study of the residual ovarian tissue removed by laparoscopy or laparotomy in adolescents with benign ovarian cysts.

BACKGROUND/PURPOSE: The stripping of benign ovarian cysts has been reported to be preferable to cyst wall ablation. The procedure can be performed via either an open or laparoscopic approach. The aim of our study was to evaluate the efficacy of the technique of stripping performed by laparoscopy and laparotomy in the treatment of benign ovarian masses in the pediatric age group with respect to healthy ovarian tissue. METHODS: This retrospective study evaluated all the pediatric or adolescent patients admitted during a 5-year period (2006-2010) for a suspected benign ovarian cyst treated with a laparoscopic technique or traditional open surgery to remove the cyst. The morphological characteristics of the tissue were graded on a semiquantitative scale from 0 to 4. RESULTS: Thirty patients were treated and divided in 2 groups: group A laparoscopy (18 patients) and group B open (12 patients). The median age was 9.1 years. No ovarian tissue could be observed in 26 cases (86.7%). In the 4 remaining (2 laparoscopic and 2 open) cases (13.3%), ovarian tissue was found, but never more than 1 mm in thickness. This finding was always in endometriotic cysts. CONCLUSIONS: We demonstrated that, in the pediatric population, no ovarian tissue is removed together with the cyst if this is nonendometriotic. The type of surgical procedure does not influence the removal of ovarian tissue. Laparoscopic stripping of ovarian cysts is the preferable surgical procedure in patients with prospective potential fertility because of their young age.