Comparison of the Surgical Treatment of Adnexal Masses in Pediatric and Adolescent Patients by Gynecologic Surgeons versus Pediatric Surgeons, a Systematic Review.

Background: Adnexal masses in pediatric patients are an uncommon pathology, and treatment often raises the question of whether Gynecologic surgeons (those graduating OBGYN residencies and associated fellowships) or Pediatric and general surgeons (those graduating general surgery or other non-obgyn residencies and fellowships) are better suited to perform the procedure. Aim: To compare gynecologic surgeons and pediatric surgeons regarding the surgical management of ovarian lesions, whether through laparotomy or laparoscopic procedures. Methods: We searched all major databases for relative studies. Results: We found that gynecologic surgeons had lower complication rates (mean 9.5% vs 14.9%) and recurrence rates (mean 10.7% vs 10.8% for laparoscopic) than pediatric surgeons. Additionally, gynecologic surgeons performed more ovarian-sparing surgeries (90% vs 55%) and had fewer laparoscopies converted to laparotomies (mean 8% vs 48%). Hospital stay was shorter with gynecologic surgeons (mean 1.9 days vs 2.1 days). The incidence of accidental tumor spillage was also higher among pediatric and general surgeons than it was with the gynecologic surgeons. Conclusion: Gynecologic surgeons may be associated with better outcomes compared to pediatric surgeons in the surgical management of pediatric and adolescent female patients with ovarian masses. Limitations include heterogeneity among studies, small number of included studies, and reliance on observational data.