Recommendations for Postoperative Surveillance of Pediatric Benign Ovarian Neoplasms.

Abstract Study Objective Assess postoperative management of pediatric patients with benign ovarian neoplasms to develop recommendations for postoperative care. Design A retrospective cohort study. Setting Eight pediatric hospitals in the Midwest. Participants Patients up to 21 years of age who underwent surgery for a benign ovarian neoplasm between January 2010 and December 2016 were included. Interventions No prospective interventions were evaluated. Main Outcome Measures Included postoperative imaging findings, recurrence rates, reoperation rates, and the timing of aforementioned results. Results 427 patients met inclusion criteria. After the index surgery, 155 (36%) patients had a routine imaging study. Among those with routine imaging, abnormalities were noted in 48 patients (31%); 7 went on to have reoperation (5%), and no malignant pathologies or torsion were identified. Excluding the 7 patients that went on to have a reoperation as a result of routine imaging, 113 patients developed symptoms postoperatively and underwent imaging as a result (27%, 113/420). Abnormalities were noted in 44 (10%), and 15 underwent reoperation (4%), among them two malignancies and three cases of torsion. Of these 44 patients, 23 had initially undergone routine imaging and subsequently went on to have symptomatic imaging, with 17% (4/23) undergoing reoperation. Conclusions Routine imaging did not identify malignancy; most lesions identified on routine imaging were incidental findings. While not powered to appreciate a statistically significant difference, patients with malignancy or torsion were identified in the symptomatic group. This suggests no benefit from routine imaging and supports symptomatic imaging post-operatively to minimize costs and patient/family burden.