Journal Article Epublish
PubMed: 41694257 DOI: 10.1016/j.xfre.2025.11.008
Safety of laparoscopic oophorectomy in a Dutch national pediatric cancer cohort.
F S Rep 7(1):69-80
Authors: Nikita H Z Clasen, M E Madeleine van der Perk, Marianne D van de Wetering, Annelies M E Bos, Anne-Lotte L F van der Kooi, Kim van Loon, Margreet A Veening, Irene M IJgosse, Sebastian J C M M Neggers, Martine van Grotel, Dorine Bresters, Hanneke M van Santen, Willem M J A Verpoest, Leendert H J Looijenga, Brigitte Arends, Jeanette van Leeuwen, Simone L Broer, Alida F W van der Steeg, Marry M van den Heuvel-Eibrink
Affiliations
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
- Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, the Netherlands.
- Department of Anesthesiology, University Medical Center Utrecht, Utrecht, the Netherlands.
- Department of Internal Medicine, Section Endocrinology, University Medical Center Rotterdam Erasmus MC, Rotterdam, the Netherlands.
- Department of Pediatric Endocrinology, University Medical Center Utrecht - Wilhelmina Children's Hospital, Utrecht, the Netherlands.
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands.
- Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands.
- Division of Child Health, University Medical Center Utrecht - Wilhelmina Children's Hospital, Utrecht, the Netherlands.
Abstract
OBJECTIVE
To report our experiences on the safety of laparoscopic oophorectomy (LO) for ovarian tissue cryopreservation in childhood cancer (CC) patients.
DESIGN
Descriptive study of a prospectively registered cohort.
SUBJECTS
All CC patients undergoing LO in the Netherlands from November 2020 until April 2024.
EXPOSURE
Laparoscopic oophorectomy for means of fertility preservation before or during gonadotoxic treatment.
MAIN OUTCOME MEASURES
Safety, including procedure-related complications, such as critical events (desaturation, bradycardia), need for mechanical ventilation in a pediatric intensive care unit (PICU), site infections, hemorrhage, and survival, scored according to Clavien Dindo (CD) classification.
RESULTS
Eighty-eight patients, median age 6.5 years (range 1-18 years) underwent LO, of which 2/88 patients developed CD grade 4, 1/88 CD grade 3, and 8/88 CD grade 2 complications, with the most common being port site infection (6%) and bleeding (6%). No clear determinant could be identified as a risk factor for complications. All patients recovered from procedure-related complications and no patient died as a consequence of oophorectomy.
CONCLUSION
Laparoscopic oophorectomy is a relatively safe procedure to preserve future fertility for girls with cancer with a high risk of gonadal failure and consequent infertility. However, LO can be accompanied by complications in children with cancer. Therefore, safety monitoring and identification of risk factors for complications based on larger cohorts in future studies are needed. Prevention of complications of LO is an important obligation to balance the future benefits against the risks of LO to enhance the future chance of pregnancy for girls with cancer.
MeSH
Fertility, Safety, Hemorrhage, Fertility Preservation, Neoplasms, Risk Factors, Infections, Ovariectomy