{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T09:32:31Z","timestamp":1763631151805,"version":"3.45.0"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T00:00:00Z","timestamp":1744416000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T00:00:00Z","timestamp":1744416000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e0 degli Studi di Roma La Sapienza"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Surg Int"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Large ovarian tumors with a predominantly cystic pattern are uncommon in adolescents. This study evaluates the effectiveness of a decompression technique utilizing a balloon trocar to facilitate ovarian-sparing surgery, while preserving oncologic principles, in adolescent patients presenting with such lesions<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of four consecutive cases managed by a single surgeon over a 7-year period ending December 2024. We describe the surgical technique of this innovative approach, and provide patient-specific clinical data including histopathologic findings and follow-up outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median patient age was 13 years (range, 10\u201317), and the median maximum tumor diameter was 17 cm (range, 10\u201328). The balloon trocar technique enabled a tight seal and closed suction drainage of the tumor cyst fluid, facilitating safe decompression and exteriorization of the mass. All surgeries were completed with negligible morbidity. Histological examination revealed three mature cystic teratomas and one serous cystadenoma. At clinical and ultrasonographic follow-up ranging 8 months to 7 years (median, 6,5 years), all patients remained free of recurrence, maintained regular menstrual cycles with normal-sized preserved ovaries, and expressed high satisfaction with their cosmetic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Large predominantly cystic ovarian tumors are generally associated with a favorable prognosis. Preemptive in situ decompression using a balloon trocar represents a simple, effective, and rapid technique to minimize the risk of tumor spillage. This approach facilitates safe ovary-sparing surgery for these large tumors, while also providing excellent cosmetic outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00383-025-06002-0","type":"journal-article","created":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T17:29:51Z","timestamp":1744478991000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Direct balloon trocar technique for closed decompression of large predominantly cystic ovarian tumors in adolescents"],"prefix":"10.1007","volume":"41","author":[{"given":"Silvia","family":"Ceccanti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Morini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Manganaro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele","family":"Masselli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Stranieri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis A.","family":"Cozzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,12]]},"reference":[{"key":"6002_CR1","doi-asserted-by":"publisher","first-page":"1247","DOI":"10.1001\/jama.2023.17183","volume":"330","author":"PC Minneci","year":"2023","unstructured":"Minneci PC, Bergus KC, Lutz C, Aldrink J, Bence C, Breech L, Dillon PA, Downard C, Ehrlich PF, Fallat M, Fraser JD, Grabowski J, Helmrath M, Hertweck P, Hewitt G, Hirschl RB, Kabre R, Lal DR, Landman M, Leys C, Mak G, Markel T, Pressey J, Raiji M, Rymeski B, Saito J, Sato TT, St Peter SD, Cooper J, Deans K, Midwest Pediatric Surgery Consortium (2023) Reducing unecessary oophorectomies for benign ovarian neoplasms in pediatric patients. JAMA 330:1247\u20131254. https:\/\/doi.org\/10.1001\/jama.2023.17183","journal-title":"JAMA"},{"key":"6002_CR2","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1016\/j.tjog.2021.05.005","volume":"60","author":"M Grigore","year":"2021","unstructured":"Grigore M, Murarasu M, Himiniuc LM, Toma BF, Duma O, Popovici R (2021) Large ovarian tumors in adolescents, a systematic review of reported cases, diagnostic findings and surgical management. Taiwan J Obstet Gynecol 60:602\u2013608. https:\/\/doi.org\/10.1016\/j.tjog.2021.05.005","journal-title":"Taiwan J Obstet Gynecol"},{"key":"6002_CR3","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1016\/j.jpedsurg.2006.12.069","volume":"42","author":"PF Ehrlich","year":"2007","unstructured":"Ehrlich PF, Teitelbaum DH, Hirschl RB, Rescorla F (2007) Excision of large cystic ovarian tumors: combining minimal invasive surgery techniques and cancer surgery\u2013the best of both worlds. J Pediatr Surg 42:890\u2013893. https:\/\/doi.org\/10.1016\/j.jpedsurg.2006.12.069","journal-title":"J Pediatr Surg"},{"key":"6002_CR4","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1016\/s0029-7844(01)01364-3","volume":"97","author":"M Shozu","year":"2001","unstructured":"Shozu M, Segawa T, Sumitani H, Inoue M (2001) Leak-proof puncture of ovarian cysts: instant mounting of plastic bag using cyanoacrylate adhesive. Obstet Gynecol 97:1007\u20131010. https:\/\/doi.org\/10.1016\/s0029-7844(01)01364-3","journal-title":"Obstet Gynecol"},{"key":"6002_CR5","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1016\/j.jpag.2020.08.009","volume":"34","author":"S Pecorelli","year":"2021","unstructured":"Pecorelli S, Tonegatti UG, Stern MV, Bulotta AL, Laffranchi F, Stegher C, Odicino F, Alberti D (2021) Management of large pediatric and adolescent ovarian neoplasms with a leak-proof extracorporeal drainage technique: our experience using a hybrid minimally invasive approach. J Pediatr Adolesc Gynecol 34:394\u2013399. https:\/\/doi.org\/10.1016\/j.jpag.2020.08.009","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"6002_CR6","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1016\/j.jpedsurg.2021.06.012","volume":"57","author":"L Watson","year":"2022","unstructured":"Watson L, Gavens E, Pachl M, Singh M, Soccorso G, McCarthy L, Arul GS (2022) Controlled aspiration of large paediatric ovarian cystic tumours. J Pediatr Surg 57:711\u2013714. https:\/\/doi.org\/10.1016\/j.jpedsurg.2021.06.012","journal-title":"J Pediatr Surg"},{"key":"6002_CR7","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1007\/s00383-013-3277-9","volume":"29","author":"E Watanabe","year":"2013","unstructured":"Watanabe E, Tanaka K, Takeda N, Takayasu H, Yokota K, Watanabe M (2013) Surgical technique to prevent spillage of cyst fluid during operation for cystic ovarian tumors. Pediatr Surg Int 29:645\u2013649. https:\/\/doi.org\/10.1007\/s00383-013-3277-9","journal-title":"Pediatr Surg Int"},{"key":"6002_CR8","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1016\/j.jpedsurg.2020.08.021","volume":"56","author":"H Kodikara","year":"2021","unstructured":"Kodikara H, McBride CA, Wanaguru D (2021) Massive, benign, cystic ovarian tumors: a technical modification for minimally invasive resection. J Pediatr Surg 56:417\u2013419. https:\/\/doi.org\/10.1016\/j.jpedsurg.2020.08.021","journal-title":"J Pediatr Surg"}],"container-title":["Pediatric Surgery International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-025-06002-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00383-025-06002-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-025-06002-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T09:28:22Z","timestamp":1763630902000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00383-025-06002-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,12]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["6002"],"URL":"https:\/\/doi.org\/10.1007\/s00383-025-06002-0","relation":{},"ISSN":["1437-9813"],"issn-type":[{"type":"electronic","value":"1437-9813"}],"subject":[],"published":{"date-parts":[[2025,4,12]]},"assertion":[{"value":"11 March 2025","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 April 2025","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None of the authors of this article has any financial or personal relationships to disclose that might inappropriately influence or bias this work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This research study was conducted retrospectively using data obtained for clinical purposes, fully adhering to the conditions and principles of Good Clinical Practice. Ethical approval was granted by the appropriate research ethics committee (No. 0208\/2025).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"We obtained written parental informed consent for the publication of all individual participants included in the study. We de-identified individual participant data, including patients\u2019 images.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}],"article-number":"115"}}