title: Is the stripping technique a tissue-sparing procedure in large simple ovarian cysts in children?
abstract: BACKGROUND
  Stripping of the cystic wall is performed by gynecologists to treat large ovarian cysts. Information in the pediatric population is poor. We prospectively evaluated the pathologic specimens of large ovarian cyst to determine whether the stripping technique is a tissue-sparing procedure even in this age.
  
  
  METHODS
  We evaluated 5 patients. Samples were taken from the intermediate part of the cystic wall and from the layer covering the cyst during excision. The presence of ovarian tissue adjacent to the cyst wall, and the morphological features of the surrounding tissue were both evaluated. Pelvic ultrasound follow-up was also performed.
  
  
  RESULTS
  Patients' mean age was 4.5 years (7 days to 12 years). All cysts were removed because all were symptomatic. The mean diameter was 86.6 mm (74-100 mm). Cysts were follicular in 2 cases, serous in other two, and endometriotic in 1 case. Adjacent ovarian tissue was present in 1 of 5 specimens and was approximately 1 to 2 mm in thickness. The layer adjacent to the cystic wall always appeared as normal ovarian tissue. Ultrasound scans at follow-up revealed presence of ovarian tissue.
  
  
  CONCLUSIONS
  The stripping procedure for large ovarian cyst excision allows to spare the adjacent normal ovarian tissue even in pediatric age because ovarian tissue is rarely excised with the cyst wall during the procedure.
authors.affiliation: Department of Medical and Surgical Pediatric Sciences-Unit of Minimally Invasive Pediatric Surgery, University of Messina, 98125 Messina, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Arena
authors.forename: Carmelo
authors.initials: C
authors.lastname: Romeo
authors.forename: Marco
authors.initials: M
authors.lastname: Castagnetti
authors.forename: GianFranco
authors.initials: G
authors.lastname: Scalfari
authors.forename: Marcello
authors.initials: M
authors.lastname: Cimador
authors.forename: Pietro
authors.initials: P
authors.lastname: Impellizzeri
authors.forename: Daniela
authors.initials: D
authors.lastname: Villari
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Zimbaro
authors.forename: Enrico
authors.initials: E
authors.lastname: DeGrazia
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010048:Ovarian Cysts / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D014463:Ultrasonography