Tsai Ching-Chou, Shen Chung-Chang, Changchien Chan-Chao, Hsu Te-Yao, Kung Fu-Tsai, Chang Shiuh-Young, Chang Ming-Yang, Huang Fu-Jen
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Niaosung, Kaohsiung, Taiwan, ROC.
Chang Gung Med J. 2002 Nov;25(11):751-7.
While some research has been reported on the use of transvaginal ultrasound-guided aspiration of ovarian cysts, none has been reported for pseudocysts. Sometimes laparotomy patients experience recurrent pelvic psuedocysts for which they may need to undergo another laparotomy. The use of transvaginal ultrasound-guided aspiration of pelvic pseudocysts may make repeated laparotmies unnecessary.
Between April 1993 and October 2001, 14 outpatients with postoperative pelvic pseudocysts underwent transvaginal ultrasound-guided aspirations with or without surgical starch irrigation. All patients had previously undergone pelvic surgeries for adenomyosis and leiomyoma, except one was stage lb cervical cancer. A total of 25 treatment cycles by transvaginal ultrasound-guided aspiration were included: 15 cycles with starch and 10 cycles without.
The 13 patients with more than 6 months follow-up had a total of 25 aspiration cycles, 22 of which (88%) had no recurrent cyst by the end of their 6-month follow-up period. Eighteen out of 25 cycles (72%) had no evidence of recurrence after 12 months of follow-up. Five patients needed only one aspiration to become disease free and six patients needed two aspirations. Only 2 patients needed 3 or more aspirations procedures. After 12 months of follow up, 33% of those irrigated with starch had a recurrent pelvic pseudocyst while 30% without starch experienced recurrence.
Because it eliminates necessity of repeat laparotomy, transvaginal ultrasound-guided aspiration of pelvic pseudocysts may become a preferred treatment for recurrent pelvic pseudocysts.
虽然已有一些关于经阴道超声引导下抽吸卵巢囊肿的研究报道，但关于假性囊肿的报道尚无。有时剖腹手术患者会出现复发性盆腔假性囊肿，为此他们可能需要再次接受剖腹手术。经阴道超声引导下抽吸盆腔假性囊肿可能使重复剖腹手术不再必要。
1993年4月至2001年10月期间，14例术后盆腔假性囊肿门诊患者接受了经阴道超声引导下抽吸，部分患者同时进行了手术淀粉冲洗。除1例为Ib期宫颈癌外，所有患者此前均因子宫腺肌病和平滑肌瘤接受过盆腔手术。经阴道超声引导下抽吸共进行了25个治疗周期：15个周期使用淀粉，10个周期未使用。
13例随访超过6个月的患者共进行了25次抽吸周期，其中22次（88%）在6个月随访期结束时囊肿未复发。25个周期中的18个（72%）在随访12个月后无复发迹象。5例患者仅需一次抽吸即可治愈，6例患者需要两次抽吸。只有2例患者需要3次或更多次抽吸手术。随访12个月后，用淀粉冲洗的患者中有33%出现盆腔假性囊肿复发，未用淀粉的患者中有30%复发。
由于经阴道超声引导下抽吸盆腔假性囊肿消除了重复剖腹手术的必要性，它可能成为复发性盆腔假性囊肿的首选治疗方法。
