Department of Obstetrics and Gynaecology, University College London Hospital, London, UK.
Ultrasound Obstet Gynecol. 2010 Aug;36(2):235-40. doi: 10.1002/uog.7610.
The aim of this study was to assess the natural history of ultrasonically diagnosed ovarian dermoid cysts in a large group of women who were managed expectantly, and to assess the factors that were associated with failure of expectant management.
Our database was searched for dermoid cysts diagnosed on ultrasonography by a single expert operator between 2001 and 2007 in this retrospective study. In women who opted for expectant management, demographic data including age, gravidity and parity were recorded. Indications for scan, site of cysts, dimensions and the outcomes of expectant management were also recorded.
Two hundred and eighty-nine women were diagnosed with a total of 323 dermoid cysts by a single expert ultrasound operator. 93/289 (32.2%; 95% CI, 26.8-37.6%) women with 105/323 (32.5%; 95% CI, 27.4-37.6%) ovarian dermoid cysts were managed expectantly for longer than 3 months. The mean age at diagnosis was 33.8 (range, 13-79) years and the median duration of follow up was 12.6 (interquartile range, 7.6-29.3) months. The mean growth rate of dermoid cysts during follow up was 1.67 mm/year. There were no demographic or morphological features that could be used to predict the growth rate of dermoid cysts. After a period of expectant management, 24/93 (25.8%; 95% CI, 16.9-34.7%) women had surgical intervention. The risk of surgical intervention was significantly increased in younger women, those of parity > or = 2 and in women with bilateral cysts or larger-diameter cysts, and reduced in women with a past history of ovarian cyst.
The success rate of expectant management of dermoid cysts is high and this approach should be considered as a viable alternative to surgical management.
本研究旨在评估一组经超声诊断的卵巢皮样囊肿患者在接受期待治疗后的自然病程，并评估与期待治疗失败相关的因素。
在这项回顾性研究中，我们检索了 2001 年至 2007 年间由一位专家操作员在超声检查中诊断的皮样囊肿的数据库。在选择期待治疗的女性中，记录了年龄、孕次和产次等人口统计学数据。还记录了扫描的适应证、囊肿的位置、大小以及期待治疗的结果。
共有 289 名女性被一位专家超声操作员诊断为 323 个皮样囊肿。93/289（32.2%；95%置信区间，26.8-37.6%）名患有 105/323（32.5%；95%置信区间，27.4-37.6%）个卵巢皮样囊肿的女性接受了超过 3 个月的期待治疗。诊断时的平均年龄为 33.8 岁（范围，13-79 岁），中位随访时间为 12.6 个月（四分位间距，7.6-29.3 个月）。皮样囊肿在随访期间的平均增长率为 1.67 毫米/年。没有任何人口统计学或形态学特征可以用来预测皮样囊肿的生长速度。在经过一段时间的期待治疗后，24/93（25.8%；95%置信区间，16.9-34.7%）名女性接受了手术干预。手术干预的风险在年轻女性、产次≥2 次的女性、双侧囊肿或较大直径囊肿的女性中显著增加，在有卵巢囊肿病史的女性中降低。
期待治疗皮样囊肿的成功率很高，这种方法应被视为手术治疗的可行替代方案。
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