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小儿及青春期女孩卵巢皮样囊肿的复发率

The recurrence rate of ovarian dermoid cysts in pediatric and adolescent girls.

作者信息

Rogers Erin M, Allen Lisa, Kives Sari

机构信息

Division of Pediatric Gynecology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

Division of Pediatric Gynecology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

出版信息

J Pediatr Adolesc Gynecol. 2014 Aug;27(4):222-6. doi: 10.1016/j.jpag.2013.11.006. Epub 2014 Mar 19.

Abstract

STUDY OBJECTIVE

To assess the rate of recurrence of ovarian dermoid cysts in pediatric and adolescent girls at the Hospital for Sick Children.

DESIGN

A retrospective chart review of all dermoid cysts surgically managed at the hospital for Sick Children from January 2003 to June 2012.

SETTING

The Hospital for Sick Children, Toronto, Canada.

PARTICIPANTS

66 adolescent and pediatric patients <18 years old treated with ovarian cystectomy of their dermoid cysts by either laparoscopy (n = 40) or laparotomy (n = 26).

MAIN OUTCOME MEASURES

Total dermoid cyst recurrence, recurrence after laparoscopy versus laparotomy, follow-up imaging completed and ultrasonographic identification of other ovarian cysts in follow-up. Data was assessed with Fisher exact test where appropriate (P < .05).

RESULTS

The mean age of patients at time of surgery was 12.9 years (range 2.5-18.1). 25/66 (38%) of patients received no follow-up, 6/66 (9%) were followed by a single ultrasonography and 35/66 (53%) were followed with annual ultrasonography for up to 5 years. 35 patients completed their initial ultrasonography where 19/35 (54%) patients had new ovarian cysts diagnosed including: 6 functional/hemorrhagic, 3 dermoid, and 10 unspecified cysts. All new dermoids were suspected at first follow-up ultrasonography (6/35), but 3 required a second follow-up ultrasonography for confirmation. Overall, 7/66 (11%) patients had recurrent or persistent dermoid cysts of which 2 (3%) required repeat surgery. There was no significant impact on the type of surgery and dermoid recurrence.

CONCLUSION

The incidence of recurrent dermoid cysts in a pediatric and adolescent population following ovarian cystectomy is 10.6% where only 3% will recur and require further surgical management.

摘要

研究目的

评估病童医院儿科及青春期女孩卵巢皮样囊肿的复发率。

设计

对2003年1月至2012年6月在病童医院接受手术治疗的所有皮样囊肿进行回顾性病历审查。

地点

加拿大多伦多病童医院。

参与者

66例18岁以下的青少年及儿科患者,通过腹腔镜手术(n = 40)或剖腹手术(n = 26)切除卵巢皮样囊肿。

主要观察指标

皮样囊肿总复发率、腹腔镜手术与剖腹手术后的复发情况、完成的随访影像学检查以及随访中超声检查发现的其他卵巢囊肿。数据在适当情况下采用Fisher精确检验进行评估(P < 0.05)。

结果

手术时患者的平均年龄为12.9岁(范围2.5 - 18.1岁)。25/66(38%)的患者未接受随访,6/66(9%)接受了一次超声检查,35/66(53%)接受了长达5年的每年一次超声检查。35例患者完成了初次超声检查,其中19/35(54%)的患者被诊断出有新的卵巢囊肿,包括:6个功能性/出血性囊肿、3个皮样囊肿和10个未明确类型的囊肿。所有新的皮样囊肿在首次随访超声检查时被怀疑(6/35),但3个需要第二次随访超声检查以确诊。总体而言,7/66(11%)的患者有复发性或持续性皮样囊肿,其中2例(3%)需要再次手术。手术方式对皮样囊肿复发无显著影响。

结论

卵巢囊肿切除术后儿科及青春期人群中复发性皮样囊肿的发生率为10.6%,其中只有3%会复发并需要进一步手术治疗。

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