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新生儿复杂卵巢囊肿的管理——我们的经验

Management of Complex Ovarian Cysts in Newborns - Our Experience.

作者信息

Manjiri S, Padmalatha S K, Shetty J

机构信息

Department of Pediatric Surgery, M.S. Ramaiah Medical College, Bangaluru-560054, India.

出版信息

J Neonatal Surg. 2017 Jan 1;6(1):3. doi: 10.21699/jns.v6i1.448. eCollection 2017 Jan-Mar.

Abstract

AIMS

To analyse the clinical presentation, clinicopathological correlation and management of complex ovarian cysts in newborn and infants.

MATERIALS AND METHODS

Over a period of 6 years (2009-2015), 25 newborns who were diagnosed to have ovarian cyst on antenatal ultrasound, were followed up. We collected data in the form of clinical features, radiological findings, pathology and mode of treatment.

RESULTS

Of the 25 fetuses who were diagnosed to have ovarian cysts, fourteen (56%) underwent spontaneous regression by 6-8 months. Eight were operated in newborn period while 3 were operated in early infancy. Seven had ovarian cyst on right side, 4 had on left side. Eight babies underwent laparoscopy while 3 underwent laparotomy. Histopathology showed varied features of hemorrhagic cyst with necrosis and calcification, serous cystadenoma with hemorrhage, benign serous cyst with hemorrhage and simple serous cyst. Post-operative recovery was uneventful in all.

CONCLUSION

All the ovarian cysts detected antenatally in female fetuses need close follow-up after birth. Since spontaneous regression is known, only complex or larger cysts need surgical intervention, preferably by laparoscopy. Majority of the complex cysts show atrophic ovarian tissue hence end up in oophorectomy but simple cysts can be removed preserving normal ovarian tissue whenever possible.

摘要

目的

分析新生儿及婴儿复杂卵巢囊肿的临床表现、临床病理相关性及治疗方法。

材料与方法

在6年期间(2009 - 2015年),对25例产前超声诊断为卵巢囊肿的新生儿进行随访。我们以临床特征、影像学检查结果、病理及治疗方式的形式收集数据。

结果

在诊断为卵巢囊肿的25例胎儿中,14例(56%)在6 - 8个月时囊肿自行消退。8例在新生儿期接受手术,3例在婴儿早期接受手术。7例右侧有卵巢囊肿,4例左侧有囊肿。8例婴儿接受腹腔镜手术,3例接受剖腹手术。组织病理学显示出具有坏死和钙化的出血性囊肿、伴有出血的浆液性囊腺瘤、伴有出血的良性浆液性囊肿及单纯浆液性囊肿的不同特征。所有患儿术后恢复均顺利。

结论

产前在女性胎儿中检测到的所有卵巢囊肿在出生后均需密切随访。由于已知囊肿可自行消退,仅复杂或较大的囊肿需要手术干预,最好采用腹腔镜手术。大多数复杂囊肿显示卵巢组织萎缩,因此最终需行卵巢切除术,但只要有可能,单纯囊肿可在保留正常卵巢组织的情况下切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0e7/5224760/6b1d7f570ba9/jns-6-3.f1.jpg

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