一项关于胎儿卵巢囊肿自然病史的回顾性多中心研究。

A retrospective multicenter study of the natural history of fetal ovarian cysts.

作者信息

Tyraskis Athanasios, Bakalis Spyros, Scala Carolina, Syngelaki Argyro, Giuliani Stefano, Davenport Mark, David Anna L, Nicolaides Kypros, Eaton Simon, De Coppi Paolo

机构信息

Paediatric Surgery Unit, King's College Hospital, London, UK.

Institute for Women's Health, University College London, UK.

出版信息

J Pediatr Surg. 2018 Oct;53(10):2019-2022. doi: 10.1016/j.jpedsurg.2018.02.049. Epub 2018 Feb 12.

DOI:10.1016/j.jpedsurg.2018.02.049

PMID:29534823

Abstract

AIM

We investigated the natural history of fetal ovarian cysts to estimate the risk of torsion according to size.

METHODS

Cases were identified from 1/1/2000 until 1/1/2015. Data were collected pre- and postnatally on cyst size and sonographic features until an outcome of surgery, torsion, or resolution. Fisher's exact test for categorical data and logistic regression for continuous data were used to test the significance of size on torsion; P value <0.05 was considered significant.

RESULTS

37 patients with unilateral ovarian cysts were included. 12 (32%) resolved spontaneously prenatally, 14 (38%) resolved spontaneously postnatally, 5 (14%) underwent surgery postnatally and 6 (16%) cases underwent torsion. Rate of torsion increased with size from 0% (n=0) in cysts ≤20mm to 33% (n=2) in cysts >50mm; however, the overall trend failed to reach statistical significance (P=0.1). Cysts of 0-40mm had a significantly higher rate of spontaneous resolution (90% vs. 44% in >40mm, P=0.003), but the rate of torsion was not significantly different (10% in 0-40mm vs. 25% in >40mm, P=0.26). The median time to postnatal resolution was 10 (5-27) weeks in those treated conservatively.

CONCLUSION

Cysts >40mm are significantly less likely to resolve spontaneously; however torsion showed no significant correlation with cyst size. No complications were observed in cysts <20mm.

LEVEL OF EVIDENCE

IV, case series with no comparison group.

摘要

目的

我们研究了胎儿卵巢囊肿的自然病史，以根据囊肿大小评估扭转风险。

方法

病例选取时间为2000年1月1日至2015年1月1日。在产前和产后收集囊肿大小及超声特征数据，直至手术、扭转或囊肿消退。采用分类数据的Fisher精确检验和连续数据的逻辑回归分析来检验囊肿大小对扭转的影响；P值<0.05被认为具有统计学意义。

结果

纳入37例单侧卵巢囊肿患者。12例（32%）在产前自发消退，14例（38%）在产后自发消退，5例（14%）在产后接受手术，6例（16%）发生扭转。扭转发生率随囊肿大小增加，囊肿≤20mm时扭转发生率为0%（n = 0），囊肿>50mm时为33%（n = 2）；然而，总体趋势未达到统计学意义（P = 0.1）。0 - 40mm的囊肿自发消退率显著更高（90%对比>40mm的囊肿为44%，P = 0.003），但扭转发生率无显著差异（0 - 40mm的囊肿为10%对比>40mm的囊肿为25%，P = 0.26）。保守治疗患者产后囊肿消退的中位时间为10（5 - 27）周。