Niu Sida, Didde Ryan D, Schuchmann Jennifer K, Zoorob Dani
Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA.
University of Kansas School of Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd. MS 3016, Kansas City, KS, 66160, USA.
Int Urogynecol J. 2020 Jan;31(1):55-61. doi: 10.1007/s00192-019-04091-9. Epub 2019 Aug 30.
Gartner's duct cysts (GDC) are benign lesions that may become symptomatic, leading to surgical intervention. There is no standard surgical technique for management of GDC. This article provides a comprehensive review of surgical the management of GDC. We also present a new technique using fluorescein dye to help delineate GDC walls and facilitate complete cyst excision.
We conducted a PubMed search for English-language articles without a defined time range. The search combined subject headings, title, abstract, and text words relating to Gartner duct cysts. Articles describing surgical management of GDC were included. Exclusion criteria included inadequate diagnosis of GDC, infected cysts, nonsurgical management, or article unavailable for interlibrary loan. A novel approach using intra-cyst fluorescein dye injection is described.
Two hundred sixty-seven articles were identified via PubMed, and 34 articles were included in the review based on eligibility criteria. Concomitant genitourinary malformations occurred in 19 of the 92 surgically managed patients. Surgical techniques included cyst excision (50 patients), tetracycline injection following aspiration (15), marsupialization (14), unroofing/partial excision (9), and puncture/evacuation (4). Recurrences occurred in 4, 1, 0, 0, and 1 patient, respectively. One patient underwent uncomplicated fluorescein dye-assisted cyst excision with no recurrence 30 months post-procedure.
The low incidence of GDCs necessitating surgical intervention has resulted in a lack of standard surgical technique, especially in patients with concurrent genitourinary malformations. Utilizing fluorescein dye provides a surgical method that can help confirm the absence of urologic involvement as well as facilitate precise excision of GDC.
加特纳管囊肿（GDC）是良性病变，可能出现症状，从而需要手术干预。目前尚无用于治疗GDC的标准手术技术。本文对GDC的手术治疗进行了全面综述。我们还介绍了一种使用荧光素染料的新技术，以帮助勾勒GDC壁并促进囊肿完整切除。
我们在PubMed上搜索了无特定时间范围限制的英文文章。搜索结合了与加特纳管囊肿相关的主题词、标题、摘要和文本词汇。纳入描述GDC手术治疗的文章。排除标准包括GDC诊断不充分、囊肿感染、非手术治疗或无法通过馆际互借获取的文章。描述了一种使用囊内注射荧光素染料的新方法。
通过PubMed检索到267篇文章，根据纳入标准，34篇文章被纳入综述。92例接受手术治疗的患者中有19例伴有泌尿生殖系统畸形。手术技术包括囊肿切除（50例患者）、抽吸后注射四环素（15例）、袋形缝合术（14例）、去顶/部分切除（9例）和穿刺/抽液（4例）。复发分别发生在4例、1例、0例、0例和1例患者中。1例患者接受了无并发症的荧光素染料辅助囊肿切除，术后30个月无复发。
需要手术干预的GDC发病率较低，导致缺乏标准手术技术，尤其是在伴有泌尿生殖系统畸形的患者中。使用荧光素染料提供了一种手术方法，有助于确认无泌尿系统受累，并便于精确切除GDC。
