Díaz de la Noval Begoña, Rodríguez Suárez Mª José, Fernández Ferrera Carmen Belén, Valdés Lafuente David, Arias Cailleau Rocío, Pérez Arias Héctor, Torrejón Becerra Juan Carlos, Suárez Gil Patricio, Lucio González Laura Rebeca
Department of Gynecology and Obstetrics, Hospital Universitario Central de Asturias, Oviedo, Spain.
Department of Biostatistics and Epidemiology, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.
J Ultrasound Med. 2020 Sep;39(9):1787-1797. doi: 10.1002/jum.15283. Epub 2020 Apr 16.
The purpose of this study was to assess the effectiveness of ultrasound (US)-guided aspiration for the management of low-risk adnexal cysts.
A longitudinal cohort of women with a low-risk adnexal cyst who underwent transvaginal US-guided aspiration from January 2012 to April 2018 were included. All procedures were performed on an outpatient basis, without anesthesia, sedation, or antibiotics. The posttreatment follow-up protocol included transvaginal US at 3 and 12 months. Potential risk factors for recurrence (ie, age, menopausal status, comorbidities, symptoms, cyst diameter, incomplete emptying, and location) were analyzed by multiple logistic regression.
A total of 156 patients were included. The median (interquartile range) cyst diameter was 66 (58-80) mm. Fifty-seven (36.5%) cases were resolved by US-guided aspiration. The median follow-up time was 556.5 (344-1070.25) days. The complication rate of the procedure was 2.6% (n = 4), with 3 cases of a major complication due to a pelvic abscess and 1 case of a minor complication due to self-limited vaginal spotting. A larger cyst size (odds ratio, 1.01; 95% confidence interval, 1.04-1.07; P = .002) and an older age (odds ratio, 1.01; 95% confidence interval, 1.03-1.05; P = .007) at diagnosis were independent factors related to recurrence.
Based on the low resolution rate, US-guided aspiration is not an effective option for the treatment of low-risk adnexal cysts. Risk factors associated with recurrence were age and cyst size at diagnosis. Larger randomized studies are necessary to assess predictive factors for cyst recurrence.
本研究旨在评估超声（US）引导下抽吸术治疗低风险附件囊肿的有效性。
纳入2012年1月至2018年4月期间接受经阴道超声引导下抽吸术的低风险附件囊肿女性的纵向队列。所有手术均在门诊进行，无需麻醉、镇静或使用抗生素。治疗后的随访方案包括在3个月和12个月时进行经阴道超声检查。通过多因素逻辑回归分析复发的潜在危险因素（即年龄、绝经状态、合并症、症状、囊肿直径、排空不完全和位置）。
共纳入156例患者。囊肿直径的中位数（四分位间距）为66（58 - 80）mm。57例（36.5%）病例通过超声引导下抽吸术得到解决。中位随访时间为556.5（344 - 1070.25）天。该手术的并发症发生率为2.6%（n = 4），其中3例因盆腔脓肿导致严重并发症，1例因自限性阴道点滴出血导致轻微并发症。诊断时囊肿尺寸较大（比值比，1.01；95%置信区间，1.04 - 1.07；P = .002）和年龄较大（比值比，1.01；95%置信区间，1.03 - 1.05；P = .007）是与复发相关的独立因素。
基于低分辨率率，超声引导下抽吸术不是治疗低风险附件囊肿的有效选择。与复发相关的危险因素是诊断时的年龄和囊肿大小。需要进行更大规模的随机研究来评估囊肿复发的预测因素。
