Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
Division of Pediatric Surgery, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.
Ann Surg. 2023 May 1;277(5):e1130-e1137. doi: 10.1097/SLA.0000000000005409. Epub 2023 Apr 6.
We conducted a multicenter study to assess treatments and outcomes in a national cohort of infants with congenital ovarian cysts.
Wide variability exists in the treatment of congenital ovarian cysts. The effects of various treatment strategies on outcomes, specifically ovarian preservation, are not known.
Female infants diagnosed with congenital intra-abdominal cysts between 2013 and 2017 at 10 Canadian pediatric surgical centers were retrospectively evaluated. Sonographic characteristics, median time to cyst resolution, incidence of ovarian preservation, and predictors of surgery were evaluated. Subgroup analyses were performed in patients with complex cysts and cysts ≥40 mm in diameter.
The study population included 189 neonates. Median gestational age at diagnosis and median maximal prenatal cyst diameter were 33 weeks and 40 mm, respectively. Cysts resolved spontaneously in 117 patients (62%), 14 (7%) prenatally, and the remainder at a median age of 124 days. Intervention occurred in 61 patients (32%), including prenatal aspiration (2, 3%), ovary sparing resection (14, 23%), or oophorectomy (45, 74%). Surgery occurred at a median age of 7.4weeks. Independent predictors of surgery included postnatal cyst diameter ≥40 mm [odds ratio (OR) 6.19, 95% confidence interval (CI) 1.66-35.9] and sonographic complex cyst character (OR 63.6, 95% CI 10.9-1232). There was no significant difference in the odds of ovarian preservation (OR 3.06, 95% CI 0.86 -13.2) between patients who underwent early surgery (n = 22) and those initially observed for at least 3 months (n = 131).
Most congenital ovarian cysts are asymptomatic and spontaneously resolve. Early surgical intervention does not increase ovarian preservation.
我们进行了一项多中心研究，以评估先天性卵巢囊肿患儿的全国队列中的治疗方法和结果。
先天性卵巢囊肿的治疗方法存在很大差异。各种治疗策略对结果的影响，特别是卵巢保留，尚不清楚。
回顾性评估了 2013 年至 2017 年间在加拿大 10 个儿科外科中心诊断为先天性腹腔内囊肿的女性婴儿。评估了超声特征、囊肿消退的中位时间、卵巢保留的发生率以及手术的预测因素。在复杂囊肿和直径≥40mm 的囊肿患者中进行了亚组分析。
研究人群包括 189 名新生儿。诊断时的中位胎龄和最大产前囊肿直径分别为 33 周和 40mm。117 例（62%）患者的囊肿自发消退，14 例（7%）在产前消退，其余患者在中位 124 天消退。61 例（32%）患者接受了干预，包括产前抽吸（2 例，3%）、卵巢保留切除术（14 例，23%）或卵巢切除术（45 例，74%）。手术发生在中位年龄 7.4 周。手术的独立预测因素包括产后囊肿直径≥40mm[比值比（OR）6.19，95%置信区间（CI）1.66-35.9]和超声复杂囊肿特征（OR 63.6，95%CI 10.9-1232）。早期手术（n=22）和至少观察 3 个月（n=131）的患者之间，卵巢保留的几率（OR 3.06，95%CI 0.86-13.2）无显著差异。
大多数先天性卵巢囊肿是无症状的，会自发消退。早期手术干预不会增加卵巢保留率。
