Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr Med Assoc J. 2022 Aug;24(8):520-523.
Laparoscopic removal of ovarian dermoid cysts has been associated with increased risk for recurrence.
To investigate the risk factors associated with recurrence of dermoid cysts.
We conducted a retrospective review of all women who underwent cystectomy for ovarian dermoid cysts by laparoscopy or laparotomy. At discharge, patients were instructed to undergo a yearly ultrasound exam. A follow-up telephone call was conducted to assess whether an additional surgery for dermoid cysts was required and whether ultrasound recurrence of dermoid cysts was suspected.
The study cohort included 102 participants (92 [90.2%] operated by laparoscopy and 10 [9.8%] by laparotomy). The mean follow-up from the index surgery to the interview was 72.1 ± 38.2 months. The rates of recurrent surgery were similar among women who underwent laparoscopic cystectomy compared with laparotomy (5/92 [5.4%] vs. 1/10 [10.0%], respectively; P = 0.5), while the rates of reported ultrasound recurrence were significantly lower in the laparoscopy group compared with the laparotomy group (10/102 [10.9%] vs. 4/10 [40.0%], respectively; P = 0.03). Additional factors including age, cyst diameter, diagnosis of torsion, intraoperative cyst spillage, estimated blood loss, intraperitoneal adhesions, and postoperative fever were not associated with recurrence.
Ultrasound recurrence of dermoid cysts is not uncommon and could be associated with the surgical approach.
腹腔镜切除卵巢皮样囊肿与复发风险增加有关。
研究与皮样囊肿复发相关的危险因素。
我们对所有因卵巢皮样囊肿而行腹腔镜或剖腹手术切除术的女性进行了回顾性研究。出院时，患者被指示每年进行一次超声检查。通过随访电话评估是否需要进行皮样囊肿的额外手术，以及是否怀疑超声检查有皮样囊肿复发。
研究队列包括 102 名参与者（92 名[90.2%]经腹腔镜手术，10 名[9.8%]经剖腹手术）。从首次手术到访谈的平均随访时间为 72.1±38.2 个月。与剖腹手术相比，腹腔镜囊肿切除术的女性再次手术率相似（5/92[5.4%]比 1/10[10.0%]，P=0.5），而腹腔镜组报告的超声复发率明显低于剖腹组（10/102[10.9%]比 4/10[40.0%]，P=0.03）。其他因素，包括年龄、囊肿直径、扭转诊断、术中囊肿破裂、估计失血量、腹腔粘连和术后发热与复发无关。
皮样囊肿的超声复发并不罕见，可能与手术方法有关。
