Department of Pediatric Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland.
Department of Pediatric Surgery, University of Helsinki Children's Hospital, Helsinki, Finland.
Eur J Pediatr Surg. 2024 Jun;34(3):215-221. doi: 10.1055/s-0043-1771211. Epub 2023 Aug 9.
Neonatal ovarian simple cyst management from the pediatric surgical aspect is unclear on cyst size, follow-up, and preferred surgical approach. Therefore, this topic was selected for the 2022 Consensus Session meeting of the European Paediatric Surgeons' Association (EUPSA).
The literature was reviewed on a predefined set of questions relating to the management of the neonatal ovarian simple cysts by a panel of 7 EUPSA members, on current evidence-based opinion and practice outlined. Each question (1) outcomes of fetal interventions in neonates after birth and consensus on size/timing of intervention, (2) consensus on the type of interventions, and (3) complications in neonatal ovarian cysts and follow-up recommendations in nonoperated/operated cysts, was presented with available evidence to congress session participants. The management approach was agreed by participants and comments were accounted to formulate the consensus statement.
There is still limited data on potential benefits and complications of prenatal ultrasound-guided aspiration; however, neonates after such procedures should be followed for 6 months. Neonates with simple ovarian cysts larger than 4 cm should be offered surgical interventions within the 2 weeks of life with complete laparoscopic cyst aspiration and fenestration with bipolar instruments being the preferred approach. Ultrasound follow-up after surgical intervention after 3 months and with the conservative approach after every 3 to 4 months until 1 year.
A peer-reviewed consensus statement for the management of neonatal ovarian simple cyst was formulated based on current evidence and peer practice. The EUPSA recognizes that the statement can be useful for pediatric surgeons in decision making for this pathology.
从小儿外科学角度来看，新生儿卵巢单纯性囊肿的管理对于囊肿大小、随访和首选手术方法尚不清楚。因此，本课题被选为 2022 年欧洲小儿外科学会（EUPsa）共识会议的主题。
由 7 名 EUPsa 成员组成的小组对与新生儿卵巢单纯性囊肿管理相关的一组预先确定的问题进行了文献回顾，概述了当前基于证据的观点和实践。每个问题（1）出生后胎儿干预的结果以及干预大小/时间的共识，（2）干预类型的共识，以及（3）新生儿卵巢囊肿的并发症和未手术/手术囊肿的随访建议，都向大会参会者提供了可用证据。与会者对管理方法达成一致，并对意见进行了记录，以制定共识声明。
虽然关于产前超声引导抽吸的潜在益处和并发症的数据仍然有限，但此类手术后的新生儿应随访 6 个月。直径大于 4cm 的单纯性卵巢囊肿新生儿应在出生后 2 周内接受手术干预，采用完全腹腔镜囊肿抽吸和双极器械开窗术是首选方法。术后 3 个月和采用保守方法后每 3 至 4 个月进行超声随访，直至 1 年。
根据现有证据和同行实践，制定了新生儿卵巢单纯性囊肿管理的同行评审共识声明。EUPsa 认识到该声明可有助于小儿外科医生在该病理的决策中。
