Section of Pediatric and Adolescent Gynecology, The Hospital for Sick Children, Department of Obstetrics and Gynecology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
University of Toronto's Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
J Pediatr Surg. 2024 Oct;59(10):161602. doi: 10.1016/j.jpedsurg.2024.06.011. Epub 2024 Jun 19.
Postnatal management of antenatally diagnosed ovarian cysts is not well-defined. The clinical course, management, and outcomes of patients with antenatally diagnosed ovarian cysts were reviewed.
Infants <1 year of age with antenatally diagnosed ovarian cyst managed at The Hospital for Sick Children between January 2017 and December 2021 were included. Patient charts were reviewed for postnatal ultrasound (US) images, management, clinical course and complications. Mixed linear regression analysis was used to model the change in cyst size over time.
In total, 52 patients were included and 10 patients had no cyst identified at their first postnatal US. Of the remaining cases, 36% were simple/physiologic and 64% had complex features. Two underwent percutaneous aspiration while 40 patients were managed expectantly with most cysts (62%) resolving. The rate of resolution was significantly higher and faster for simple compared to complex cysts (84% versus 52%, p < 0.05). Cysts that persisted at the end of the study period (n = 14) had all decreased in size, with a rate of resolution similar to resolved cysts. Only one patient managed expectantly required urgent laparoscopy for salpingoophorectomy.
Antenatally diagnosed ovarian cysts exhibit high rates of resolution with expectant management, supporting the safety and efficacy for expectant management for these patients.
III.
产前诊断的卵巢囊肿的产后管理尚无明确标准。本研究回顾了产前诊断为卵巢囊肿的患者的临床经过、处理方法和结局。
本研究纳入了 2017 年 1 月至 2021 年 12 月在多伦多 SickKids 医院接受治疗的 1 岁以下产前诊断为卵巢囊肿的婴儿。回顾了患者的病历，以获取产后超声（US）图像、处理方法、临床经过和并发症等信息。采用混合线性回归分析来模拟囊肿大小随时间的变化。
共纳入 52 例患者，其中 10 例患者在首次产后 US 中未发现囊肿。在其余病例中，36%为单纯/生理性，64%具有复杂特征。2 例行经皮抽吸术，40 例患者接受了期待治疗，大多数囊肿（62%）消失。单纯性囊肿的消退率明显高于复杂性囊肿（84%比 52%，p<0.05），且消退速度更快。在研究结束时仍存在的囊肿（n=14）均有所缩小，消退率与已消退的囊肿相似。仅 1 例接受期待治疗的患者因附件切除术而行紧急腹腔镜检查。
期待治疗对产前诊断的卵巢囊肿具有较高的消退率，支持对这些患者进行期待治疗的安全性和有效性。
III 级。
