Esposito C, Garipoli V, Di Matteo G, De Pasquale M
Division of Pediatric Surgery, Federico II University of Naples, 80131 Naples, Italy.
Surg Endosc. 1998 Sep;12(9):1152-4. doi: 10.1007/s004649900804.
Cysts are the most common ovarian masses found in newborn girls. Spontaneous regression, which occurs in approximately 25-50% of cases, is more frequent with smaller cysts. Pre- or postnatal complications are common; these complications may consist of intracystic bleeding, torsion of the cyst or corresponding annex, or self-amputation of the cyst. When the cyst is <4 cm it is possible to perform a simple echographic monitoring to check for the possibility of spontaneous involution; all other cases require surgery.
Between February 1985 and June 1997, we treated 22 neonatal ovarian cysts laparoscopically. In 14 cases, the right side was involved; in eight cases, it was the left. The patients' ages ranged between 7 days and 5 months (median, 45 days). In all cases, we used three trocars. An intraperitoneal cystectomy was done in eight cases, a transparietal cystectomy in four cases, an ovariectomy in seven cases, and the simple removal of the cyst in one case where self-amputation had occurred. In two cases of bilateral pathology, the cysts, which were <1 cm, were left untreated.
Average operating time was 40 min (range, 25-60 min). Intraabdominal pressure never exceeded 6-8 mmHg during the intervention. The postoperative course was always under 3 days. No intra- or postsurgical complications were recorded, and long-term ultrasonographic follow-ups were all normal.
Our experience indicates that the laparoscopic approach is a reliable and safe technique in the treatment of neonatal ovarian cysts.
囊肿是新生女婴中最常见的卵巢肿物。约25% - 50%的病例会发生自发消退，囊肿越小，自发消退越常见。产前或产后并发症很常见；这些并发症可能包括囊内出血、囊肿或相应附件扭转，或囊肿自截。当囊肿<4 cm时，可行简单的超声监测以检查自发消退的可能性；所有其他情况均需手术治疗。
1985年2月至1997年6月，我们对22例新生儿卵巢囊肿进行了腹腔镜治疗。其中14例右侧受累；8例左侧受累。患者年龄在7天至5个月之间（中位数为45天）。所有病例均使用三个套管针。8例行腹腔内囊肿切除术，4例行经壁囊肿切除术，7例行卵巢切除术，1例囊肿已自截的病例仅行囊肿简单切除。2例双侧病变且囊肿<1 cm的病例未予治疗。
平均手术时间为40分钟（范围为25 - 60分钟）。术中腹腔内压力从未超过6 - 8 mmHg。术后病程均在3天以内。未记录到手术中和手术后的并发症，长期超声随访均正常。
我们的经验表明，腹腔镜手术是治疗新生儿卵巢囊肿的一种可靠且安全的技术。
