腹腔镜辅助下单纯抽吸法治疗新生儿单纯性卵巢囊肿的近期疗效观察

Laparoscopic aspirations for simple neonatal ovarian cysts:a short-term follow-up study

目的目前学界对于新生儿较大单纯性卵巢囊肿(直径>4 cm)的手术方案尚无共识,传统观点多认为需要保留卵巢,行卵巢囊肿剥离术。近年来,有研究发现单纯行囊肿穿刺抽液亦安全、简单、有效。本研究拟探讨腹腔镜辅助下单纯抽吸法治疗卵巢囊肿的有效性及安全性。方法以2019年4月至2020年4月广州市妇女儿童医疗中心收治的6例单纯性卵巢囊肿患者为研究对象,采取腹腔镜辅助下单纯抽吸法治疗。同时收集患者临床资料,随访临床结局并总结分析。结果6例患者平均手术年龄(12.0±10.8)d,平均体质量(3390±410)g;其中早产儿2例,足月儿4例。囊肿均位于右侧。囊肿平均长径(62.2±24.9)mm。均采用腹腔镜辅助下单纯囊肿抽吸术,术中发现卵巢扭转1例,于腔镜指引下抽尽囊液并复位后仍保留卵巢。手术时间25~80 min,中位手术时间32.5 min。术中平均出血量1 mL。术后平均住院时间(2.7±0.5)d。术后均顺利恢复出院,随访2~8个月,囊肿均完全消失,卵巢恢复正常大小(≤2 cm)。无一例囊肿复发或扭转等并发症,无一例死亡。结论对于新生儿期诊断的直径>4 cm的单纯性卵巢囊肿,采用腹腔镜下囊肿穿刺抽液术简单、安全、有效,值得积极推广。

Objective Currently surgical consensus is lacking for simple neonatal ovarian cysts larger than 4 cm.Traditional view holds that ovary should be preserved and cystectomy is an ideal choice.As demonstrated by some recent studies,it is safe,simple and effective to perform cyst puncture and drainage alone by laparoscopy.The goal of this study was to explore the effectiveness and safety of laparoscopic assisted aspiration for neonatal ovarian cysts.Methods From April 2019 to April 2020,6 neonates diagnosed as simple ovarian cyst fulfilling the inclusion criteria underwent laparoscopic assisted cyst aspiration.Clinical data were collected and analyzed.Results The involved side was all right.The average operative age was(12.0±10.8)days and the average body weight(3390±410)grams.There were 2 premature and 4 full-term infants.The average largest diameter of cyst was(62.2±24.9)mm.Laparoscopic-assisted aspiration of cyst was performed and there was one case of torsion.Under the guidance of laparoscopy,cyst was thoroughly drained and ovary preserved.The average operative duration was 32.5(25-80)min,the average volume of blood loss 1 ml and the average postoperative hospital stay(2.7±0.5)days.All of them recovered with a successful postoperative discharge.Favorable cyst regression occurred within(2-8)months.Ultrasound indicated that all ovaries regained a normal size(≤2 cm).No cyst recurrence,torsion,death or other related complications was observed during follow-ups.Conclusion For simple neonatal ovarian cyst with a diameter>4 cm,laparoscopic cyst aspiration is simple,safe and effective.It is worthy of a wider popularization.