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Treatment and Outcomes of Congenital Ovarian Cysts A Study by the Canadian Consortium for Research in Pediatric Surgery (CanCORPS).

Authors :
Safa N
Yanchar N
Puligandla P
Sewitch M
Baird R
Beaunoyer M
Campbell N
Chadha R
Griffiths C
Jones S
Kaur M
Le-Nguyen A
Nasr A
Piché N
Piper H
Prasil P
Romao RLP
VanHouwelingen L
Wales P
Guadagno E
Emil S
Source :
Annals of surgery [Ann Surg] 2023 May 01; Vol. 277 (5), pp. e1130-e1137. Date of Electronic Publication: 2023 Apr 06.
Publication Year :
2023

Abstract

Objective: We conducted a multicenter study to assess treatments and outcomes in a national cohort of infants with congenital ovarian cysts.<br />Summary Background Data: Wide variability exists in the treatment of congenital ovarian cysts. The effects of various treatment strategies on outcomes, specifically ovarian preservation, are not known.<br />Methods: Female infants diagnosed with congenital intra-abdominal cysts between 2013 and 2017 at 10 Canadian pediatric surgical centers were retrospectively evaluated. Sonographic characteristics, median time to cyst resolution, incidence of ovarian preservation, and predictors of surgery were evaluated. Subgroup analyses were performed in patients with complex cysts and cysts ≥40 mm in diameter.<br />Results: The study population included 189 neonates. Median gestational age at diagnosis and median maximal prenatal cyst diameter were 33 weeks and 40 mm, respectively. Cysts resolved spontaneously in 117 patients (62%), 14 (7%) prenatally, and the remainder at a median age of 124 days. Intervention occurred in 61 patients (32%), including prenatal aspiration (2, 3%), ovary sparing resection (14, 23%), or oophorectomy (45, 74%). Surgery occurred at a median age of 7.4weeks. Independent predictors of surgery included postnatal cyst diameter ≥40 mm [odds ratio (OR) 6.19, 95% confidence interval (CI) 1.66-35.9] and sonographic complex cyst character (OR 63.6, 95% CI 10.9-1232). There was no significant difference in the odds of ovarian preservation (OR 3.06, 95% CI 0.86 -13.2) between patients who underwent early surgery (n = 22) and those initially observed for at least 3 months (n = 131).<br />Conclusions: Most congenital ovarian cysts are asymptomatic and spontaneously resolve. Early surgical intervention does not increase ovarian preservation.<br />Competing Interests: The authors report no conflicts of interest.<br /> (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)

Details

Language :
English
ISSN :
1528-1140
Volume :
277
Issue :
5
Database :
MEDLINE
Journal :
Annals of surgery
Publication Type :
Academic Journal
Accession number :
35166261
Full Text :
https://doi.org/10.1097/SLA.0000000000005409