Treatment of large ovarian cysts in newborns and the effectiveness of laparoscopic approach

Abstract

Aim: Ovarian cysts are more frequently diagnosed antenatally due to the advances in imaging studies. They are mostly asymptomati during antenatal or postnatal period, but loss of the organ can occur in case of torsion or intracystic bleeding. The aim of this study was to investigate the effect of early laparoscopic surgical treatment of neonatal ovarian cysts on preservation of ovaries. Material and Methods: Medical records of patients with ovarian cysts larger than 5 cm in the last 4 years were retrospectively analyzed. Age, cyst diameter, sonographically detected anatomical structure of the cyst, treatment method, age at surgery, length of the hospital stay and outcomes of the follow-up were evaluated. Results: Between January 2010 and September 2014, 6 newborns were operated for large ovarian cysts. Gestational age of all cases at diagnosis ranged between 35 and 38 weeks with a mean gestational age of 36.8±1.3 weeks. Three of the cysts were simple, and the other 3 were reported as complicated ultrasonographically. For the simple cysts, laparoscopy assisted cystectomy was performed at the mean age of 6.2±1.4 days. The other three patients needed laparoscopy-assisted oophorectomy at the mean age of 10±2.1 days. The mean operative time was 23±5 minutes. The postoperative course was uneventful and the mean time of hospitalization was 23.7 (23.7±5.8) hours. Histopathological examinations of the specimens were reported as ovarian follicular cysts. Conclusion: In conclusion, antenatal ovarian cysts larger than 5 cm at diagnosis should be consulted with a pediatric surgeon, and with the aim to preserve the ovarian tissue; immediate intervention should be done after the delivery. Laparoscopy assisted surgery can be preferred due to the safe, short and easy intervention opportunities. © Cocuk Cerrahisi Dergisi. All rights reserved.