Вроджені кісти яєчника: діагностика та лікування в неонатальному періоді

Abstract

The indications and method of surgery in newborns with prenatally diagnosed ovarian cysts remain under discussion. Purpose - to summarize own experience in the treatment of newborns with congenital ovarian cysts. Materials and methods. This study based on the results of treatment of 15 newborns that were operated in I surgical department of Lviv Regional Children’s Clinical Hospital «OKHMATDYT» at 2010-2021 years. For the diagnose confirming, the US was applied in all newborns after birth. The urgent hospitalization, immediately after birth, required 7 (46.7%) newborns and 4 (26.7%) newborns - during of the first month of life, by that 4 (26.7%) infants were hospitalized for elective surgery during six months after birth. The open surgery was applied in 9 (60%) patients and laparoscopic - in 6 (40%) patients. The postoperative mortality was 6.7%. Results of the study were evaluated by the statistical program StatPlus: mac, AnalystSoft Inc. (version v8). Results. Among of 54 fetuses, after the birth the presence of cyst was confirmed in 15 (27.8%) of newborns, which were operated. Indications for urgent surgery immediately after birth (46.7% of newborns) was the presence of huge (>6 cm) cyst in abdomen, which in 2 newborns determined with respiratory disorders and in 2 newborns - intestinal obstruction. Increasing of the cyst’s size with the pain syndrome was the indication for the urgent surgery during of the first month of life (26.7% of infants) and the presence of cyst without tendency to decreasing of its size was the indication for elective surgery (26.7% of infants). Ovary-sparing surgery was succeeded only in 20% of patients and in 80% of patients performed adnexectomy. Conclusions. By the antenatally revealing of ovarian cyst, the scheduled US control is required with the aim to monitoring of the dynamic of cyst size. The indications for the surgery in neonatal period are: 1) cysts with the diameter >4 cm; 2) clear suspicions for the complications (torsion, self-amputation, compression of abdominal organs); 3) enlargement of cyst size after the born. The choice of method of surgery determined by size and the character of cystic formation. The research was carried out in accordance with principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of clinical hospital «OKHMATDYT». The informed agreement of parents was obtained for conducting the study. No conflict of interests was declared by the authors.