• Nadia Safa, Natalie Yanchar, Pramod Puligandla, Maida Sewitch, Robert Baird, Mona Beaunoyer, Niamh Campbell, Rati Chadha, Christopher Griffiths, Sarah Jones, Manvinder Kaur, Annie Le-Nguyen, Ahmed Nasr, Nelson Piché, Hannah Piper, Pascale Prasil, Rodrigo L P Romao, Lisa VanHouwelingen, Paul Wales, Elena Guadagno, Sherif Emil, and Canadian Consortium for Research in Pediatric Surgery (CanCORPS).
• Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
• Ann. Surg. 2023 May 1; 277 (5): e1130e1137e1130-e1137.

ObjectiveWe conducted a multicenter study to assess treatments and outcomes in a national cohort of infants with congenital ovarian cysts.Summary Background DataWide variability exists in the treatment of congenital ovarian cysts. The effects of various treatment strategies on outcomes, specifically ovarian preservation, are not known.MethodsFemale 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.ResultsThe 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).ConclusionsMost congenital ovarian cysts are asymptomatic and spontaneously resolve. Early surgical intervention does not increase ovarian preservation.Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.

27 keywords...

hide…