TY - JOUR
T1 - Treatment and Outcomes of Congenital Ovarian Cysts A Study by the Canadian Consortium for Research in Pediatric Surgery (CanCORPS)
AU - Safa, Nadia
AU - Yanchar, Natalie
AU - Puligandla, Pramod
AU - Sewitch, Maida
AU - Baird, Robert
AU - Beaunoyer, Mona
AU - Campbell, Niamh
AU - Chadha, Rati
AU - Griffiths, Christopher
AU - Jones, Sarah
AU - Kaur, Manvinder
AU - Le-Nguyen, Annie
AU - Nasr, Ahmed
AU - Piché, Nelson
AU - Piper, Hannah
AU - Prasil, Pascale
AU - Romao, Rodrigo L.P.
AU - Vanhouwelingen, Lisa
AU - Wales, Paul
AU - Guadagno, Elena
AU - Emil, Sherif
N1 - Publisher Copyright:
© 2021 The Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Objective: We conducted a multicenter study to assess treatments and outcomes in a national cohort of infants with congenital ovarian cysts. 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. 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. 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). Conclusions: Most congenital ovarian cysts are asymptomatic and spontaneously resolve. Early surgical intervention does not increase ovarian preservation.
AB - Objective: We conducted a multicenter study to assess treatments and outcomes in a national cohort of infants with congenital ovarian cysts. 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. 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. 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). Conclusions: Most congenital ovarian cysts are asymptomatic and spontaneously resolve. Early surgical intervention does not increase ovarian preservation.
KW - congenital
KW - cyst
KW - diagnosis
KW - management
KW - ovarian
KW - ovarian preservation
KW - prenatal
KW - ultrasound
UR - http://www.scopus.com/inward/record.url?scp=85152274541&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85152274541&partnerID=8YFLogxK
U2 - 10.1097/SLA.0000000000005409
DO - 10.1097/SLA.0000000000005409
M3 - Article
C2 - 35166261
AN - SCOPUS:85152274541
SN - 0003-4932
VL - 277
SP - E1130-E1137
JO - Annals of surgery
JF - Annals of surgery
IS - 5
ER -