Abstract
ABSTRACT
Nineteen newborns with prenatal diagnosis of ovarian cysts were referred to our institution during a 6-year period. Only those cysts more than 5-cm in diameter were included. Nine cases presented simple cysts and 7 of them underwent needle aspiration, 5 under ultrasound guidance and 2 with laparoscopic assistance. In one case an open surgical cystectomy was performed and the other had spontaneous resolution. No oophorectomies were performed in this group. Ten patients had complicated ultrasound pattern (septa, fluid/debris, calcification). From this group, 8 patients had ovarian torsion and 6 underwent laparoscopic oophorectomy (one bilateral). Open surgical oophorectomy was performed in 2 patients early in the series. Two cases were misdiagnosed. In one case a simple cyst appeared as complicated because of associated meconium peritonitis with calcifications. The other case underwent an initial laparoscopy that unveiled an intestinal duplication that was excised under open surgery. Mean operative time for laparoscopic approach was of 40 minutes and all patients left the hospital within 24 hours. We conclude that it is possible to preserve the neonatal ovary in noncomplicated cysts. Both laparoscopic and ultrasound-guided needle aspiration are safe and minimally invasive procedures for simple cyst-definitive treatment. Initial laparoscopic approach is the procedure of choice for complicated cysts thus providing diagnostic and treatment capabilities.
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