Laparoscopic management of ovarian cysts in newborns.
BACKGROUND
Cysts are the most common ovarian masses found in newborn girls. Spontaneous regression, which occurs in approximately 25-50% of cases, is more frequent with smaller cysts. Pre- or postnatal complications are common; these complications may consist of intracystic bleeding, torsion of the cyst or corresponding annex, or self-amputation of the cyst. When the cyst is <4 cm it is possible to perform a simple echographic monitoring to check for the possibility of spontaneous involution; all other cases require surgery.


METHODS
Between February 1985 and June 1997, we treated 22 neonatal ovarian cysts laparoscopically. In 14 cases, the right side was involved; in eight cases, it was the left. The patients' ages ranged between 7 days and 5 months (median, 45 days). In all cases, we used three trocars. An intraperitoneal cystectomy was done in eight cases, a transparietal cystectomy in four cases, an ovariectomy in seven cases, and the simple removal of the cyst in one case where self-amputation had occurred. In two cases of bilateral pathology, the cysts, which were <1 cm, were left untreated.


RESULTS
Average operating time was 40 min (range, 25-60 min). Intraabdominal pressure never exceeded 6-8 mmHg during the intervention. The postoperative course was always under 3 days. No intra- or postsurgical complications were recorded, and long-term ultrasonographic follow-ups were all normal.


CONCLUSIONS
Our experience indicates that the laparoscopic approach is a reliable and safe technique in the treatment of neonatal ovarian cysts.
Division of Pediatric Surgery, Federico II University of Naples, 80131 Naples, Italy.
C
C
Esposito
V
V
Garipoli
G
G
Di Matteo
M
M
De Pasquale
D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy; D010048:Ovarian Cysts / Q000151:congenital* / Q000601:surgery