Surgical approach towards neonatal simple cysts in the past 3 decades: review of techniques in quest for the optimal approach

摘要

Abstract Background Ovarian cysts are the most common antenatally diagnosed fetal abdominal masses with an estimated incidence of 1:2600. Surgical management of simple ovarian cysts > 4 cm does not have a standardized management approach. The aim of this study is to review the current literature in regards to the indication and choice of minimal access surgery procedures for the management of simple neonatal ovarian cysts.Materials and methods Pubmed and Embase database were searched for neonatal ovarian cysts managed over a 30-year time period from 1990 to 2020 using the search terms “laparoscopy in neonates” and “simple ovarian cysts”.Results Laparoscopic techniques have been described since 1995 and four broad technical approaches and their variations were identified: (a) cyst aspiration and exteriorization for resection, (b) cyst aspiration, (c) complete laparoscopic cyst resection, and (d) cyst aspiration and un-roofing or marsupialization.Conclusion The laparoscopic approach to simple ovarian cysts > 4 cm in neonates is not standardized. All the surgical approaches proposed include initial aspiration of the cyst; however, the management of the cyst itself is variable. Due to the relative paucity of published data, it is not possible to identify the optimal surgical option.