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Eur J Pediatr Surg 2024; 34(03): 215-221
DOI: 10.1055/s-0043-1771211
Original Article

European Paediatric Surgeons' Association Consensus Statement on the Management of Neonatal Ovarian Simple Cysts

Amulya K. Saxena 
1   Department of Pediatric Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
,
Annika Mutanen
2   Department of Pediatric Surgery, University of Helsinki Children's Hospital, Helsinki, Finland
,
Ramon Gorter
3   Department of Pediatric Surgery, Emma Children's Hospital UMC, Amsterdam, the Netherlands
,
Andrea Conforti
4   Department of Medical and Surgical Neonatology, Bambino Gesu' Children's Hospital, Rome, Italy
,
Pietro Bagolan
4   Department of Medical and Surgical Neonatology, Bambino Gesu' Children's Hospital, Rome, Italy
,
Paolo De Coppi 
5   Department of Paediatric Surgery, UCL Institute of Child Health, London, United Kingdom of Great Britain and Northern Ireland
6   Department of Surgery, Great Ormond Street Hospital for Children, London, United Kingdom of Great Britain and Northern Ireland
,
Tutku Soyer 
7   Department of Pediatric Surgery, Hacettepe Universitesi Tip Fakultesi, Ankara, Turkey
,
the European Paediatric Surgeons' Association› Author Affiliations
Funding None.
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Abstract

Introduction Neonatal ovarian simple cyst management from the pediatric surgical aspect is unclear on cyst size, follow-up, and preferred surgical approach. Therefore, this topic was selected for the 2022 Consensus Session meeting of the European Paediatric Surgeons' Association (EUPSA).

Methods The literature was reviewed on a predefined set of questions relating to the management of the neonatal ovarian simple cysts by a panel of 7 EUPSA members, on current evidence-based opinion and practice outlined. Each question (1) outcomes of fetal interventions in neonates after birth and consensus on size/timing of intervention, (2) consensus on the type of interventions, and (3) complications in neonatal ovarian cysts and follow-up recommendations in nonoperated/operated cysts, was presented with available evidence to congress session participants. The management approach was agreed by participants and comments were accounted to formulate the consensus statement.

Results There is still limited data on potential benefits and complications of prenatal ultrasound-guided aspiration; however, neonates after such procedures should be followed for 6 months. Neonates with simple ovarian cysts larger than 4 cm should be offered surgical interventions within the 2 weeks of life with complete laparoscopic cyst aspiration and fenestration with bipolar instruments being the preferred approach. Ultrasound follow-up after surgical intervention after 3 months and with the conservative approach after every 3 to 4 months until 1 year.

Conclusion A peer-reviewed consensus statement for the management of neonatal ovarian simple cyst was formulated based on current evidence and peer practice. The EUPSA recognizes that the statement can be useful for pediatric surgeons in decision making for this pathology.

Keywords

consensus statement - neonate - simple ovarian cyst - surgical management - conservative treatment


Publication History

Received: 16 May 2023

Accepted: 26 May 2023

Article published online:
09 August 2023

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