BMJ. 1996 Nov 2;313(7065):1110-3.
Role of puncture and aspiration in expectant management of simple ovarian
cysts: a randomised study.
Zanetta G, Lissoni A, Torri V, Dalla Valle C, Trio D, Rangoni G, Mangioni C.
Department of Obstetrics and Gynaecology, Ospedale San Gerardo di Monza, III
Branch of the University of Milan, Italy.
Objectives:
To assess the potential of expectant management for simple
ovarian cysts diagnosed by transabdominal or transvaginal ultrasonography.
To compare the results of needle aspiration with those achieved with simple
observation.
Design:
Randomised trial.
Setting:
Hospital department of
obstetrics and gynaecology.
Subjects:
278 women with simple cysts randomly
allocated to simple observation (143) or ultrasound guided fine needle
aspiration (135) between 1990 and 1994.
Settings, Design and Main Outcome Measures:
Resolution of
cyst or development of malignancy.
Results:
After six months 269 were
available for follow up. The rate of resolution was 46% (59/128) with
aspiration and 44.6% (63/141) with observation. Only the diameter of the
cyst (P < 0.0001) was a significant independent prognostic factor for
resolution in a multivariate analysis. Age and treatment had no significant
effect. One woman was subsequently found to have borderline malignant
changes on histopathological examination. Her cyst was detected by
transabdominal ultrasonography.
Conclusions:
Expectant management for up to
six months does not cause risks for the patients and allows spontaneous
resolution in over a third of cases, avoiding the costs and risks of
unnecessary surgery. Aspiration does not provide better results than simple
observation.
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