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  • Title: Ultrasound-Guided Aspiration With and Without Ethanol Sclerotherapy in the Management of Simple Adnexal Cysts: A Single-Center Experience.
    Author: Castellarnau M, García-Tejedor A, Carreras R, Cayuela E, Ponce J.
    Journal: J Minim Invasive Gynecol; 2016 Feb 01; 23(2):242-51. PubMed ID: 26496806.
    Abstract:
    STUDY OBJECTIVES: To compare the efficacy of ultrasound-guided aspiration versus aspiration with ethanol sclerotherapy in the management of simple adnexal cysts measuring 3 to 10 cm, and to explore the risk factors for recurrence associated with each approach. DESIGN: A prospective follow-up of patients after cyst aspiration with and without ethanol sclerotherapy in simple adnexal cysts in a single-center trial (Canadian Task Force classification II-1). SETTING: Bellvitge Teaching Hospital, Barcelona, Spain. PATIENTS: Cyst aspiration and ethanol sclerotherapy were performed in 66 and 75 patients, respectively, between 2002 and 2014. Women enrolled before March 2009 underwent simple aspiration (group 1), and those enrolled after March 2009 underwent ethanol sclerotherapy (group 2). INTERVENTIONS: Ultrasound-guided fine-needle aspiration with and without ethanol sclerotherapy. MEASUREMENTS AND MAIN RESULTS: Potential risk factors for recurrence-age, menopausal status, symptoms, cyst diameter, laterality, aspirated volume, simple US-guided aspiration or alcohol sclerotherapy, and complications-were analyzed by logistic regression. The recurrence rates were analyzed by the Kaplan-Meier and Mantel-Haenszel methods. The overall recurrence rates were 72.7% (48 of 66) in group 1 and 22.7% (17 of 75) in group 2 (p < .0001). Risk factors significantly associated with recurrence were simple aspiration without ethanol sclerotherapy (odds ratio [OR], 19.7; 95% confidence interval [CI], 6.756-57.714), postmenopausal status (OR, 9.3; 95% CI, 1.720-50.956), and cyst size (OR, 1.04; 95% CI, 1.005-1.093). CONCLUSION: Based on the lower recurrence rate, ethanol sclerotherapy was more efficacious than simple aspiration in the management of simple adnexal cysts measuring <10 cm.
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