경화치료술은 양성 재발성 자궁부속기 낭종 혹은 가성낭종 치료에 있어서 제한적이지만 수술적 치료를 대체할 수 있을 것으로 사료되며 시술시에 무수알콜을 포함한 조직경화제를 병용투여함으로써 경화작용의 상승효과와 부작용 감소효과를 얻을 것으로 사료되며 낭종 흡인액과 무수알콜 세척액으로 세포병리학적 진단을 시행하므로 정확성을 높일 수 있을 것으로 기대되고 있다. 그러나 제한된 조건의 낭종치료가 아닌 일반적인 골반강내 양성 낭종치료에 대한 경화술의 적용은 본연구가 대상 환자가 적고 국한적이며 추적 관찰 기간이 충분치 않아 향후 지속적이고 광범위한 연구가 필요하며 또한 흡인된 낭액에 대한 세포병리학적 진단의 정확성 평가의 보완이 선행된 후에야 고려해야 한다고 사료된다.

Objective: To evaluate the applicability and efficacy of the sclerotherapy for management of pseudocysts and recurrent benign ovarian cysts.Material and Method: From February 1997 to August 1997, six patients with suspected pseudocyst and fifteen patients with suspected benign recurrent adnexal cyst (12 cases of endometrioma: 2 cases of serous cystadenoma: 1 case of paraovarian cyst) who had undergone previous pelvic surgery were included in this prospective study. All patients underwent pelvic color doppler sonography (CDS) and their blood sampled for the tumor makers α-FP, CEA, β-hCG, CA-125. The patients without suspicion of malignany were scheduled for sclerotherapy. Under intravenous analgesia, the cysts were irrigated with dehydrated alcohol of 2/3 volumn first and then with 5% doxycycline of 10% volume was inserted after complete cyst aspiration under the transvaginal ultrasonogram. The aspirated contents were sent for cytologic examination. All the patients were followed up monthly with CDS for over 4 months. Results: All cysts revealed to be benign upon cytologic examination, were 4cm-15cm in size, and 25cc-820cc in aspirated volume. In two patients with serous cystadenoma confirmed by cytology, pelviscopic surgery were performed. In thirteen patients with benign recurrent adnexal cyst, there was excellent ovarian parenchymal preservation and no recurrances with this procedure after follow-up for 4-10 months. But in the two patients with pseudocysts, the cysts recurred after repetitive attempts and sustained for 4-6 months with reduction of size and symptom. Conclusion: Sclerotherapy is an easy, safe and highly effective procedure and considered as valid alternative method for management of benign recurrent adnexal cyst, although for pseudocysts the efficacy was not conclusive. But considering the limitation of ultrasonography and tumor markers in determining malignancy of tumor, this procedure has to be confined to patients with the benign recurrent cyst confirmed by previouslyoperative procedures.