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Conservative surgery for treatment of hydatid cysts in children
Zafer Türkyilmaz1, Kaan Sönmez, Ramazan Karabulut
1Department of Pediatric Surgery, Gazi Medical Faculty, Besevler, 06500 Ankara, Turkey. zafertrk@yahoo.com
Insights
Pediatric hydatid cysts in the lungs and abdomen can be effectively treated with conservative surgery. This approach avoids organ resection, leading to zero operative mortality and low morbidity for treating echinococcosis.
Area of Science:
- Medicine
- Surgery
- Parasitology
Background:
- Human echinococcosis is a significant health concern, particularly in endemic regions like Turkey.
- Pediatric cases of pulmonary and abdominal hydatid cysts require careful surgical management.
Purpose of the Study:
- To analyze surgical outcomes in pediatric patients with pulmonary and abdominal hydatid cysts over a 15-year period.
- To evaluate the effectiveness of conservative surgical techniques in managing hydatid disease.
Main Methods:
- Retrospective analysis of 42 pediatric patients (ages 2-15) treated between 1986 and 2001.
- Detailed review of cyst locations, surgical procedures, complications, and recurrence rates.
- Focus on conservative approaches like cystotomy, capitonnage, partial pericystectomy, and omentoplasty.
Main Results:
- Zero operative mortality and a 14% morbidity rate were observed.
- Three patients (7%) with disseminated disease experienced recurrence.
- Conservative procedures were employed for all lung and liver cysts, with cyst excision for localized abdominal disease.
Conclusions:
- Conservative surgical approaches are highly successful for pediatric pulmonary and abdominal hydatid cysts.
- Partial organ resections are unnecessary for treating hydatid disease.
- Techniques such as cystotomy plus capitonnage and partial pericystectomy with omentoplasty yield excellent results.
Abstract:
Human echinococcosis is endemic in Turkey and many other areas of the world. Fifteen years of surgical assessment related to involved structures, operative procedures, complications, and the recurrence rate is analyzed in pediatric patients with pulmonary and abdominal hydatid cysts. Between 1986 and 2001, the records of 42 pediatric patients (15 girls, 27 boys; ages 2-15 years) with pulmonary and abdominal hydatid cysts operated on in our clinic were analyzed retrospectively. The features of the disease, involved structures, operative procedures, complications, and recurrences were noted. A total of 26 patients presented with solitary cysts in the lung (9) and liver (17). Another 11 had multiple cysts in both lung and liver, and 5 had disseminated abdominal disease. Conservative surgical procedures were used for all lung and liver cysts: cystotomy (7) or cystotomy plus capitonnage (13) for lung cysts; partial pericystectomy with capitonnage (25), omentoplasty (28), tube drainage in the presence of bile leakage (5), or a combination of these procedures for liver cysts. Cyst excision was used for omental and peritoneal localizations when feasible. Radical procedures were never used (wedge or major liver and lung resections). Operative mortality was zero, and the morbidity rate was 14%. Three patients with disseminated disease (7%) showed recurrence. We suggest that no partial organ resections are necessary for hydatid disease, and highly successful results can be achieved using conservative surgical approaches, such as cystotomy plus capitonnage for lung cysts and partial pericystectomy with capitonnage, omentoplasty, or both for liver cysts.
