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Surgical approach of pulmonary hydatidosis in childhood
I C Kurkcuoglu1, A Eroglu, N Karaoglanoglu
1Department of Thoracic Surgery, School of Medicine, Ataturk University, 25240 Erzurum, Turkey.
Insights
This study reviewed surgical treatments for pediatric lung hydatid disease. Parenchyma-preserving surgeries are recommended to reduce recurrence and improve outcomes in children.
Area of Science:
- Pediatric Surgery
- Parasitology
- Thoracic Surgery
Background:
- Hydatid disease of the lung is a parasitic infection caused by Echinococcus granulosus.
- Pulmonary hydatid cysts are common in endemic areas, particularly affecting children.
- Surgical intervention is the primary treatment for symptomatic pulmonary hydatid cysts.
Purpose of the Study:
- To review the outcomes of various surgical treatments for pulmonary hydatid disease in pediatric patients.
- To evaluate the efficacy and complications associated with different surgical techniques.
- To identify optimal surgical strategies for managing lung hydatid disease in children.
Main Methods:
- A retrospective review of 102 pediatric patients treated for pulmonary hydatid cysts between 1990 and 2001.
- Diagnostic methods included chest radiography, computed tomography, and abdominal ultrasonography.
- Surgical procedures included partial cystectomy and capitonnage, with various approaches like thoracophrenotomy and sternotomy.
Main Results:
- The majority of cysts were located in the right lung (66.6%).
- Concomitant liver hydatid disease was present in 12 patients with right lung involvement.
- The overall complication rate was 9.8%, with incision site infection and air leakage being the most common. One patient (1%) died due to sepsis.
Conclusions:
- Parenchyma-protective operations are recommended, especially in endemic areas, to minimize recurrence risk.
- Single-stage operations in suitable cases can reduce treatment costs, hospital stay, and morbidity.
- Surgical management should aim for parenchyma preservation to ensure better long-term outcomes in pediatric patients.
Abstract:
To review the results of different surgical treatment in hydatid disease of the lung in paediatric patients. A total of 102 children with pulmonary hydatid cysts were treated at the our clinic in the period from 1990 to 2001. There were 59 boys and 43 girls and their age ranged from 4 to 16 years (mean 10.2). Chest radiography, computed tomography and abdominal ultrasonography were the most commonly used diagnostic techniques. The cysts were located in the right lung in 68 patients (66.6%), in the left lung in 30 patients (29.4%), in both lungs in four patients (3.9%). Concomitant liver cyst hydatid was also detected in 12 patients that were located at right lung, and two patients with bilateral lung involvement. All cases were managed surgically. Of 14 cases with concomitant liver and intrathoracic hydatid cysts, right thoracophrenotomy was performed in 12, median sternotomy in one, and phrenotomy in other. Partial cystectomy and capitonnage were the most commonly used surgical methods. Post-operative complication was seen in 10 (9.8%) patients. Infection at the incision site occurred in four patients and air leakage in three. Complications of capitonnage were seen in three patients. One patient (1%) died at fourth post-operative day due to sepsis. Parenchyma protective operations should be performed especially in children living in endemic areas because of the possibility of recurrence of the disease in the future. Single stage operations in suitable cases decrease the cost of treatment and make surgical therapy suitable in both children and young adults, by reducing the hospital in-patient time and morbidity.