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[Conservative surgical treatment of pulmonary hydatid disease in children]
Safet Guska1, Zinaida Cerimagić, Ilijaz Pilav
1Klinika za torakalnu hirurgiju, Klinitki centar Univerziteta Sarajevo. guska@bih.net.ba
Insights
Pediatric pulmonary hydatid disease requires lung-sparing surgery. This approach minimizes complications and recurrence, making it the preferred treatment for children with lung cysts.
Area of Science:
- Thoracic Surgery
- Pediatric Surgery
- Parasitology
Background:
- Hydatid disease is endemic in livestock-raising regions globally, with high prevalence in the Mediterranean.
- Bosnia and Herzegovina is a region with significant hydatid disease incidence.
Purpose of the Study:
- To retrospectively analyze the presentation, surgical treatment, and outcomes of pediatric hydatid disease.
- To evaluate the effectiveness of lung-preserving surgical techniques in children.
Main Methods:
- Surgical treatment of 58 pediatric patients (ages 4-15) with pulmonary hydatid disease.
- Diagnosis confirmed using chest radiographs, computed tomography (CT), and ultrasonography.
- Emphasis on lung parenchyma preservation during surgical interventions.
Main Results:
- 100% diagnostic accuracy achieved with clinical assessment and imaging (X-ray, CT).
- Solitary cysts in 68.97% of patients, multiple cysts in 31.03%.
- Lung-preserving surgeries performed in all cases with low complication (5.17%) and recurrence (3.45%) rates, and no mortality.
Conclusions:
- Lung-preserving surgical interventions are the optimal treatment for pediatric pulmonary hydatid cysts.
- Radical procedures like segmentectomy, lobectomy, and pneumonectomy should be minimized in children.
- This approach leads to favorable outcomes with minimal morbidity.
Background:
Hydatide disease is endemic in sheep and cattle-raising areas world wide. Its prevalence is also high in the Mediterranean region including Bosnia and Herzegovina.
Objective:
Retrospective appraisal of the presentation, approach to surgical treatment and outcome of hydatid disease in children at the Clinic for Thoracic Surgery UCC Sarajevo between January 2000 and January 2007.
Patients And Methods:
We surgically treated 58 patients (48 male, 10 female) with a diagnosis of pulmonary hydatid disease with average age of 11,36 +/- 3,78 (range 4 to 15) years. Chest radiographs, computed tomograms and ultrasonography were the main methods of diagnosis. The basic principle of surgery was to preserve lung parenchyme as much as possible.
Results:
Clinical assessment of the symptoms, plain and lateral chest X-rays and computed tomograms led to the correct diagnosis in 100,0% (58/58) of patients. Solitary lung cyst was found in 68,97% (40/58) patients while the remaining 31,03% (18/58) were multiple cysts in one or more lobes of one or both lungs. Intact cysts were found in 51,35% (38/74) and ruptured cysts in 48,65% (36/74) cases. Lung preserving surgical interventions were done in all of the patients. Postoperative complications were seen in 5,17% (3/58) patients. There was no mortality. Recurrent hydatid cysts were observed in 3,45% (2/58) patients.
Conclusion:
Lung preserving surgical interventions are the treatment of choice for pulmonary hydatid cysts in children. Radical surgical procedures such as segmentectomy, lobectomy and pneumonectomy should be avoided as much as possible.