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Outcomes and Risk Factors for Morbidity After Lung Hydatidosis Surgery in Children
Zied Chaari1, Saloua Ammar2, Aymen Ben Ayed1
1Department of Thoracic and Cardiovascular Surgery, University of Sfax-Habib Bourguiba University Hospital, Sfax, Tunisia.
Insights
Conservative surgery is the preferred treatment for pediatric lung hydatidosis (LH), showing low mortality. Identifying risk factors for complications can improve surgical outcomes in children with this parasitic lung disease.
Area of Science:
- Pediatric Surgery
- Parasitic Diseases
- Thoracic Surgery
Background:
- Lung hydatidosis (LH) is a parasitic infection affecting the lungs, primarily caused by Echinococcus granulosus.
- Surgical management of pediatric lung hydatidosis requires careful consideration of outcomes and risk factors.
Purpose of the Study:
- To evaluate the outcomes of surgical interventions for lung hydatidosis in children.
- To identify independent risk factors associated with postoperative morbidity in pediatric patients undergoing surgery for lung hydatidosis.
Main Methods:
- A retrospective, analytical study was conducted over 35 years, including all pediatric surgical cases of lung hydatidosis.
- Univariate and multivariable analyses were employed to determine predictors of postoperative complications.
Main Results:
- The study included 456 children undergoing 544 procedures for 704 lung hydatidosis cysts.
- Conservative surgery was performed in 98.5% of cases, with a 24.4% complication rate and 0.2% mortality.
- Independent risk factors for morbidity included anatomical lung resection, ICU stay, complicated cysts, larger cyst size (≥60 mm), multiple bronchial fistulas, liver hydatidosis, and empyema.
Conclusions:
- Conservative lung-sparing surgery is the optimal treatment for pediatric lung hydatidosis, associated with low mortality.
- Understanding identified risk factors can guide clinical management and enhance postoperative outcomes for children with lung hydatidosis.
Objective:
To examine outcomes and associated risk factors for children who undergo surgery for lung hydatidosis (LH).
Study Design:
Through a retrospective and analytical-aim-study, over a period of 35 years in 2 surgical departments, we reported all operative cases for LH in children, regardless of cyst number, location, and aspect. Univariate and multivariable analyses were used to assess variables potentially predictive of postoperative morbidity.
Results:
In total, 456 children with a mean age of 10.3 years were included. We performed 544 surgical procedures for 704 cysts with a median size of 60 mm (range 10-200 mm). Thirty-six percent of cysts were complicated. Conservative surgery was performed in 98.5% of cases and anatomical lung resection was required for 1.47% of children. Postoperative complications occurred in 24.4% of children and one death was recorded (0.2%). After multivariable analysis, the independent-associated morbidity risk factors for postoperative morbidity were anatomical lung resection, intensive care unit stay, complicated cyst, a cyst size ≥60 mm, ≥3 bronchial fistulas, associated liver hydatidosis, and the presence or occurrence of empyema during surgery.
Conclusions:
Conservative surgery sparing the lung parenchyma is the treatment of choice for lung hydatidosis and is associated with a low mortality rate. Knowledge of independent risk factors for morbidity may help clinicians to manage children with LH more adequately and improve postoperative outcomes.
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