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Pediatric hepatic hydatid cysts: recurrence risk factors following laparoscopic surgery-a 16-year cohort analysis
Marwa Messaoud1, Amani N Alansari2, Radhouene Ben Salah1
1Pediatric Surgery Department, Faculty of Medecine, Fattouma Bourguiba Hospital, University of Monastir, Monastir, Tunisia.
Insights
Recurrence of hepatic hydatid cysts in children after laparoscopic surgery is linked to longer surgical times and cyst location. Perioperative albendazole therapy did not significantly reduce recurrence rates in this study.
Area of Science:
- Pediatric Surgery
- Hepatobiliary Surgery
- Parasitic Infections
Background:
- Hepatic hydatid cyst recurrence after laparoscopic surgery is a significant challenge in pediatric patients.
- Perioperative albendazole therapy is proposed to reduce recurrence, but its efficacy requires further investigation.
- Identifying predictive factors for recurrence is crucial for improving pediatric patient outcomes.
Purpose of the Study:
- To identify predictive factors associated with the recurrence of hepatic hydatid cysts in children following laparoscopic surgery.
- To evaluate the impact of cyst characteristics and perioperative albendazole therapy on recurrence rates.
- To enhance surgical strategies and postoperative management for pediatric patients with hepatic hydatid cysts.
Main Methods:
- Retrospective cross-sectional analytical study of pediatric patients (<16 years) undergoing laparoscopic surgery for hepatic hydatid cysts (2006-2021).
- Data collected included patient demographics, cyst characteristics (size, location, number), albendazole therapy, surgical duration, and complications.
- Logistic regression analysis was employed to identify factors associated with cyst recurrence (p < 0.05).
Main Results:
- A total of 152 pediatric patients were analyzed, with a recurrence rate of 12%.
- Longer surgical duration (HR=1.02) and cysts located outside liver segment II (HR=0.11) were independently associated with recurrence.
- Perioperative albendazole therapy was more common in the non-recurrence group but did not reach statistical significance.
Conclusions:
- Extended surgical duration and specific cyst locations are key predictors of post-laparoscopy recurrence in pediatric hepatic hydatid cysts.
- Perioperative albendazole therapy, while more frequent in non-recurrence cases, did not significantly reduce recurrence rates in this cohort.
- Tailored surgical approaches and vigilant postoperative monitoring are essential for optimizing outcomes in pediatric patients.
Background:
Recurrence of hepatic hydatid cysts after laparoscopic surgery poses a significant challenge in pediatric patients. The administration of albendazole therapy pre- and post-operatively is proposed to reduce recurrence rates, yet its impact requires further investigation. This study aims to identify predictive factors associated with recurrence of hepatic hydatid cysts in children following laparoscopic surgery, focusing on cyst characteristics and perioperative albendazole therapy.
Methods:
A retrospective cross-sectional analytical study was conducted using medical records of pediatric patients under 16 years of age who underwent laparoscopic surgery for hepatic hydatid cysts between 2006 and 2021. Collected data included patient demographics, cyst characteristics (size, location, and number), preoperative and postoperative albendazole therapy, surgical duration, and intraoperative complications. Logistic regression analysis was used to identify factors associated with cyst recurrence during the follow-up period, with statistical significance set at p < 0.05.
Results:
A total of 152 pediatric patients were included, with a mean age of 7.9 ± 3.3 years. The recurrence rate was 12% (n = 18). In multivariate analysis, longer surgical duration (HR = 1.02; 95% CI 1.00-1.03; p = 0.013) and cysts located outside liver segment II (HR = 0.11; 95% CI 0.01-0.9; p = 0.039) were independently associated with recurrence. Albendazole therapy, administered pre- or post-operatively, was more frequent in the non-recurrence group but did not reach statistical significance. No cases of peritoneal hydatidosis were recorded during follow-up.
Conclusion:
Key predictors of post-laparoscopy recurrence included extended surgical duration and cyst location. Although perioperative albendazole therapy was more frequent in the non-recurrence group, it did not reach statistical significance in reducing recurrence rates. These findings highlight the importance of tailored surgical approaches and careful postoperative monitoring to improve patient outcomes.
