Rebhandl W, Turnbull J, Felberbauer F X, Tasci E, Puig S, Auer H, Paya K, Kluth D, Tasci O, Horcher E
Department of Pediatric Surgery, University of Vienna Medical School, Austria.
Pediatr Pulmonol. 1999 May;27(5):336-40. doi: 10.1002/(sici)1099-0496(199905)27:5<336::aid-ppul7>3.0.co;2-1.
From 1986-1996, 33 children with 49 pulmonary hydatid cysts underwent surgical treatment in Vienna and Istanbul. Cysts were unilateral in 28 and bilateral in 5 cases; unruptured cysts (URC) were diagnosed in 19 patients, and 14 children presented with ruptured cysts (RC). Ten patients had cysts in other organs (liver, spleen, central nervous system) in addition to pulmonary cysts. Diagnosis was primarily based on chest X-ray and computed tomography scan. In Austrian children, a new combination of serological tests was used successfully (71% positive). The standard surgical procedure was cystotomy followed by capitonnage. The main postoperative complications were fever and wound infection. There were two recurrences after a mean follow-up of 4.8 years, and one patient died because of multiple organ involvement. We conclude that the therapy of choice in pediatric pulmonary hydatidosis is complete surgical elimination of the cyst by cystotomy and capitonnage, whereas more extended resections should be avoided. Ideally, benzimidazole treatment should be combined with surgery. New serological tests can improve diagnostic accuracy.
1986年至1996年期间，维也纳和伊斯坦布尔有33名患有49个肺包虫囊肿的儿童接受了手术治疗。囊肿单侧的有28例，双侧的有5例；19例诊断为未破裂囊肿（URC），14例儿童表现为破裂囊肿（RC）。10例患者除肺囊肿外，其他器官（肝脏、脾脏、中枢神经系统）也有囊肿。诊断主要基于胸部X线和计算机断层扫描。在奥地利儿童中，一种新的血清学检测组合被成功应用（阳性率71%）。标准手术程序是囊肿切开术，随后进行内翻缝合。主要术后并发症是发热和伤口感染。平均随访4.8年后有2例复发，1例患者因多器官受累死亡。我们得出结论，小儿肺包虫病的首选治疗方法是通过囊肿切开术和内翻缝合完全手术切除囊肿，而应避免更广泛的切除。理想情况下，苯并咪唑治疗应与手术相结合。新的血清学检测可以提高诊断准确性。
