Kanat Fikret, Turk Emel, Aribas Olgun Kadir
Department of Chest Diseases, Meram Medical School of Selcuk University, Konya, Turkey.
ANZ J Surg. 2004 Oct;74(10):885-9. doi: 10.1111/j.1445-1433.2004.03022.x.
The purpose of the present study was to compare the clinical features and the surgical approaches of the pulmonary hydatid cysts in children and adults.
One hundred and thirty-four patients, operated on for pulmonary hydatid cysts over the last 10 years were retrospectively evaluated in two groups: 39 children who were younger than 18 years old (29%) and 95 adults (71%). The patients in each group were analysed according to their clinical, radiological and surgical findings.
The frequency of pulmonary hydatid cysts in children was significantly higher in boys (74%) than in girls (26%). However, there was no sex tendency in adults (52% in male vs 48% in women). The sex difference in hydatid cyst frequencies between adults and children was significant (P < 0.05). Among preoperative pleural complications, pneumothorax (15.5%) in children and empyema (11%) in adults were more frequent. The frequency of concomitant hepatic cysts was less in children than in adults (33%vs 79%). Huge pulmonary cysts (=10 cm) were more common in children (31%) than in adults (22%). Cystotomy with capitonnage was the most frequently preferred method in both groups. Postoperative complications developed in six children (16%) and 19 adults (19%), and were more frequent in patients with huge cysts (27%vs 16%). No recurrence was observed in both groups.
Isolated pulmonary cysts are more common in children than adults. The cysts also tend to be bigger in children than adults. The frequency of concomitant hepatic cysts is less in children. Because of higher lung expansion ability and improvement capacity in children, resection should be avoided and lung saving surgical procedures should be performed. In spite of differences observed in the clinical features it does not change the treatment of pulmonary hydatid cysts in children.
本研究的目的是比较儿童和成人肺包虫囊肿的临床特征及手术方式。
回顾性评估过去10年中接受肺包虫囊肿手术的134例患者,分为两组:39例18岁以下儿童(29%)和95例成人(71%)。根据临床、影像学和手术结果对每组患者进行分析。
儿童肺包虫囊肿的发生率男孩(74%)显著高于女孩(26%)。然而,成人中无性别倾向(男性52%,女性48%)。成人与儿童包虫囊肿发生率的性别差异显著(P<0.05)。术前胸膜并发症中,儿童气胸(15.5%)和成人脓胸(11%)更为常见。儿童合并肝囊肿的发生率低于成人(33%对79%)。巨大肺囊肿(≥10 cm)在儿童中(31%)比成人中(22%)更常见。两组最常采用的方法是囊肿切开缝合术。6例儿童(16%)和19例成人(19%)出现术后并发症,巨大囊肿患者更常见(27%对16%)。两组均未观察到复发。
孤立性肺囊肿在儿童中比成人更常见。儿童的囊肿也往往比成人更大。儿童合并肝囊肿的发生率较低。由于儿童肺扩张能力和恢复能力较强,应避免切除,应采用保留肺的手术方法。尽管临床特征存在差异,但这并不改变儿童肺包虫囊肿的治疗方法。