Karavdic Kenan, Guska Safet
Clinic for Paediatric Surgery, Clinical Center University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina.
Med Arh. 2011;65(1):16-9.
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. Retrospective appraisal of the pressentation, approach to surgical treatment and outcome of hydatid disease in children at the Clinic for Pediatric Surgery and Clinic for Thoracic Surgery University of Sarajevo Clinics Centre in period between 2000-2008. We surgically treated 72 patients (57 male, 15 female) with a diagnosis of pulmonary hydatid disease with average age of 10.36 +/- 4.28 (range 4 to 18) years. Chest radiographs, computer tomograms and ultrasonography were the main methods of diagnosis. The basic principle of surgery was to preserve lung parenchyme as much as possible. Clinical assessment of the symptoms, plain and lateral chest X-rays and computed tomograms led to the correct diagnosis in 100% (72/72) of patients. Solitary lung cysts were found in 79.17% (57/72) patients. While the remaining were multiple cysts in one or more lobes of one or both lungs. Intact cysts were found in 48 (52.17%) and rupture cysts in 44 (47.83%) cases. Lung preserving surgical intervention were done in all of the patients. There was no mortality. Recurrent hydatid cysts were observed in 2.78% (2/72) patients. 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 in children.
包虫病在世界各地的牛羊养殖地区呈地方性流行。在包括波斯尼亚和黑塞哥维那在内的地中海地区，其患病率也很高。回顾性评估2000年至2008年期间萨拉热窝大学临床中心儿科外科诊所和胸外科诊所儿童包虫病的临床表现、手术治疗方法及结果。我们对72例诊断为肺包虫病的患者（男57例，女15例）进行了手术治疗，平均年龄为10.36±4.28岁（4至18岁）。胸部X光片、计算机断层扫描和超声检查是主要的诊断方法。手术的基本原则是尽可能保留肺实质。通过对症状的临床评估、胸部正侧位X光片和计算机断层扫描，100%（72/72）的患者得到了正确诊断。79.17%（57/72）的患者发现为孤立性肺囊肿。其余患者为一侧或双侧一个或多个肺叶的多发性囊肿。48例（52.17%）为完整囊肿，44例（47.83%）为破裂囊肿。所有患者均进行了保留肺的手术干预。无死亡病例。2.78%（2/72）的患者观察到复发性包虫囊肿。保留肺的手术干预是儿童肺包虫囊肿的首选治疗方法。儿童应尽可能避免进行诸如肺段切除术、肺叶切除术和全肺切除术等根治性手术。
