Department of Thoracic Surgery, Mohamed V Military University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco.
Department of Thoracic Surgery, Mohamed V Military University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco.
J Pediatr Surg. 2020 Mar;55(3):433-436. doi: 10.1016/j.jpedsurg.2019.03.003. Epub 2019 Mar 19.
The objective of this study was to describe the role of surgical management of ruptured hydatid cysts into the pleural cavity in children. A review of the management of patients with intrapleural rupture of pulmonary hydatid cysts in children at our center was performed.
A retrospective chart review was performed on all children who developed intrapleural rupture of a hydatid cyst in the lung. Patients with intrapleural rupture from other locations (liver, mediastinum, diaphragm, kidney) were excluded.
In these 19 patients, there were 11 males and 8 females with a mean age of 9.4 years (range 7-16 years). Different clinical symptoms, biological, and imaging data allowed the diagnosis. The surgical approach consisted of a posterolateral thoracotomy and decortication in all patients. In addition, different procedures were needed for the pulmonary lesion according to the degree of lung destruction. Radical resections were required in four cases, including lobectomies (n = 1) and segmentectomies (n = 3). Conservative treatment was possible in 15 patients (simple capitonnage and bronchial fistula closure). Post-operative complications occurred in 2 cases (10.5%), including one pyothorax with a prolonged air leak and one wound infection. There were no postoperative deaths. There was no recurrence of thoracic hydatid disease in postoperative follow-up ranging from 1 to 3 years (mean: 2 years).
Intrapleural hydatid cyst rupture may be prevented by early treatment of simple forms to avoid increased morbidity.
Level IV.
本研究旨在描述儿童胸腔内破裂包虫囊肿的手术治疗作用。我们对中心收治的儿童肺内包虫囊肿破裂患者的治疗情况进行了回顾性分析。
对所有发生肺内包虫囊肿破裂的儿童患者进行了回顾性图表分析。排除了其他部位（肝、纵隔、膈肌、肾）包虫囊肿破裂的患者。
在这 19 例患者中，男 11 例，女 8 例，平均年龄 9.4 岁（7-16 岁）。不同的临床症状、生物学和影像学数据有助于诊断。所有患者均采用后外侧开胸和去皮质术。此外，根据肺部破坏程度，肺部病变需要不同的手术方式。4 例患者需要根治性切除，包括肺叶切除术（n=1）和肺段切除术（n=3）。15 例患者可采用保守治疗（单纯包裹和支气管瘘闭合）。2 例（10.5%）发生术后并发症，包括一例脓胸伴长时间漏气和一例伤口感染。无术后死亡病例。术后随访 1-3 年（平均 2 年）未见胸腔包虫病复发。
早期治疗单纯性包虫囊肿可预防胸腔内包虫囊肿破裂，降低发病率。
IV 级。
