Masood Pirzada Faisal, Mufti Gowhar Nazir, Wani Sajad Ahmad, Sheikh Khurshid, Baba Aejaz Ahsan, Bhat Nisar Ahamd, Hamid Raashid
Department of Paediatric Surgery, SKIMS, Srinagar, Jammu and Kashmir, India.
Department of Paediatric Surgery, GMC, Srinagar, Jammu and Kashmir, India.
J Minim Access Surg. 2022 Jul-Sep;18(3):360-365. doi: 10.4103/jmas.JMAS_220_20.
: Surgery continues to be the mainstay of treatment of hydatid cysts of the liver. Laparoscopy provides a lesser invasive tool for achieving results same as with the established open surgical techniques. The purpose of the study was to evaluate the feasibility and safety of laparoscopic management of hepatic hydatid disease in children.
It was a prospective randomised study conducted over a period of 7 years. Children with Gharbi Type I, II, III cysts, ≤3 cysts and superficial accessible cysts were treated laparoscopically and their outcomes were compared with matched controls treated by open approach.
Sixty patients were included in the study with thirty patients in each matched group. Thirty paediatric patients (male 12:female 18) with 35 liver hydatid cysts underwent laparoscopic surgery. The mean cyst size was 8.8 ± 2.39 cm. Two patients needed conversion to open. No significant spillage of cyst contents was observed in any of the patients. Duration of hospital stay, time to removal of drains, duration of parenteral analgesia, severity of pain in postoperative period, time to ambulation and time to return to full orals were significantly lower in laparoscopic group compared to open group. Complication rates in both the groups were similar.
With proper patient selection, laparoscopic management of hydatid cysts of the liver in children is feasible and safe option with low morbidity, low rates of conversion and minimal complications.
手术仍然是治疗肝包虫囊肿的主要方法。腹腔镜检查提供了一种侵入性较小的工具，可取得与既定开放手术技术相同的效果。本研究的目的是评估儿童肝包虫病腹腔镜治疗的可行性和安全性。
这是一项为期7年的前瞻性随机研究。对患有加尔比I型、II型、III型囊肿、囊肿数量≤3个且易于腹腔镜手术触及的浅表囊肿的儿童进行腹腔镜治疗，并将其结果与采用开放手术治疗的匹配对照组进行比较。
该研究纳入了60例患者，每组匹配30例。30例患有35个肝包虫囊肿的儿科患者（男12例：女18例）接受了腹腔镜手术。囊肿平均大小为8.8±2.39厘米。2例患者需要转为开放手术。所有患者均未观察到囊肿内容物明显外溢。与开放手术组相比，腹腔镜手术组的住院时间、引流管拔除时间、胃肠外镇痛时间、术后疼痛严重程度、下床活动时间和恢复正常饮食时间均显著缩短。两组的并发症发生率相似。
经过适当的患者选择，儿童肝包虫囊肿的腹腔镜治疗是一种可行且安全的选择，具有低发病率、低中转率和极少的并发症。
