Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia.
Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia.
J Pediatr Surg. 2023 Dec;58(12):2362-2367. doi: 10.1016/j.jpedsurg.2023.07.003. Epub 2023 Jul 8.
Liver hydatid cyst affects approximately 95% of the world's echinococcosis cases. Despite advances in treatment, the recurrence rate remains high and is influenced by several factors that are yet to be determined. The objective of this study was to identify the predictive factors of liver hydatid cyst recurrence following surgery in children and to establish a treatment regimen aimed at preventing this postoperative morbidity.
A bi-centric retrospective descriptive and analytic study was conducted involving 122 children who underwent surgery for liver hydatid cysts between January 1st, 2009, and December 31st, 2017. All factors that could potentially contribute to recurrence were thoroughly investigated. The data was processed using SPSS.v21, and a significant level of p-value 0.05 was applied.
Out of the 122 children, 20 patients experienced cyst recurrence (16.39%). Among them, there were nine girls and eleven boys. The median time of recurrence was 16.5 months. Abdominal ultrasonography demonstrated efficacy in detecting recurrence. Several factors were identified as predictors of postoperative recurrence, including intimate contact of the hydatid cyst with the large vessels (p = 0.031), intraperitoneal effusion (p = 0.042), bile duct dilation (p = 0.032), and postoperative spontaneous discontinuation of medical treatment (p = 0.010). Among these factors, two independent risk factors for recurrence were identified: intimate contact of the hydatid cyst with the large vessels (p = 0.011) and the presence of an intraperitoneal effusion (p = 0.018).
Our study has identified several predictors of postoperative recurrence, including two previously undocumented risk factors in the literature. Awareness of these risk factors can assist surgeons in implementing preventive measures to avoid the recurrence of hydatid cysts.
Prognosis study Level II.
肝包虫囊肿影响了世界上约 95%的包虫病病例。尽管治疗方法有所进步，但复发率仍然很高，而且受到一些尚未确定的因素的影响。本研究的目的是确定儿童肝包虫囊肿手术后复发的预测因素，并制定旨在预防这种术后发病率的治疗方案。
进行了一项双中心回顾性描述性和分析性研究，共纳入 122 例 2009 年 1 月 1 日至 2017 年 12 月 31 日期间接受肝包虫囊肿手术的儿童。对可能导致复发的所有因素进行了深入调查。数据使用 SPSS.v21 处理，应用具有统计学意义的 p 值为 0.05。
在 122 例患儿中，20 例（16.39%）出现囊肿复发。其中，女孩 9 例，男孩 11 例。复发的中位时间为 16.5 个月。腹部超声检查对复发的检测具有良好的效果。确定了几个因素可作为术后复发的预测因素，包括包虫囊肿与大血管的密切接触（p=0.031）、腹腔积液（p=0.042）、胆管扩张（p=0.032）和术后自行停止药物治疗（p=0.010）。在这些因素中，确定了两个与复发相关的独立危险因素：包虫囊肿与大血管的密切接触（p=0.011）和腹腔积液（p=0.018）。
本研究确定了术后复发的几个预测因素，包括文献中未记录的两个危险因素。了解这些危险因素可以帮助外科医生采取预防措施，避免包虫囊肿的复发。
预后研究 II 级。
