Department of Pediatric Surgery, Medical School, Dicle University, Diyarbakır 21280, Turkey.
Department of Stem Cell and Tissue Engineering, Istinye University, Istanbul 34460, Turkey.
Medicina (Kaunas). 2024 Oct 15;60(10):1696. doi: 10.3390/medicina60101696.
: The aim of this study was to evaluate the clinical presentation, treatment outcomes, and complications associated with hepatic hydatid cysts in a pediatric population. : This retrospective study analyzed 214 pediatric patients with liver hydatid cysts, focusing on clinical presentation, treatment outcomes, and associated complications. Patients were classified based on treatment modality, including non-operative management with albendazole, PAIR, and surgical intervention. This study compared cyst characteristics, recurrence rates, and complications such as cysto-biliary fistulas. : Among the patients, 68% ( = 145) had a single cyst and 86% ( = 184) were found to have isolated liver cysts. No significant statistical difference was observed between Group 1 and Group 2 in terms of age, gender, and basic laboratory values and general characteristics of the cysts, such as the lobe where the cyst was located, involvement of multiple organs, number of cysts, the state of cyst rupture, and recurrence; no statistically significant difference was found between the groups ( > 0.05 for each comparison). Cyst rupture incidence was 6%, and the average incidence of recurrence was 2%, with a surgical recurrence incidence of 3%. A total of 37 patients had a laparotomy, while 7 had laparoscopic surgery. In total, capitonnage was performed in 68 patients, omentopexy in 4, and cystostomy in 6. Consequently, among the treated patients (PAIR + surgery), the incidence of cysto-biliary fistula was 11%, anaphylaxis was 2%, surgical recurrence was 3%, and the incidence of reoperation (Clavien-Dindo ≥ 3) was 6%. The average follow-up period was 72 months, during which no mortality was observed. : We identified key clinical outcomes related to both non-surgical treatments (cyst rupture and recurrence) and surgical groups (cysto-biliary fistulas, anaphylaxis, the need for reoperation, rupture, and recurrence).
本研究旨在评估小儿肝包虫囊肿的临床表现、治疗效果和相关并发症。这项回顾性研究分析了 214 例小儿肝包虫囊肿患者，重点关注临床表现、治疗效果和相关并发症。根据治疗方式将患者分为非手术治疗（阿苯达唑）、PAIR 和手术干预三组。本研究比较了囊肿特征、复发率和并发症，如胆瘘。在患者中，68%（=145）为单个囊肿，86%（=184）为孤立性肝囊肿。在年龄、性别、基本实验室值和囊肿一般特征（如囊肿所在的肝叶、是否累及多个器官、囊肿数量、囊肿破裂状态和复发情况）方面，第 1 组和第 2 组之间无统计学差异（各比较均>0.05）。囊肿破裂发生率为 6%，平均复发率为 2%，手术复发率为 3%。共有 37 例行剖腹手术，7 例行腹腔镜手术。总共对 68 例患者进行了囊壁缝合术，对 4 例患者进行了大网膜固定术，对 6 例患者进行了囊腔造口术。因此，在接受治疗的患者（PAIR+手术）中，胆瘘发生率为 11%，过敏反应发生率为 2%，手术复发率为 3%，再次手术（Clavien-Dindo≥3）发生率为 6%。平均随访时间为 72 个月，期间无死亡病例。我们确定了与非手术治疗（囊肿破裂和复发）和手术组（胆瘘、过敏反应、需要再次手术、破裂和复发）相关的关键临床结果。
