Our surgical experience in children with multiple pulmonary hydatid cysts
Multipl pulmoner hidatik kist olan çocuklarda cerrahi deneyimlerimiz
Keywords:
Hidatik kist, multipl, çocukAbstract
There are very few data on multiple pulmonary hydatid cysts in childhood. Our aim in this study is to present the clinical features and treatment method of 23 pediatric patients with multiple pulmonary hydatid cysts in the light of literature information.
Twenty-three pediatric patients with two or more pulmonary cysts who were operated on between January 2010 and December 2020 for pulmonary hydatid cysts were included in the study. The patients were evaluated in terms of age, gender, symptoms, radiological imaging methods, surgical treatment, length of stay in the hospital, and postoperative complications.
15 (65.2%) of the patients were male and 8 (34.7%) were female. The mean age was 11.3 ± 4.2 years. The most common symptom was cough. The total number of cysts was 52. Six of 23 patients had a perforated hydatid cyst at admission. Perforation was in the pleural space in 4 patients, and in the bronchial system in 2 patients. While the cysts were unilateral in 19 patients, it was bilateral in 4 patients (17.3%). 6 patients had more than one cyst in the same lobe (2-4 cysts). Cystotomy and capitonage were applied in all patients. Two patients with perforated cysts had empyema and decortication was performed. Resection was not performed in any patient. Postoperative complications were atelectasis in 3 patients and prolonged air leak in 1 patient.
Parenchyma-sparing surgery should be preferred even if multiple hydatid cysts are in the same lobe because of the high expansiveness of the remaining parenchyma in children.
ÖZET
Çocukluk çağında multipl pulmoner hidatik kistler ile ilgili çok az veri vardır. Çalışmadaki amacımız kliniğimizde multipl pulmoner hidatik kistli 23 çocuk olgunun klinik özellikleri ve tedavi yöntemini, literatür bil-gileri ışığında sunmaktır. Pulmoner kist hidatik nedeniyle 2010 ocak ile 2020 aralık ayı arasında ameliyat edilen iki veya ikiden fazla pulmoner kiste sahip 23 çocuk hasta çalışmaya dahil edildi. Hastaların yaş, cinsiyet, semptom, radyolojik görüntüleme yöntemleri, cerrahi tedavisi, hastanede kalış süresi ve postoperatif komplikasyonlar açısından değer-lendirildi. Hastaların 15’i (% 65.2) erkek, 8’i (% 34.7) kadındı. Ortalama yaş 11.3 ± 4.2 yıldı. En sık görülen semp-tom öksürük idi. Kist sayısı toplam 52 idi. 23 hastanın 6’sında başvuru sırasında perfore hidatik kisti mevcuttu. Dört hastada perforasyon plevral aralığa iken 2’sinde bronşial sisteme idi. Ondokuz hastada kistler tek taraflı iken 4 hastada (%17.3) çift taraflı idi. 6 hastada aynı lob içerisinde birden fazla kist vardı (2-4 kist). Tüm hastalarda kistotomi ve kapitonaj uygulandı. Kistin perfore olduğu 2 hastada ampiyem vardı ve dekortikasyon uygulandı.
Esme et al. Çocuklarda multipl hidatik kist
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Hiçbir hastada rezeksiyon uygulanmadı. Postoperatif komplikasyon olarak 3 hastada atelektazi gelişirken 1 has-tada uzamış hava kaçağı oldu. Çocuklarda geride kalan parankimin eksapansiyon kabiliyetinin yüksekliği nedeniyle multipl hidatik kist aynı lobta dahi olsa parankim koruyucu cerrahi tercih edilmelidir.
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