Outcomes and Risk Factors for Morbidity After Lung Hydatidosis Surgery in Children

IF 3.9 2区 医学 Q1 PEDIATRICS
Zied Chaari MD , Saloua Ammar MD , Aymen Ben Ayed MD , Emna Krichen MD , Aymen Dammak MD , Jihen Jdidi MD , Abdessalem Hentati MD , Riadh Mhiri MD , Faiza Safi MD , Imed Frikha MD
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Abstract

Objective

To examine outcomes and associated risk factors for children who undergo surgery for lung hydatidosis (LH).

Study design

Through a retrospective and analytical-aim-study, over a period of 35 years in 2 surgical departments, we reported all operative cases for LH in children, regardless of cyst number, location, and aspect. Univariate and multivariable analyses were used to assess variables potentially predictive of postoperative morbidity.

Results

In total, 456 children with a mean age of 10.3 years were included. We performed 544 surgical procedures for 704 cysts with a median size of 60 mm (range 10–200 mm). Thirty-six percent of cysts were complicated. Conservative surgery was performed in 98.5% of cases and anatomical lung resection was required for 1.47% of children. Postoperative complications occurred in 24.4% of children and one death was recorded (0.2%). After multivariable analysis, the independent-associated morbidity risk factors for postoperative morbidity were anatomical lung resection, intensive care unit stay, complicated cyst, a cyst size ≥60 mm, ≥3 bronchial fistulas, associated liver hydatidosis, and the presence or occurrence of empyema during surgery.

Conclusions

Conservative surgery sparing the lung parenchyma is the treatment of choice for lung hydatidosis and is associated with a low mortality rate. Knowledge of independent risk factors for morbidity may help clinicians to manage children with LH more adequately and improve postoperative outcomes.
儿童肺水肿手术后的疗效和发病风险因素。
研究目的研究设计:研究设计:通过回顾性和分析性目的研究,我们报告了两个外科部门 35 年来的所有儿童肺水肿手术病例,无论囊肿数量、位置和大小。我们使用单变量和多变量分析来评估可能预测术后发病率的变量:共纳入 456 名儿童,平均年龄为 10.3 岁。我们为 704 个囊肿进行了 544 次手术,囊肿的中位尺寸为 60 毫米(10-200 毫米不等)。36%的囊肿为复杂性囊肿。98.5%的病例采取了保守性手术,1.47%的患儿需要进行解剖性肺切除。24.4%的患儿出现术后并发症,1例死亡(0.2%)。经过多变量分析,与术后发病率相关的独立发病风险因素为解剖性肺切除、重症监护室住院、复杂囊肿、囊肿大小≥60毫米、支气管瘘≥3个、伴有肝水肿、术中出现或发生气肿:结论:保留肺实质的保守性手术是肺包虫病的首选治疗方法,死亡率较低。了解发病的独立风险因素有助于临床医生更充分地管理肺水肿患儿并改善术后效果。
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来源期刊
Journal of Pediatrics
Journal of Pediatrics 医学-小儿科
CiteScore
6.00
自引率
2.00%
发文量
696
审稿时长
31 days
期刊介绍: The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents. The Journal publishes original work based on standards of excellence and expert review. The Journal seeks to publish high quality original articles that are immediately applicable to practice (basic science, translational research, evidence-based medicine), brief clinical and laboratory case reports, medical progress, expert commentary, grand rounds, insightful editorials, “classic” physical examinations, and novel insights into clinical and academic pediatric medicine related to every aspect of child health. Published monthly since 1932, The Journal of Pediatrics continues to promote the latest developments in pediatric medicine, child health, policy, and advocacy. Topics covered in The Journal of Pediatrics include, but are not limited to: General Pediatrics Pediatric Subspecialties Adolescent Medicine Allergy and Immunology Cardiology Critical Care Medicine Developmental-Behavioral Medicine Endocrinology Gastroenterology Hematology-Oncology Infectious Diseases Neonatal-Perinatal Medicine Nephrology Neurology Emergency Medicine Pulmonology Rheumatology Genetics Ethics Health Service Research Pediatric Hospitalist Medicine.
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