根据远程监测变化的儿童脾囊肿手术矫正或保守治疗结果

A. Kuzyk, V. Prytula, D. Krivchenya, A. Nakonechnyi, T. Gutor
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引用次数: 0

摘要

儿童脾囊肿(SC)的治疗是多变的和有争议的。根据这些形成物在脾脏中的大小和位置,可以采用开放或腹腔镜手术或保守(非侵入性)治疗进行手术矫正。SC治疗的结果应该是完全消除囊肿腔。目的:根据远程监测的变化,评价小儿CS手术矫正或保守治疗的效果。材料和方法。我们对265例0 ~ 17岁儿童(平均11.25±4.21岁)进行了SC检查和治疗,其中175例(66.04±2.91%)患儿接受手术治疗,90例(33.96±2.91%)患儿接受保守治疗。我们对病历中记录的所有信息进行了统计处理。上述信息可以在一定程度上描述治疗过程和病理动态监测的情况。结果。最常见的囊肿部位为脾上段(33.21±2.89%)或脾中段(29.81±2.81%)。几乎每4例SC患者(27.92±2.76%)有其他脏器或系统病变,每10例(9.81±1.83%)有脾脏其他病变。残余囊肿检出率为46.42±3.06%;1-3年内完全消退。小尺寸残留囊肿(经手术矫正后仍存在)术后消退速度明显快于保守处理后脾脏小尺寸囊肿消退速度(p<0.05)。结论。儿童SC的治疗策略包括个体手术矫正或保守治疗的不同选择,这取决于位置、大小、与主要血管结构的关系以及脾脏实质损伤的不同。儿童SC的治疗结果取决于病变的体积、位置、病因、矫正方法以及在术后期间对合并症背景下所有建议的依从性。这项研究是按照《赫尔辛基宣言》的原则进行的。研究方案经所有参与机构的当地伦理委员会批准。获得患者的知情同意进行研究。作者未声明存在利益冲突。关键词:脾囊肿,儿童,手术治疗,保守处理,结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Results of surgical correction or conservative management of splenic cysts in children according to remote monitoring changes
Treatment of splenic cysts (SC) in children is variable and controversial. Depending on the size and location of these formations in the spleen, surgical correction is possible in open or laparoscopic surgery, or conservative (non-invasive) management. The result of SC treatment should be the complete elimination of the cyst cavity. Purpose - to evaluate the results of surgical correction or conservative management of CS in children according to remote monitoring changes. Materials and methods. We conducted the study on 265 children aged 0-17 years (mean age 11.25±4.21 years), who were examined and treated for SC. One hundred seventy-five (66.04±2.91%) children underwent surgery, and 90 (33.96±2.91%) patients received conservative treatment. We subjected all the information recorded in the medical records to statistical processing. The mentioned information could characterize the situation with the treatment process and with dynamic monitoring of this pathology to some extent. Results. The most common localizations of cysts were the upper (33.21±2.89%) or middle segments of the spleen (29.81±2.81%). Almost every fourth patient (27.92±2.76%) with SC had pathology of other organs or systems, and every tenth (9.81±1.83%) had other diseases of the spleen. We detected residual cyst in 46.42±3.06% of patients; it underwent complete regression within 1-3 years. Residual cyst of small size (which persisted after surgical correction) regressed much faster after surgery compared with regression of cystic formation of small size in the spleen with conservative management (p<0.05). Conclusions. Therapeutic tactics for SC in children involve different options for individual surgical correction or conservative management, depending on the location, size, relationship to the architecture of the main vessels and the variant of damage to the parenchyma of the spleen. The outcome of treatment of children with SC depends on the volume, location, etiology of the lesion, the method of correction and compliance with all recommendations in the postoperative period against the background of comorbidities. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Key words: splenic cyst, children, surgical treatment, conservative management, results.
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