Surgical Approach to Childhood Hydatid Cyst Disease: Experience of Two Centers

Objective: We aimed to compare and evaluate our surgical approaches to childhood hydatid cyst (HC) disease by examining the diagnosis, fol-low-up and treatment records of patients with HC who underwent open surgery-percutaneous intervention.Material and Methods: Demographic, clinical, laboratory, treatment and follow-up findings of 35 patients with HC requiring surgical intervention between May 2010 and May 2020 were analyzed retrospectively.Results:Thirty-five patients were included in the study. Abdominal pain was seen at a rate of 77.1% in the children, chest pain at a rate of 13.2% and cough at a rate of 5.3%. One patient (2.8%) presented with dyspnea. There was only lung involvement in 21.1%, only liver involvement in 60.9%, liv-er and lung involvement in 7.9%. In one (2.6%) patient, only spleen and in one (2.6%) patient, liver and kidney involvement were detected. Tho-racotomy was performed in patients with lung involvement. Laparotomy was performed in 12 (40%) patients with liver involvement, catheter in 10 (33.3%) and percutaneous aspiration-injection-re-aspiration (PAIR) in eight (26.6%) patients. Post-operative atelectasis developed in two (40%) patients after thoracotomy and one (8.3%) after laparotomy. Wound infec-tion developed in three (25%) patients after laparotomy. When length of hospital stay after liver interventions was compared, there was a statisti-cally significant shorter hospitalization time (p< 0.001) in the patients that underwent PAIR compared to the patients that underwent open surgery. However, there was no statistically significant difference between cathe-terization and open surgery (p= 0.54). Recurrence occurred in two patients with lung involvement and five (16.6%) patients with hepatic involvement. When the first attempts to the liver (laparotomy, catheter, PAIR) and re -currence were compared, no statistical difference was found in any of the interventions (respectively, p= 0.63, 0.57, 0.37).Conclusion: Hydatid cyst affects many organs. It most commonly affects the lungs and liver. Although the number of our patients is limited, our study revealed that the use of percutaneous methods gives effective and reliable results in pediatric liver HC requiring surgical treatment.