CHOICE OF TACTICS AND METHOD OF SURGICAL TREATMENT OF COMBINED ECHINOCOCCOSIS OF THE LUNG AND LIVER IN CHILDREN

Abstract

Echinococcosis, a severe and widespread parasitic disease, remains a critical public health concern, particularly in pediatric populations. This study addresses the challenges of combined echinococcosis affecting the lungs and liver in children. The aim is to develop a comprehensive strategy and determine the optimal surgical approach for effective treatment.

Methods: A retrospective analysis of 346 children (3-14 years) with various forms of echinococcosis was conducted. Of these, 11.3% presented with combined echinococcosis of the lungs and liver. Clinical, laboratory, and radiological assessments, including chest radiography, ultrasound, and computed tomography, were employed. Surgical interventions were based on organ-preserving principles, with a focus on simultaneous and staged echinococcectomy. Techniques included a modified capitonnage method, electrocoagulation, and bronchial occlusion during pulmonary echinococcectomy. Postoperative chemotherapy with Zentel was administered to prevent relapses.

Results: Surgical success was influenced by disease stage, anatomical factors, and patient characteristics. Simultaneous echinococcectomy was performed in 35.9% of cases, while a two- or three-stage approach was employed in 51.3%. Preliminary bronchial occlusion during pulmonary echinococcectomy proved crucial in minimizing complications. Postoperative chemotherapy with Zentel contributed to satisfactory lung and liver function; no relapses were observed.

Conclusion: The study highlights the complexity of surgical tactics in managing combined echinococcosis in pediatric patients. A comprehensive approach, incorporating preoperative preparation, careful surgical strategy selection, and optimal intervention methods, proved effective. The findings emphasize the importance of prioritizing echinococcectomy based on cyst risk and initiating phased interventions with pulmonary localization. This approach achieved favorable outcomes and demonstrated the significance of a well-structured surgical strategy in treating combined echinococcosis in children, pointing towards a promising avenue for future research and clinical practice.