{"title":"儿童肺水肿手术后的疗效和发病风险因素。","authors":"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","doi":"10.1016/j.jpeds.2024.114367","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To examine outcomes and associated risk factors for children who undergo surgery for lung hydatidosis (LH).</div></div><div><h3>Study design</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"276 ","pages":"Article 114367"},"PeriodicalIF":3.9000,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcomes and Risk Factors for Morbidity After Lung Hydatidosis Surgery in Children\",\"authors\":\"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\",\"doi\":\"10.1016/j.jpeds.2024.114367\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To examine outcomes and associated risk factors for children who undergo surgery for lung hydatidosis (LH).</div></div><div><h3>Study design</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>\",\"PeriodicalId\":54774,\"journal\":{\"name\":\"Journal of Pediatrics\",\"volume\":\"276 \",\"pages\":\"Article 114367\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-10-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pediatrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0022347624004700\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022347624004700","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
Outcomes and Risk Factors for Morbidity After Lung Hydatidosis Surgery in Children
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.
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.