Echinococcosis of the liver in children

A. Yu. Razumovsky; A. N. Smirnov; V. V. Kholostova; N. A. Al-Mashat; A. E. Stepanov; Ya. P. Sulavko

doi:10.16931/1995-5464.2021-4-24-31

Echinococcosis of the liver in children

A. Yu. Razumovsky, A. N. Smirnov, V. V. Kholostova, N. A. Al-Mashat, A. E. Stepanov, Ya. P. Sulavko

https://doi.org/10.16931/1995-5464.2021-4-24-31

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Abstract

Aim. The paper presents the experience of treatment of echinococcal cysts in children, which reflects most of the existing methods of treatment.

Materials and methods. From 2010 to 2021, 81 patients with hepatic echinococcosis aged from 3 to 17 years (average 14.3 ± 1.3) were treated at the bases of the Department of Pediatric Surgeons of the Pirogov Russian State Medical University. All patients were examined according to the standard procedure, including: general clinical examination, examination of liver function, ultrasonography, chest X-ray, CT scan, blood test for IgG to echinococcus antigens. All children were divided into 2 groups according to the type of the surgery: in the group 1, 27 (33.3%) children underwent laparoscopic surgery; in the group 2, 54 (66.7%) children – laparotomy.

Results. The treatment duration accounted 12.5 ± 3.1 days in group 1 and 9.2 ± 1.3 days in group 2 (p < 0.0067). In the group 1 the drainage duration was higher (6.8 ± 0.6) than in the group 2 (4.1 ± 0.3) (p < 0.03). Complications occurred in 7 patients, relapse of cysts – in 2 patients.

Conclusion. Children with echinococcal cysts in Central Russia occur with a constant frequency and require to apply modern approaches in diagnosis and treatment. The classification and treatment protocol of echinococcosis, adopted by WHO, are easy-to-use and proves its effectiveness. There is no significant difference in germicidal agents’ effect on echinococcus and the effect on the development of relapse. The method of selection in the treatment of solitary and superficial cysts is laparoscopic interference with the mandatory application of a PAIR and a high-power aspirator. An important stage of the interference is the treatment of the fibrous capsule of the cyst, if it is impossible to completely remove it, with an argon-plasma coagulator.

Keywords

echinococcosis, liver, cysts, children, laparoscopy interference, relapse, end result

About the Authors

A. Yu. Razumovsky

Department of Pediatric Surgery of the FSAEI HE Pirogov Russian National Research Medical University; FSFBPHF Children’s City Clinical Hospital № 5 named after N. F. Filatov
Russian Federation

Alexander Yu. Razumovsky – Doct. of Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Medical Sciences, Head of the Department of Pediatric Surgery of Pirogov Russian National Research Medical University, Head of the Department of Thoracic Surgery and Surgical Gastroenterology of Children’s City Clinical Hospital № 5 named after N. F. Filatov, President of the Association of Pediatric Surgery, Chief Pediatric Surgeon of Moscow Health Department