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      Kyste hydatique pulmonaire chez l'enfant traité par thoracoscopie: huit ans d'expérience

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          Abstract

          L’échinococcose kystique est une pathologie fréquente en zone d'endémie: pourtour méditerranéen, Afrique de l'est et l'Amérique du Sud. L'hydatidose reste à l'heure actuelle un problème majeur de santé publique. Notre travail consiste en une étude rétrospective de 27 malades opérés pour kyste hydatique pulmonaire (KHP) par thoracoscopie, au service de chirurgie pédiatrique du centre hospitalier universitaire HASSAN II à Fès, sur une période de huit ans allant de janvier 2004 au décembre 2011.

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          Thoracoscopic treatment of pulmonary hydatid cyst in a child.

          Hydatid disease has a wide geographic distribution around the world. In human, the lungs are the second most commonly affected sites. Pulmonary hydatidosis is much more frequently encountered in children than in adults. Surgical treatment has remained the standard option in the management of hydatid disease. However, surgeons were able to replicate the principles of conventional surgery using minimally invasive techniques. Herein, we report a case of pulmonary hydatid cyst in a 9-year-old girl treated successfully using the thoracoscopic approach.
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            Comparative evaluation of thoracoscopy versus thoracotomy in the management of lung hydatid disease.

            Lung hydatid disease is an endemic problem in Mediterranean countries, and the ideal surgical management for it is still debated. In this prospective study, we aimed to evaluate the feasibility and safety of thoracoscopy in patients with lung hydatid disease. We studied the advantages of thoracoscopic procedure over posterolateral thoracotomy. A total of 32 patients with an uncomplicated, unilateral lung hydatid cyst were subjected to surgical treatment over a period of 5 years. Of the 32 patients, 18 were treated with thoracotomy and 14 with thoracoscopy. Observations were made with regard to duration and ease of operation, complications, hospital stay, return to activity, and recurrence. The mean operative duration in the thoracoscopy group was 95.21 min compared to 137.77 min in thoracotomy group (P < 0.0001). Postoperative analgesia requirement was less in the thoracoscopic group (mean 4.92 days) compared to that in the thoracotomy group (mean 13.94 days; P < 0.0001). The intercostal drain was removed earlier in the thoracoscopic group (mean 5 days) than in the thoracotomy group (mean 8.83 days; P < 0.0001). The postoperative hospital stay was 8.35 days (mean) in thoracoscopic group and 18.77 days in the thoracotomy group (P < 0.0001). The most serious morbidity was wound infection, with three cases (16.66%) in the thoracotomy group and one (7.11%) in the thoracoscopy group. There was no operative mortality and no recurrence during the follow-up period. We strongly recommend the use of thoracoscopy as a primary tool for the management of uncomplicated, unilateral lung hydatid disease. Thoracoscopy offers a great advantage over open thoracotomy in terms of very low morbidity.
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              Minimal access surgery for hydatid cyst disease: laparoscopy, thoracoscopy and retroperitoneal approach

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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                12 July 2013
                2013
                : 15
                : 96
                Affiliations
                [1 ]Service de chirurgie pédiatrique, CHU hassan II, Fès, Maroc
                Author notes
                [& ]Corresponding author: Khalid Khattala, Service de chirurgie pédiatrique, CHU Hassan II de Fès, Maroc
                Article
                PAMJ-15-96
                10.11604/pamj.2013.15.96.1873
                3810153
                b1104528-1b72-44d6-a2d3-d3990974f0d0
                © Khalid Khattala et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 07 July 2012
                : 24 September 2012
                Categories
                Case Series

                Medicine
                kyste hydatique,thoracoscopie,enfant,maroc,hydatid cyst,thoracoscopy,child,morocco
                Medicine
                kyste hydatique, thoracoscopie, enfant, maroc, hydatid cyst, thoracoscopy, child, morocco

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