Conservative (non-invasive) management of children with splenic cysts
Keywords:spleen cyst, children, conservative, non-invasive, management, results
Surgeons’ views on tactics for treatment of splenic cysts (SC) in children are widely discussed in the literature. Indications and methods of conservative (non-invasive) management (observation) of children with SC is different issue.
Purpose – to develop rational tactical approache for conservative (non-invasive) management of children with SC.
Materials and methods. A retrospective analysis of conservative (non-invasive) management of 90 (33.96%) of 265 patients with SC was performed. Children were not operated if the SC was less than 20 mm (n=61) in diameter. They were first monitored by ultrasound 2 times for 6 months, then – 2 times a year, until puberty. We did not observe the progression of cyst growth in these children. Also did not operate children in whom the size of SC was from 20 to 62 mm, had an asymptomatic course and parents did not consent to surgical treatment (n=29). This is the most difficult group of patients to analyze, as most of them lack information about the dynamic observation. According to the results of dynamic observation in 19 of 29 examined patients’ regression of SC was not observed, which later served as an indication for surgical treatment.
Results and conclusions. In the presence of SC, a choice of surgical treatment or conservative (non-invasive) management is possible. Tactical approach for treatment of children with SC is strictly individual and depends on the size and location of the parenchymal lesion. In SC up to 20 mm diameter, conservative (non-invasive) management is rational, which is confirmed by the lack of progression of cyst growth in these children. Dynamic observation of patients with SC with a diameter of more than 20 mm without regression, serves as an indication for surgical treatment.
The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of an participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest was declared by the authors.
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