Results of surgical correction or conservative management of splenic cysts in children according to remote monitoring changes
DOI:
https://doi.org/10.15574/PS.2022.74.56Keywords:
splenic cyst, children, surgical treatment, conservative management, resultsAbstract
Treatment of splenic cysts (SC) in children is variable and controversial. Depending on the size and location of these formations in the spleen, surgical correction is possible in open or laparoscopic surgery, or conservative (non-invasive) management. The result of SC treatment should be the complete elimination of the cyst cavity.
Purpose - to evaluate the results of surgical correction or conservative management of CS in children according to remote monitoring changes.
Materials and methods. We conducted the study on 265 children aged 0-17 years (mean age 11.25±4.21 years), who were examined and treated for SC. One hundred seventy-five (66.04±2.91%) children underwent surgery, and 90 (33.96±2.91%) patients received conservative treatment. We subjected all the information recorded in the medical records to statistical processing. The mentioned information could characterize the situation with the treatment process and with dynamic monitoring of this pathology to some extent.
Results. The most common localizations of cysts were the upper (33.21±2.89%) or middle segments of the spleen (29.81±2.81%). Almost every fourth patient (27.92±2.76%) with SC had pathology of other organs or systems, and every tenth (9.81±1.83%) had other diseases of the spleen. We detected residual cyst in 46.42±3.06% of patients; it underwent complete regression within 1-3 years. Residual cyst of small size (which persisted after surgical correction) regressed much faster after surgery compared with regression of cystic formation of small size in the spleen with conservative management (p<0.05).
Conclusions. Therapeutic tactics for SC in children involve different options for individual surgical correction or conservative management, depending on the location, size, relationship to the architecture of the main vessels and the variant of damage to the parenchyma of the spleen. The outcome of treatment of children with SC depends on the volume, location, etiology of the lesion, the method of correction and compliance with all recommendations in the postoperative period against the background of comorbidities.
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 all participating institutions. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
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