EN
TÜRKÇE
Poster - 176
Risk factors for recurrence of liver hydatid cyst in children: a retrospective study from a tunisian pediatric surgery department
Syrine Laribi 1, Myriam Ben Fredj 1, Rihab Nasri 2, Afef Toumi 1, Sabrine Ben Youssef 1, Sawsen Chakroun 3, Maha Ben Mansour 3, Amine Ksia 1, Mongi Mekki 1, Mohsen Belghith 1, Lassaad Sahnoun 1
1 Pediatric surgery department, Fattouma Bourguiba Hospital.
2 Preventive and community medicine department, Fattouma Bourguiba Hospital.
3 Pediatric anaesthesia and intensive care department, Fattouma Bourguiba Hospital.
Purpose:
Liver hydatid cyst is a parasitic disease that remains a public health concern in endemic regions. In children, recurrence after treatment poses significant clinical challenges and may necessitate repeat interventions. This study aimed to assess the prevalence of liver hydatid cyst recurrence in children after a minimum follow-up of three years and to identify the factors associated with this recurrence.
Methods:
This retrospective analytical study was conducted in the pediatric surgery department at Fattouma Bourguiba University Hospital in Monastir, Tunisia. It included 118 children aged 16 years or younger who were treated for liver hydatid cyst between 2010 and 2020. Data on clinical presentation, laboratory findings, imaging results, treatment modalities, and follow-up were collected and analyzed. Multivariate logistic regression was performed to identify independent predictors of recurrence.
Results:
Among the 118 children, the recurrence rate after a minimum follow-up of three years was 20.3 percent. Of the 24 children who experienced recurrence, 18 received medical treatment and 21 underwent repeat surgery. Univariate analysis identified several factors significantly associated with recurrence, including the type of initial treatment (higher recurrence after exclusive medical treatment, p = 0.04), presence of intraoperative daughter cysts (p = 0.01), and biliary fistulas occurring during (p = 0.017) or after surgery (p = 0.023). In multivariate analysis, the presence of daughter cysts (adjusted odds ratio = 4.139; 95 percent confidence interval [1.613–10.621]; p = 0.003) and postoperative biliary fistulas (adjusted odds ratio = 5.866; 95 percent confidence interval [1.583–21.733]; p = 0.008) emerged as independent predictors of recurrence.
Conclusion:
Recurrence of liver hydatid cyst in children remains frequent despite treatment. Identifying key intraoperative and postoperative risk factors allows better targeting of high-risk patients and tailoring of therapeutic strategies. Long-term monitoring and optimized surgical techniques are essential to reduce recurrence.