Pediatric surgery international · 2026
Laparoscopic versus open surgery for pediatric hepatic cystic echinococcosis in endemic regions: a meta-analysis supporting minimally invasive management.
СтатьяМетаанализСравнительное исследованиеСистематический обзорНазвание и аннотация: Перевод в очереди
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Yonten Sherop, Guo Sijia, Wang Jiakun, Panden, Kinzi Tenzin, Lhamo Tsering, Yangzom Sonam, Dondan, Pan Sijia, Huang Lan, Zhang Wei, Tsering Purpo, Li Shuai
Аннотация
BACKGROUND: Hepatic cystic echinococcosis (HCE) imposes a significant health burden on children in endemic regions. This meta-analysis compares perioperative outcomes between laparoscopic (LS) and open surgery (OS) for pediatric HCE to inform surgical management strategies.
METHODS: Following PRISMA guidelines, we systematically searched PubMed, CNKI, Wanfang, and VIP for studies (February 2019-April 2024) comparing LS and OS in children with HCE. Two reviewers independently screened studies, extracted data, and assessed quality using the Newcastle-Ottawa Scale. Pooled analysis was performed for operative time, blood loss, hospital stay, biliary complications, residual cavity effusion, and recurrence.
RESULTS: Eleven studies involving 556 children (LS = 210, OS = 346) were included. LS was associated with significantly reduced intraoperative blood loss (SMD = -1.11, 95% CI: -1.36 to -0.86, P < 0.001) and shorter hospital stay (SMD = -1.12, 95% CI: -1.81 to -0.42, P = 0.002) compared to OS. Operative time was also shorter in the LS group (SMD = -0.36, 95% CI: -0.85 to 0.14, P < 0.001). There were no significant differences in rates of biliary complications (OR = 1.17, 95%CI 0.26-5.35, P = 0.083), residual cavity effusion (OR = 0.34, 95%CI 0.08-1.47, P = 0.149), or recurrence (OR = 0.57, 95%CI 0.21-1.56, P = 0.277).
CONCLUSION: For selected pediatric HCE patients, laparoscopic surgery offers faster recovery with less surgical trauma and a comparable safety profile to open surgery. These findings support integrating minimally invasive techniques into pediatric surgical practice in endemic, resource-limited settings.
METHODS: Following PRISMA guidelines, we systematically searched PubMed, CNKI, Wanfang, and VIP for studies (February 2019-April 2024) comparing LS and OS in children with HCE. Two reviewers independently screened studies, extracted data, and assessed quality using the Newcastle-Ottawa Scale. Pooled analysis was performed for operative time, blood loss, hospital stay, biliary complications, residual cavity effusion, and recurrence.
RESULTS: Eleven studies involving 556 children (LS = 210, OS = 346) were included. LS was associated with significantly reduced intraoperative blood loss (SMD = -1.11, 95% CI: -1.36 to -0.86, P < 0.001) and shorter hospital stay (SMD = -1.12, 95% CI: -1.81 to -0.42, P = 0.002) compared to OS. Operative time was also shorter in the LS group (SMD = -0.36, 95% CI: -0.85 to 0.14, P < 0.001). There were no significant differences in rates of biliary complications (OR = 1.17, 95%CI 0.26-5.35, P = 0.083), residual cavity effusion (OR = 0.34, 95%CI 0.08-1.47, P = 0.149), or recurrence (OR = 0.57, 95%CI 0.21-1.56, P = 0.277).
CONCLUSION: For selected pediatric HCE patients, laparoscopic surgery offers faster recovery with less surgical trauma and a comparable safety profile to open surgery. These findings support integrating minimally invasive techniques into pediatric surgical practice in endemic, resource-limited settings.