Лапароскопічне лікування кіст селезінки у дітей

With the development of minimally invasive surgery, surgical treatment of splenic cysts (SC) with laparoscopy has become quite relevant. Aim of study:  to analysis the effectiveness of laparoscopic treatment of splenic cysts in children. Materials and methods.  We have experience in the surgical treatment of 164 patients with SC in children aged 6 months to 18 years. Clinical and laboratory data, ultrasound, CT or MRI were used for diagnosis. With the help new diagnostic methods, it was possible to detect SC in the early stage. We followed the organo-saving principle during surgical treatment of SC in 112 children; various variants of open organ-saving operations on the spleen have been performed. In 52 patients SC were resected by laparoscopy. Results.  Depending on localization, size, correlation with the architecture of major vessels and the variant of parenchyma lesions laparoscopic cystectomy (n=20), fenestration of the cyst wall with capitonnage (n=14) and partial resection of the spleen (n=18) were performed. In five patients, a relapse of the cyst was observed in long term. These were the children after fenestration of the cyst without capitonnage (n=2) and after fenestration of the cyst with its filling with the tissue of the greater omentum (n=3). The recurrence of the SC was corrected by an open operation. Seven children in the postoperative period retained the minimal residual cavity of the cyst, which automatically healed (scared) in the dynamics follow up during 1-2 years. Conclusions.  The partial resection of the spleen, taking into account its segmental blood supply, is a rational method of treatment of SC, which radically eliminates pathology and retains all important functions of the spleen. Laparoscopic correction of SC in children has limited indications because of organsaving approach in the treatment of this pathology. The individual selection of patients depend on the localization, size, ratio to the architecture of the major vessels and the variant of lesions of the parenchyma of the spleen on the basis of radiological methods of diagnosis and acquired experience of profile clinics.