Text Box: SURGICAL TREATMENT OF 37 CHILDREN WITH HYDATIDOSIS OF THE LIVER AND LUNGS Zhao Yu-Yuan Department of Surgery, First Hospital of Lanzhou Medical College, Lanzhou, China Objective: To analyze diagnosis, surgical treatment methods and prognosis of hydatidosis of the liver and lungs in children. Methods: 37 cases of hydatidosis in children were reviewed and analyzed, who were operated from January 1960 to December 2000 in our hospital, among whom males were 23 cases and females were 14 cases with average age of 7.9 years (3-14 year-old). Disease course was 3 months to 7 years (average 4.7 years). Main complains were chest distress, cough, epigastric fullness, fever and slight pain. The diagnosis was made according to living history in epidemic area of hydatidosis, contact history with dogs, cattle and sheep. X-ray, B-ultrasound and CT examination and Casoni Test, ELISA and IHF, et cetera. Results: In the multiple hydatidosis, 4 cases (10.8%) were at the left and right lobes of the liver and both sides of lungs, 7 cases (18.92%) at the left and right lobes of the liver and right lung, and 3 cases (8.11%) at left and right lobes of liver and left lung. In single hydatidosis, 13 cases (35.4%) were at right lobe of liver and right lung, 2 cases (5.41%) at right lobe and left lung, 5 cases (13.51%) at left lobe of liver and right lung, and 3 cases (8.11%) at left lobe of liver and left lung. All the patients were treated by operation, among whom, 7 cases with hydatitosis at the top of right lobe of liver and right lung were treated by one-time open chest operation though right side, and all the others were treated by two time operation on lung hydtidosis with interval of 3-5 months, and liver hydatidosis was operated in the end. As a result, one case was died of anaphylactic shock during operation on lung hydatidosis, 4 cases were infected at cavity of extra cyst of liver hydatidosis (2 cases were cured by re-operation). The data showed that curative ratio was 83.78%, mortality was 2.7%, complication ratio was 18.92%, and 20 year relapse ratio by following-up was 13.51%. Conclusion: In children hydatidosis, simultaneous infection at liver and lungs was relatively fewer, but the threatening to children was higher if it happened. The infection may be caused through digestive tract by swallowing down warm eggs or by being infected in uterus by blood transportation of placenta. The diagnosis of children hydatidosis was not difficult, but the early diagnosis and treatment were necessary. Because the tolerance of children was limited, the staging operation should be carried out. The lung hydatidosis grows up quickly, is easily infected, if it broken, may cause suffocation except anaphylaxis. Therefore, lung hydatidosis should be firstly treated by operation. The disease focus should be operated two or three times. Endoscopic microtrauma operation possesses very good foreground in children liver and lung hydatidosis, and it should be extended and used. The general prognosis in children hydatidosis was good if operation opportunity and method was properly mastered. Only the relapse ratio of multiple lung and liver hydatidosis in children was as high as 13.51%, high attention should be paid. 1719