Clinical and serological outcomes with different surgical approaches for human hepatic hydatidosis.

Autor:	Abdelraouf A; Department of Surgery, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt., El-Aal AA; Department of Medical Parasitology, Faculty of Medicine, Cairo University, Egypt., Shoeib EY; Department of Medical Parasitology, Faculty of Medicine, Cairo University, Egypt., Attia SS; Department of Medical Parasitology, Faculty of Medicine, Cairo University, Egypt., Hanafy NA; Department of Medical Parasitology, Faculty of Medicine, Cairo University, Egypt., Hassani M; Department of Tropical Medicine, National Hepatology and Tropical Medicine Research institute, Cairo, Egypt., Shoman S; Department of Tropical Medicine, National Hepatology and Tropical Medicine Research institute, Cairo, Egypt.
Jazyk:	angličtina
Zdroj:	Revista da Sociedade Brasileira de Medicina Tropical [Rev Soc Bras Med Trop] 2015 Sep-Oct; Vol. 48 (5), pp. 587-93.
DOI:	10.1590/0037-8682-0223-2015
Abstrakt:	Introduction: Hydatidosis is the result of infection with the larval stages of some species of the genus Echinococcus. Treatment approaches for hydatid cysts include the use of albendazole, surgery, and/or medico-surgical procedures. The choice of the therapeutic surgical approach depends on the cyst number and localization, surgeon expertise, and presence of complications. The present study aimed to compare the outcomes of the following therapeutic approaches for the treatment of hepatic hydatid cysts: pericystectomy; the puncture, aspiration, injection, and reaspiration (PAIR) technique; and the PAIR technique followed by deroofing, evacuation of cysts, and omentoplasty. Methods: The 54 patients were divided into 3 groups: Group I (14 patients) who underwent pericystectomy, Group II (23 patients) who underwent the PAIR technique, and Group III (17 patients) who underwent the PAIR technique followed by deroofing and omentoplasty. The diagnosis of hydatid cysts was based on serological testing using enzyme-linked immunosorbent assay, abdominal ultrasound, and parasitological examination of the cyst contents. Morbidity, mortality, length of hospital stay, recurrence, and postoperative complications were evaluated. Results: Postoperative bleeding, infection, and recurrence were reported in Groups I and II; Group III did not experience postoperative infection and had shorter hospital stays. Recurrence and postoperative complications did not occur in Group III. Conclusions: The partial surgical procedure with deroofing, evacuation of the cysts, and omentoplasty, as performed in the present study, is recommended as a safe and effective method for elimination of the entire parasite with minimal possibility for intra-peritoneal spillage.
Databáze:	MEDLINE
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