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包虫囊肿病的微创手术:腹腔镜、胸腔镜和后腹腔镜入路

Minimal access surgery for hydatid cyst disease: laparoscopic, thoracoscopic, and retroperitoneoscopic approach.

作者信息

Chowbey P K, Shah S, Khullar R, Sharma A, Soni V, Baijal M, Vashistha A, Dhir A

机构信息

Department of Minimal Access Surgery, Sir Ganga Ram Hospital, New Delhi, India.

出版信息

J Laparoendosc Adv Surg Tech A. 2003 Jun;13(3):159-65. doi: 10.1089/109264203766207672.

Abstract

Surgery has remained the mainstay for the treatment of hydatid cyst. The rapid development of laparoscopic techniques has encouraged surgeons to replicate principles of conventional hydatid surgery using a minimally invasive approach. Several reports have confirmed the feasibility of laparoscopic hepatic hydatid surgery. We report the use of a laparoscopic approach for cysts located in the liver, lung, and retroperitoneum. Fifteen patients with hydatid cysts, including one patient with a recurrent cyst, of various organs, including the liver, lung, and retroperitoneum, were operated on laparoscopically. Sixteen hydatid cysts were drained in a total of 15 patients. The mean operative time was 84 +/- 6 minutes (60-125 minutes). The mean duration of the hospital stay was 2.3 days (1-6 days). The mean cyst diameter was 9.2 cm (6.4-13.5 cm). No conversions to open surgery were required. One complication, a trocar-induced bowel perforation, occurred, and there was no mortality. During 3 to 44 months (mean, 27 months) of follow-up, no recurrences developed. Minimal access surgery is a safe, effective, and viable option for the management of selected patients with hydatid cysts in various locations, such as the liver, lung, and retroperitoneum.

摘要

手术一直是治疗包虫囊肿的主要方法。腹腔镜技术的迅速发展促使外科医生采用微创方法来应用传统包虫手术的原则。多项报告证实了腹腔镜肝包虫手术的可行性。我们报告了对位于肝脏、肺和腹膜后的囊肿采用腹腔镜手术方法的情况。15例患有包括肝脏、肺和腹膜后等不同器官包虫囊肿的患者接受了腹腔镜手术,其中1例为复发性囊肿。15例患者共引流了16个包虫囊肿。平均手术时间为84±6分钟(60 - 125分钟)。平均住院时间为2.3天(1 - 6天)。囊肿平均直径为9.2厘米(6.4 - 13.5厘米)。无需转为开放手术。发生了1例并发症,即套管针导致的肠穿孔,且无死亡病例。在3至44个月(平均27个月)的随访期间,未出现复发。对于处理肝脏、肺和腹膜后等不同部位的特定包虫囊肿患者,微创外科手术是一种安全、有效且可行的选择。

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