Mirelis C G, Bekiaridou K A, Bougioukas I G, Xanthoulis A I, Tsalkidou E G, Nannou G, Vafiadis K T, Tentes A A K
Department of Surgery, Didimotichon General Hospital, Didimotichon, Greece.
Acta Chir Belg. 2006 Nov-Dec;106(6):684-7. doi: 10.1080/00015458.2006.11679981.
BACKGROUND/AIMS: Non-radical surgery is the preferred method of treatment of hydatid liver disease, and is associated with low mortality and recurrence rate. The purpose of the study is the retrospective analysis of the outcome of patients who were treated surgically in a single institution.
Between 1987 and 2005, 59 patients, mean age 58.2 +/- 15.9 (13-83) years, underwent surgery for liver hydatid disease. The patients were reassessed with physical examination, serological tests and radiological examination for the evaluation of the recurrence rate.
Most cysts were solitary, the more frequently affecting the right lobe of the liver. Radical surgery was possible in four cases (6.8%) that were classified as PNM stage I. Partial cystectomy and omentoplasty was performed in 37 patients (62.7%) and external drainage with partial cystectomy in 18 patients (30.5%). The hospital morbidity was 27.2% and was found to be related to ASA class (p = 0.019). Hospital mortality was 5.1%. The median follow-up time was 94 (1-228) months and 45 out of 59 patients (76.3%) were reassessed, but no recurrence was recorded. There was no significant difference in morbidity, mortality, and hospital stay between partial cystectomy combined with external drainage or omentoplasty (p > 0.05).
PNM staging seems to be a reliable tool in selecting patients with liver hydatid disease for non-radical or radical surgery. Omentoplasty is an easy and effective surgical method for the treatment of hepatic echinococcosis but is not different than partial cystectomy and external drainage in regard to morbidity, mortality, and recurrence.
背景/目的：非根治性手术是肝包虫病的首选治疗方法，其死亡率和复发率较低。本研究旨在对在单一机构接受手术治疗的患者的预后进行回顾性分析。
1987年至2005年间，59例平均年龄为58.2±15.9（13 - 83）岁的患者接受了肝包虫病手术。通过体格检查、血清学检查和影像学检查对患者进行重新评估，以评估复发率。
大多数囊肿为单发，更常见于肝右叶。4例（6.8%）PNM分期为I期的患者可行根治性手术。37例患者（62.7%）接受了部分囊肿切除术和网膜成形术，18例患者（30.5%）接受了部分囊肿切除外加外引流术。医院发病率为27.2%，发现与ASA分级有关（p = 0.019）。医院死亡率为5.1%。中位随访时间为94（1 - 228）个月，59例患者中有45例（76.3%）接受了重新评估，但未记录到复发情况。部分囊肿切除联合外引流或网膜成形术在发病率、死亡率和住院时间方面无显著差异（p > 0.05）。
PNM分期似乎是选择肝包虫病患者进行非根治性或根治性手术的可靠工具。网膜成形术是治疗肝包虫病的一种简单有效的手术方法，但在发病率、死亡率和复发方面与部分囊肿切除和外引流术并无差异。
