Aydinli Bulent, Ozturk Gurkan, Polat K Yalcin, Atamanalp S Selcuk, Ozbey Isa, Onbas Omer, Akcay M Nuran, Balik Ahmet A, Guvendi Bulent
Department of General Surgery, School of Medicine, Atatürk University, Erzurum, Turkey.
ANZ J Surg. 2007 Jun;77(6):455-9. doi: 10.1111/j.1445-2197.2007.04094.x.
Hydatid cyst (HC) continues to be endemic in the Mediterranean countries, such as Turkey. Living in a rural area is an important risk factor for the disease. HC is most commonly seen in the liver and lungs, but retroperitoneal hydatid cyst is very rare. The objective of this study was to evaluate the clinical and radiographic findings and surgical treatment of this unusual lesion.
Between 1979 and 2004, 14 cases with primary retroperitoneal hydatid cyst were treated surgically at our clinic.
Symptoms included flank pain in eight (57.1%) and palpable mass in six patients (42.8%). The cyst was located in the right retroperitoneum in seven patients (50%), left retroperitoneum in five patients (35.7%), retrovesical region in one patient (7.1%) and paravesical region in one patient (7.1%). Surgical approaches were right paramedian extraperitoneal approach in four patients, left paramedian extraperitoneal approach in two patients and midline transperitoneal approach in eight patients. Total pericystectomy was chosen as the surgical procedure in all patients except in five (35.7%), who had partial cystectomy for cysts located near the vital structures. There were no complications and mortality postoperatively.
A primary HC of the retroperitoneum is a distinct clinical entity that must be considered when caring for a patient with a retroperitoneal mass in endemic regions. It should be treated after the diagnosis is confirmed without any delay because of secondary spillages due to perforations and other possible complications.
包虫囊肿（HC）在地中海国家如土耳其仍然是地方病。生活在农村地区是该疾病的一个重要危险因素。HC最常见于肝脏和肺部，但腹膜后包虫囊肿非常罕见。本研究的目的是评估这种不寻常病变的临床和影像学表现以及手术治疗。
1979年至2004年间，我们诊所对14例原发性腹膜后包虫囊肿患者进行了手术治疗。
症状包括8例（57.1%）患者出现侧腹痛，6例（42.8%）患者可触及肿块。囊肿位于右腹膜后7例（50%），左腹膜后5例（35.7%），膀胱后区域1例（7.1%），膀胱旁区域1例（7.1%）。手术方式为4例患者采用右旁正中腹膜外入路，2例患者采用左旁正中腹膜外入路，8例患者采用中线经腹入路。除5例（35.7%）因囊肿位于重要结构附近而行部分囊肿切除术外，所有患者均选择全囊肿切除术。术后无并发症及死亡病例。
原发性腹膜后HC是一种独特的临床实体，在地方病流行地区，当诊治腹膜后肿块患者时必须考虑到。由于穿孔导致的继发性溢出及其他可能的并发症，确诊后应立即进行治疗，不得延误。
