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根治性手术预防肝包虫病早期局部复发及与囊肿相关并发症的疗效

Efficacy of radical surgery in preventing early local recurrence and cavity-related complications in hydatic liver disease.

作者信息

Yüksel Osman, Akyürek Nusret, Sahin Tolga, Salman Bülent, Azili Cem, Bostanci Hasan

机构信息

Department of Surgery, Hepato-Pancreato-Biliary Surgery Unit, Gazi University Medical School Beşevler, 06500, Ankara, Turkey.

出版信息

J Gastrointest Surg. 2008 Mar;12(3):483-9. doi: 10.1007/s11605-007-0301-1. Epub 2007 Oct 5.

Abstract

BACKGROUND

Hydatic disease of the liver remains to be a complex worldwide problem especially in rural areas. Early local recurrence and cavity-related complications are still a matter of conflict in the management of hydatic liver disease. The aim of this study is to investigate efficacy of the type of surgical treatment in preventing early local recurrence and cavity-related complications of this disease. Here, we present the preliminary results of our study.

METHODS

This study was performed prospectively including 32 patients who were operated for hydatic liver disease between January 2001 and January 2005. Patients were randomized into radical and conservative surgery groups. Recurrences at the primary surgical site in the first 2 years were considered as early local recurrence and biliary leakage, biliary fistula, cavity abscess, etc. were considered as cavity-related complications.

RESULTS

Early local recurrences were observed only after conservative surgical procedures (p=0.045). Recurrent cysts were found to be due to satellite cysts or pericystic disease. Cavity-related complications were seen in six patients in the conservative surgery group (p=0.011).

CONCLUSIONS

In suitable patients, radical surgical resection provides an effective surgical management option in preventing early local recurrence and cavity-related complications when compared to conservative surgical approaches.

摘要

背景

肝包虫病仍是一个复杂的全球性问题,尤其是在农村地区。早期局部复发和与囊肿相关的并发症在肝包虫病的治疗中仍然存在争议。本研究的目的是探讨手术治疗类型对预防该病早期局部复发和与囊肿相关并发症的疗效。在此,我们展示了我们研究的初步结果。

方法

本研究前瞻性纳入了2001年1月至2005年1月期间因肝包虫病接受手术的32例患者。患者被随机分为根治性手术组和保守性手术组。前2年原发手术部位的复发被视为早期局部复发,胆漏、胆瘘、囊肿脓肿等被视为与囊肿相关的并发症。

结果

仅在保守性手术后观察到早期局部复发(p = 0.045)。发现复发性囊肿是由于卫星囊肿或囊肿周围病变。保守性手术组有6例患者出现与囊肿相关的并发症(p = 0.011)。

结论

与保守性手术方法相比,对于合适的患者,根治性手术切除在预防早期局部复发和与囊肿相关的并发症方面提供了一种有效的手术治疗选择。

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