Department of Surgery, Diyarbakir Education and Research Hospital, 21400, Diyarbakir, Turkey,
J Gastrointest Surg. 2013 Oct;17(10):1784-95. doi: 10.1007/s11605-013-2303-5. Epub 2013 Aug 15.
The aim of this study was to discuss the management of patients with splenic hydatid cyst (SHC) and to provide a review of the literature in this field.
The outcomes of patients surgically treated for SHC at the Diyarbakir Education and Research Hospital (DERH) between January 2006 and May 2013 were assessed by retrospectively reviewing demographic, radiological, and clinical data. In addition, the outcome profiles of these patients were compared to the overall outcomes of surgically treated SHC cases reported in the literature. Relevant case series (≥4 cases) were identified by searching the PubMed, Medline, and Google Scholar databases for publications from 1990 to May 2013 in English or Turkish languages.
Nine patients with SHC received surgical treatment at DERH (age range, 18-53 years old; mean, 36.9 ± 11.8; female/male, 7/2), including five (55.6%) primary SHC and four (44.4%) secondary (100% liver) SHC cases. Two patients had previous SHC surgery. Seven patients received albendazole therapy, both preoperative (10-21 days) and postoperative (10-42 days) periods. All patients received vaccination, either preoperative (n = 4) or postoperative (n = 5). Six patients underwent splenectomy and three underwent splenectomy with partial cystectomy and omentopexy, and no patient experienced SHC recurrence during follow-up (1-60 months). The literature review identified 27 full-text articles representing 333 surgically treated SHC cases, among which 60.5% had primary SHC and 39.5% had secondary SHC. Two hundred thirty of 333 patients underwent splenectomy, 81 underwent spleen-sparing surgery, and 17 underwent puncture, aspiration, injection, and reaspiration. The remaining five patients were not operated for various reasons.
We found no significant difference in recurrence rates between splenectomy and spleen-sparing surgery, either in our patient cohort or among cases reported in the literature. Nevertheless, we cannot make any solid recommendations for either procedure based on these results, as the studies were largely retrospective.
本研究旨在讨论脾包虫囊肿（SHC）患者的治疗方法，并对该领域的文献进行综述。
回顾性分析 2006 年 1 月至 2013 年 5 月在迪亚巴克尔教育与研究医院（DERH）接受手术治疗的 SHC 患者的人口统计学、影像学和临床资料，评估其治疗结果。此外，将这些患者的治疗结果与文献中报道的接受手术治疗的 SHC 病例的总体治疗结果进行比较。通过在 PubMed、Medline 和 Google Scholar 数据库中以英语或土耳其语检索 1990 年至 2013 年 5 月的文献，确定了相关的病例系列（≥4 例）。
DERH 共收治 9 例 SHC 患者（年龄 18-53 岁，平均 36.9±11.8 岁；女性/男性为 7/2），其中 5 例（55.6%）为原发性 SHC，4 例（44.4%）为继发性（100%肝）SHC 病例。2 例患者曾行 SHC 手术治疗。7 例患者接受阿苯达唑治疗，包括术前（10-21 天）和术后（10-42 天）治疗。所有患者均接受了疫苗接种，包括术前（n=4）或术后（n=5）接种。6 例行脾切除术，3 例行脾切除术+部分囊肿切除术+大网膜固定术，随访期间无患者出现 SHC 复发（1-60 个月）。文献复习共纳入 27 篇全文文献，涉及 333 例接受手术治疗的 SHC 病例，其中 60.5%为原发性 SHC，39.5%为继发性 SHC。333 例患者中，230 例行脾切除术，81 例行保留脾脏手术，17 例行穿刺抽吸注射后再抽吸术。其余 5 例因各种原因未行手术治疗。
无论在我们的患者队列中还是在文献报道的病例中，脾切除术和保留脾脏手术的复发率均无显著差异。然而，由于这些研究大多为回顾性研究，我们不能基于这些结果对任何一种手术方法提出明确的建议。
