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巨大肝包虫囊肿的手术治疗:囊肿空肠吻合术与部分囊肿切除术的比较

Surgical treatment of giant liver hydatid cysts: comparison of cystojejunostomy and partial cystectomy.

作者信息

Acar Fahrettin, Sahin Mustafa, Alptekin Hüsnü, Yılmaz Hüseyin, Kafalı M Ertuğrul

机构信息

Department of General Surgery, Faculty of Medicine, Selcuk University, Campus of Alaaddin Keykubat, Selcuklu, 42075, Konya, Turkey,

出版信息

Surg Today. 2014 Nov;44(11):2065-71. doi: 10.1007/s00595-014-0887-3. Epub 2014 Mar 25.

Abstract

PURPOSE

The aim of this study was to compare partial cystectomy and internal drainage of the cyst cavity with cystojejunostomy for the surgical treatment of giant hepatic hydatid cysts.

METHODS

Patients who underwent any type of surgical treatment between March 2009 and May 2013 for giant hepatic hydatid cysts were retrospectively evaluated. The data collected included demographic variables, diagnostic methods, surgical procedures, morbidity and mortality rates.

RESULTS

Twenty-eight patients who underwent surgery for giant hepatic hydatid cysts were included. There were 16 (57 %) female patients, with a mean age of 32.8 years. The diagnostic methods primarily included abdominal ultrasonography and computed tomography, which were performed in 62 % of the patients. The patients were divided into two groups with respect to the treatment modality: Group A (n = 13) treated with cystojejunostomy and Group B (n = 15) treated with partial cystectomy. The overall rate of cavity-related complications was 25 % in Group B, whereas none of the patients in Group A had a cavity-related complication during the follow-up period (p < 0.05).

CONCLUSION

Cystojejunostomy is an effective and safe surgical approach for the treatment of giant hepatic hydatid cysts, with a lower rate of morbidity than partial cystectomy, and thus may be the surgical treatment of choice for giant hepatic hydatid cysts.

摘要

目的

本研究旨在比较部分囊肿切除术及囊肿腔内引流联合囊肿空肠吻合术治疗巨大肝包虫囊肿的效果。

方法

回顾性评估2009年3月至2013年5月间接受任何类型手术治疗的巨大肝包虫囊肿患者。收集的数据包括人口统计学变量、诊断方法、手术方式、发病率和死亡率。

结果

纳入28例接受巨大肝包虫囊肿手术的患者。其中女性患者16例(57%),平均年龄32.8岁。主要诊断方法包括腹部超声和计算机断层扫描,62%的患者接受了这些检查。根据治疗方式将患者分为两组:A组(n = 13)采用囊肿空肠吻合术治疗,B组(n = 15)采用部分囊肿切除术治疗。B组与囊肿腔相关并发症的总发生率为25%,而A组在随访期间无患者发生与囊肿腔相关的并发症(p < 0.05)。

结论

囊肿空肠吻合术是治疗巨大肝包虫囊肿的一种有效且安全的手术方法,发病率低于部分囊肿切除术,因此可能是巨大肝包虫囊肿手术治疗的首选方法。

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