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手术治疗与经皮引流治疗肝包虫囊肿的比较:流行地区的一项回顾性研究

Comparison of surgical procedures and percutaneous drainage in the treatment of liver hydatide cysts: a retrospective study in an endemic area.

作者信息

Akkucuk Seckin, Aydogan Akin, Ugur Mustafa, Yetim Ibrahim, Davran Ramazan, Oruc Cem, Kilic Erol, Temiz Muhyittin

机构信息

Department of General Surgery, Medicine School of Mustafa Kemal University 31100, Serinyol, Hatay, Turkey.

Department of Radiology, Medicine School of Mustafa Kemal University 31100, Serinyol, Hatay, Turkey.

出版信息

Int J Clin Exp Med. 2014 Aug 15;7(8):2280-5. eCollection 2014.

Abstract

INTRODUCTION

Surgical procedures are still the golden standard option in the treatment of liver cystic echinococcosis. However, minimal invasive technics like percutaneous drainage are rising trends. We aimed to compare the efficacy of surgical and percutaneous options in the treatment of liver hydatidosis in an endemic area.

METHODS

Patients who underwent surgical or percutaneous procedures for hydatid disease between January 2007 and December 2012 were retrospectively evaluated. Recurrence rates, hospital stay time, and related factors were analyzed.

RESULTS

There were 44 (35.5%) male and 80 (64.5%) female patients in this study. Eighty two patients (Group I) had undergone surgery (66.1%) and 42 patients (Group II) had undergone percutaneous drainage (33.9%). The mean cyst size was 7.28 ± 2.51 cm in Group I and 8.76 ± 3.30 cm in Group II. Nine recurrences (7.3%) were detected during study. Five of the recurrences were in Group II (11.9%) and four (4.9%) of them were in Group I. The mean length of hospital stay of all patients was 5.42 ± 3.16 days.

DISCUSSION

Percutaneous drainage techniques can be a good alternative to surgery in selected patients. In complicated cases like cystobiliary fistula, surgery is superior to percutaneous approaches. The hospital stay time, recurrence rate and postoperative complications were not enhanced when compared to percutaneous treatment in our study. Despite all controversy about the low morbidity after percutaneous treatment, surgical approach is still a preferable option in patients with liver hydatidosis when it is performed by experienced surgeons.

摘要

引言

外科手术仍是肝囊性包虫病治疗的金标准选择。然而,诸如经皮引流等微创技术呈上升趋势。我们旨在比较手术和经皮治疗方法在流行地区肝包虫病治疗中的疗效。

方法

回顾性评估2007年1月至2012年12月间接受手术或经皮治疗包虫病的患者。分析复发率、住院时间及相关因素。

结果

本研究中有44名(35.5%)男性和80名(64.5%)女性患者。82名患者(第一组)接受了手术(66.1%),42名患者(第二组)接受了经皮引流(33.9%)。第一组囊肿平均大小为7.28±2.51厘米,第二组为8.76±3.30厘米。研究期间检测到9例复发(7.3%)。其中5例复发在第二组(11.9%),4例(4.9%)在第一组。所有患者的平均住院时间为5.42±3.16天。

讨论

经皮引流技术在部分患者中可作为手术的良好替代方法。在诸如囊肿胆管瘘等复杂病例中,手术优于经皮治疗方法。在我们的研究中,与经皮治疗相比,住院时间、复发率及术后并发症并未增加。尽管经皮治疗后发病率较低存在诸多争议,但当由经验丰富的外科医生进行手术时,手术方法仍是肝包虫病患者的首选。

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