Manterola Carlos, Urrutia Sebastián
Rev Chilena Infectol. 2015 Feb;32(1):43-9. doi: 10.4067/S0716-10182015000200010.
Hepatic echinococcosis (HE) surgery is common in southern's Chile hospitals; however, related publications are scarce and with conflicting results, especially with regard to postoperative morbidity (POM), due to the diversity in it severity. The aim of this study is to determine POM in patients undergoing surgery for complicated HE (CHE).
Case series part of a prospective cohort. Patients undergoing surgery for CHH in hospitals Hernán Henríquez Aravena hospital and Clínica Mayor of Temuco, between 2000 and 2012 were included. The main outcome variable was development of POM using the Clavien scale. Other variables of interest were hospital stay, mortality and recurrence. Descriptive statistics were applied and incidence of POM was determined.
73 patients with a median age of 41 years and 58.9% female were studied. The median ultrasound diameter cysts were 15.0 cm. The average surgical time was 125.4 ± 26.3 min. The surgical procedure used most often was the pericystectomy (84.9%); and 84.9% of cases was performed concomitantly some other surgical procedure. The incidence of POM was 19.2%, 78.6% of whose cases were Grade I or II Clavien. The aetiology was 10.9% of medical complications and 8.2% of surgical complications. 1.4% of mortality was recorded; and with a median follow up of 97 months, no recurrence was verified.
POM in a cohort of patients with CHE is lower than the published and low severity. Subgroups with higher POM were: patients with coexistence of more than one complication, those with colangiohydatidosis and patients with liver abscess of hydatid origin.
肝包虫病(HE)手术在智利南部医院较为常见;然而,相关出版物稀少且结果相互矛盾,尤其是关于术后发病率(POM),因为其严重程度存在差异。本研究的目的是确定接受复杂肝包虫病(CHE)手术患者的POM。
前瞻性队列研究的病例系列。纳入2000年至2012年间在埃尔南·恩里克斯·阿拉韦纳医院和特木科市市长诊所接受CHH手术的患者。主要结局变量是使用Clavien量表评估的POM发生情况。其他感兴趣的变量包括住院时间、死亡率和复发情况。应用描述性统计方法并确定POM的发生率。
研究了73例患者,中位年龄41岁,女性占58.9%。超声测量囊肿的中位直径为15.0厘米。平均手术时间为125.4±26.3分钟。最常使用的手术方法是囊肿切除术(84.9%);84.9%的病例同时进行了其他一些手术。POM的发生率为19.2%,其中78.6%的病例为Clavien I级或II级。病因是10.9%的医疗并发症和8.2%的手术并发症。记录到1.4%的死亡率;中位随访97个月,未证实有复发。
CHE患者队列中的POM低于已发表的数据且严重程度较低。POM较高的亚组包括:存在多种并发症的患者、胆管包虫病患者和肝包虫源性肝脓肿患者。