Aljaiuossi Anas, Ba-Shammakh Saleh A, Bani Hani Mohammad, Al-A'athal Musab S, Elsobuh Yazeed M, Abu Sarhan Hashem, Ennab Raed Mahmoud, Al-Zubi Mohammad, Alhwari Mohammad J, Al Omari Laith G, Mohammad Feras M, Al Lami Mohamed S, Zeitoon Hammam B, Alomari Saad A, Ababneh Salman M
Faculty of Medicine, Yarmouk University, Irbid.
Department of General Surgery, Ministry of Health, Amman, Jordan.
Ann Med Surg (Lond). 2024 Jul 1;86(9):4999-5006. doi: 10.1097/MS9.0000000000002320. eCollection 2024 Sep.
Primary splenic hydatidosis, a rare manifestation of Echinococcus granulosus infection, presents unique diagnostic and therapeutic challenges. This study compares spleen-preserving surgeries with total splenectomy for treating primary splenic hydatid cysts, focusing on short- and long-term outcomes in the Jordanian context, a region particularly affected by this condition.
This retrospective analysis was conducted on 18 patients diagnosed with primary splenic hydatid cysts at two Jordanian hospitals from January 2015 to June 2021. Selection criteria included confirmed diagnosis and complete medical records. Surgical approaches, including laparoscopic partial splenectomy, cystectomy, and cyst deroofing, supplemented by albendazole therapy, were compared based on patient demographics, symptoms, surgical details, complications, and recurrence rates.
The study group was composed of (=7, 38.9%) male and (=11, 61.1%) female patients, with an average age of 33.7 years. Most presented with left upper quadrant pain. Postoperative complications occurred in 22% of patients, with an 11% recurrence rate during follow-up. No significant statistical difference in recurrence rates was observed between spleen-preserving surgeries and total splenectomy. These findings highlight the efficacy of less invasive, spleen-preserving techniques in managing primary splenic hydatidosis, showing comparable outcomes to total splenectomy with minimal impact on recurrence rates.
Spleen-preserving surgery offers a viable alternative to total splenectomy in treating primary splenic hydatid cysts. This approach maintains immune functionality and reduces septic risks, especially in pediatric patients. The study underscores the importance of individualized treatment approaches and suggests further research with larger cohorts for more comprehensive insights into managing this rare condition. The limitations of this study include its small sample size and retrospective nature.
原发性脾包虫病是细粒棘球绦虫感染的一种罕见表现,带来了独特的诊断和治疗挑战。本研究比较了保留脾脏手术与全脾切除术治疗原发性脾包虫囊肿的效果,重点关注约旦地区(该病特别高发的地区)的短期和长期结果。
对2015年1月至2021年6月期间在约旦两家医院确诊为原发性脾包虫囊肿的18例患者进行回顾性分析。入选标准包括确诊和完整的病历。根据患者人口统计学、症状、手术细节、并发症和复发率,比较了手术方法,包括腹腔镜部分脾切除术、囊肿切除术和囊肿去顶术,并辅以阿苯达唑治疗。
研究组由男性(=7,38.9%)和女性(=11,61.1%)患者组成,平均年龄33.7岁。大多数患者表现为左上腹疼痛。22%的患者出现术后并发症,随访期间复发率为11%。保留脾脏手术和全脾切除术之间的复发率无显著统计学差异。这些发现突出了微创、保留脾脏技术在治疗原发性脾包虫病方面的有效性,显示出与全脾切除术相当的结果,对复发率影响最小。
保留脾脏手术是治疗原发性脾包虫囊肿的全脾切除术的可行替代方案。这种方法维持免疫功能并降低感染风险,尤其是在儿科患者中。该研究强调了个体化治疗方法的重要性,并建议进行更大样本量的进一步研究,以更全面地了解这种罕见疾病的管理。本研究的局限性包括样本量小和回顾性性质。