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囊性棘球蚴病病例:普通外科的回顾性评估

Cystic Echinococcosis Cases: A Retrospective Evaluation in a General Surgery Department.

作者信息

Gökçe Oruç Numan, Alkan Sevil, Karadağ Volkan

机构信息

Department of General Surgery, Çanakkale Onsekiz Mart University School of Medicine, Çanakkale, Türkiye.

Department of Diseases and Clinical Microbiology, Çanakkale Onsekiz Mart University School of Medicine, Çanakkale, Türkiye.

出版信息

Infect Dis Clin Microbiol. 2024 Dec 19;6(4):291-297. doi: 10.36519/idcm.2024.425. eCollection 2024 Dec.

Abstract

OBJECTIVE

Cystic echinococcosis (CE) caused by the larval stage of the parasite is a global health problem. This study aimed to assess cases of CE admitted to our General Surgery Department retrospectively, as there is no known similar publication concerning surgical treatment of abdominal cystic echinococcosis in Çanakkale province.

MATERIALS AND METHODS

We analyzed laboratory and radiological findings alongside clinical and demographic features, treatments, and outcomes of cases undergoing surgical treatment for abdominal cystic echinococcosis in our department between 2012 and 2022.

RESULTS

Among the 37 cases reviewed, the mean age was 45.59±7.1 years, and 19 (51.35%) were female. While the majority (54.05%) were from urban districts, only 37.84% were involved in animal husbandry and agriculture. Most common complaint was abdominal pain (67.57%), with an average symptom duration of 4.3±1.02 months. The diagnosis was confirmed by visualization of the cuticular membrane through pathological examination. IHA testing yielded positive in 29 cases. Spleen involvement was seen in 3 (8.11%) cases and isolated liver involvement in 34 (91.89%) cases. Gharbi type III cysts (n=15) were the most frequent. The average cyst size was 106.32 mm (range 50-200); 29 cases had solitary cysts, six had double cysts, and one had triple and quadruple cysts. Cystotomy with capitonage and laparoscopic pericystectomy were performed in 30 cases and seven cases, respectively. Our recurrence rate was low (2.7%). Early and late complications developed in 12 (32.43%) cases.

CONCLUSION

Abdominal pain was the primary presenting symptom; radiology is valuable in diagnosis. Occupation in agriculture or animal husbandry is not the main risk factor in our region. Surgical interventions have favorable outcomes with low recurrence rates, particularly laparoscopic pericystectomy.

摘要

目的

由该寄生虫幼虫阶段引起的囊性棘球蚴病(CE)是一个全球性的健康问题。本研究旨在回顾性评估我院普通外科收治的CE病例,因为在恰纳卡莱省尚无关于腹部囊性棘球蚴病外科治疗的类似已知出版物。

材料与方法

我们分析了2012年至2022年期间在我科接受腹部囊性棘球蚴病手术治疗的病例的实验室和影像学检查结果,以及临床和人口统计学特征、治疗方法和治疗结果。

结果

在回顾的37例病例中,平均年龄为45.59±7.1岁,女性19例(51.35%)。虽然大多数(54.05%)来自市区,但只有37.84%从事农牧业。最常见的主诉是腹痛(67.57%),平均症状持续时间为4.3±1.02个月。通过病理检查观察到角质层膜确诊。间接血凝试验(IHA)检测29例呈阳性。3例(8.11%)累及脾脏,34例(91.89%)仅累及肝脏。加尔比III型囊肿(n = 15)最为常见。囊肿平均大小为106.32 mm(范围50 - 200);29例为单发性囊肿,6例为双发性囊肿,1例为三发性和四发性囊肿。分别对30例和7例进行了带帽囊肿切开术和腹腔镜囊肿切除术。我们的复发率较低(2.7%)。12例(32.43%)发生了早期和晚期并发症。

结论

腹痛是主要的首发症状;放射学检查对诊断有重要价值。在我们地区,从事农牧业并非主要危险因素。手术干预效果良好,复发率低,尤其是腹腔镜囊肿切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3239/11687232/de6ff1f89c53/IDCM-6-4-425_Figure1.jpg

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