Akin M L, Erenoglu C, Uncu E U, Basekim C, Batkin A
Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
J R Army Med Corps. 1998 Oct;144(3):139-43. doi: 10.1136/jramc-144-03-04.
Hydatid disease of the liver is highly prevalent in oriental countries including Turkey, in which their population live mostly in rural areas. The outcome of surgical methods used in the management of a cystic cavity in patients with hepatic hydatid disease was evaluated. Three hundred and forty consecutive patients who presented to Department of General Surgery between 1988 and 1996 with hepatic hydatid disease were reviewed retrospectively. In the first group surgical methods without drainage such as cystectomy (n = 11), capitonnage (n = 55), omentoplasty (n = 91) and capitonnage + omentoplasty (n = 53), in the second group surgery with drainage such as external drainage (n = 74), internal drainage (n = 7), and combined methods (n = 21) were applied. Symptoms, physical findings, types of surgical management, complication rate, hospitalisation period, mortality and recurrence rates were evaluated. Complication rate, average hospitalisation period, recurrence and mortality rates were 12.5%, 9.5 days, 9.9% and 0% respectively in patients without drainage and 63.7%, 26.5 days, 12.7% and 0.9% respectively in patients with drainage. It is concluded that surgical treatment of hydatid disease of the liver without drainage decreases postoperative complication rate and average hospitalisation period, and drainage or nondrainage of cystic cavity has no effect on recurrence.
肝包虫病在包括土耳其在内的东方国家极为普遍,这些国家的人口大多居住在农村地区。对肝包虫病患者囊性腔隙治疗中所采用手术方法的结果进行了评估。回顾性分析了1988年至1996年间连续收治于普通外科的340例肝包虫病患者。第一组采用不引流的手术方法,如囊肿切除术(n = 11)、内囊摘除术(n = 55)、大网膜填塞术(n = 91)以及内囊摘除术 + 大网膜填塞术(n = 53);第二组采用引流手术方法,如外引流术(n = 74)、内引流术(n = 7)以及联合手术方法(n = 21)。对症状、体格检查结果、手术治疗类型、并发症发生率、住院时间、死亡率和复发率进行了评估。不引流患者的并发症发生率、平均住院时间、复发率和死亡率分别为12.5%、9.5天、9.9%和0%,引流患者的相应数据分别为63.7%、26.5天、12.7%和0.9%。结论是,肝包虫病的手术治疗不进行引流可降低术后并发症发生率和平均住院时间,并且囊性腔隙引流与否对复发无影响。