More Than 25 Years of Surgical Treatment of Hydatid Cysts in a Nonendemic Area Using the "Frozen Seal" Method
More Than 25 Years of Surgical Treatment of Hydatid Cysts in a Nonendemic Area Using the "Frozen Seal" Method
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DOI：
10.1007/s00268-009-0267-0
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发表时间：
2010-01-01
影响因子：
2.6
通讯作者：
Breslau, P. J.
中科院分区：
文献类型：
--
作者：
Stoot, J. H. M. B.;Jongsma, C. K.;Breslau, P. J.
肝包虫病在世界上仍然是一种地方病，在荷兰是一种输入性疾病。本研究的目的是评价在荷兰的一个单一的中心手术治疗包虫病的患者的治疗和结果，这项回顾性研究包括112例连续手术治疗包虫病在1981年和2007年之间。主要结局是疾病复发。次要结果是感染、并发症、再手术、住院时间和死亡率。所有病例的棘球蚴病均通过计算机断层扫描或超声检查（US）诊断。血清学（酶联免疫吸附试验，免疫荧光法）证实了92.9%的诊断。囊肿多见于肝脏（73.5%）。所有囊肿均采用冷冻封闭技术进行手术。复发9例（8.0%）。5例（4.5%）在后期需要手术治疗。记录了20例（17.9%）并发症。4例（3.6%）需要放射性引流，3例（2.7%）需要再次手术。在平均24个月（范围0.5-300个月）时，使用超声和/或血清学进行随访。除1例并发症外，所有并发症均发生在肝脏手术组，但无统计学意义（P = 0.477）。有并发症者住院时间明显长于无并发症者（P < 0.001）。本研究无死亡病例，提示手术冷冻封闭法治疗包虫病是安全有效的。未来的研究需要证明其在包虫病治疗中的地位，因为新的发展显示出有希望的结果。
Hydatid disease of the liver remains endemic in the world and is an imported disease in The Netherlands. The aim of this study was to evaluate the treatment and outcome of surgically treated patients for hydatid disease in a single center in The Netherlands.This retrospective study included 112 consecutive patients surgically treated for hydatid disease between 1981 and 2007. The primary outcome was relapse of the disease. Secondary outcomes were infections, complications, reoperations, length of hospital stay, and mortality.In all cases, echinococcosis was diagnosed by computed tomography or ultrasonography (US). Serology (enzyme-linked immunosorbent assay, immunofluorescence) confirmed the diagnosis in 92.9%. Most of the cysts were seen only in the liver (73.5%). All cysts were operated on with the frozen seal technique. Relapse of disease was seen in 9 (8.0%) cases. Five (4.5%) required surgical treatment at a later stage. Twenty (17.9%) complications were recorded. Four (3.6%) needed radiological drainage and three (2.7%) a reoperation. Follow-up was performed with US and/or serology at a mean of 24 months (range 0.5-300 months). All but one complication were seen in the liver-operated group, this proved not to be of statistical significance (P = 0.477). Patients with complications stayed significantly longer in hospital than did the patients without complications (P < 0.001). No mortality was observed in this study.The present study suggests that the frozen seal method of surgery for hydatid disease is safe and effective. Future studies are needed to prove its position in the treatment of hydatid disease as new developments show promising results.