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Cruz Cidoncha A, Rúiz-Tovar J, Robín A, San Miguel C, Pérez-Flecha M, Galván A, Minaya A, Aguilera Velardo A, López-Quindós P, Moreno A, Jiménez C, González E, Medina Pedrique M, García-Ureña MA. Is Surgery for Hepatic Echinococcosis Appropriate in a Low-Volume Center? Surg Infect (Larchmt) 2021; 22:1081-1085. [PMID: 34449274 DOI: 10.1089/sur.2021.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Cystic echinococcosis is a parasitic disease that develops in endemic areas due to the transmission of Echinococcus granulosus. The liver is the organ most affected. The most frequent symptoms include pain, palpable mass, jaundice, and fever. Diagnosis is based on epidemiologic history, examination, imaging, and serologic tests. Patients and Methods: We conducted a retrospective study of patients with hepatic echinococcosis diagnosed in our center. We collected data from our patients regarding personal history, cyst characteristics, surgery performed, and post-operative complications. Results: Sixteen patients were diagnosed with hepatic echinococcosis, 11 of whom underwent surgery. We found multiple cysts in six patients (37.5%) and a single cyst in 10 (62.5%). In 14 patients the cysts were found only in the right hepatic lobe (87.5%) and in two patients they were found in both lobes (12.5%). Segment 4 was affected in seven cases. The sizes ranged from 2.7 to 20 cm. Endoscopic retrograde cholangiopancreatography was prior to surgery in five patients. The interventions performed were partial cyst-pericystectomies in eight patients, a total cyst-pericystectomy in one case, and drains were placed in two cases of rupture. Post-operative fistulas were evident in five patients, four of which were closed. The fifth, which occurred after emergency surgery for rupture of the cyst, has maintained suppuration. The mean follow-up was 3.5 years. There was no post-operative mortality or recurrence to date. Conclusions: We can state that center without highly specialized hepato-biliary surgery units can assume the surgery of hydatid liver cysts excluding those with well-defined characteristics. The establishment of recommendations for the referral of patients with complex hydatid cysts may help in the optimal management of this pathology.
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Affiliation(s)
- Arturo Cruz Cidoncha
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Jaime Rúiz-Tovar
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Alvaro Robín
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Carlos San Miguel
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Marina Pérez-Flecha
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Armando Galván
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Ana Minaya
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Asunción Aguilera Velardo
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Patricia López-Quindós
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Almudena Moreno
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Carmen Jiménez
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Enrique González
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Manuel Medina Pedrique
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Miguel A García-Ureña
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
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García-Ureña M, López-Monclús J, Blázquez LA, Robín A, Castellón C, López P, Palencia N, Melero D, Cruz A, Jiménez C, Becerra R, González E, Aguilera A, Moreno A, Esther Q, Luis PJ, Josefa CM, Teresa AM, Sol V, Beatriz R, Alberto M, Oscar B, Carlos SC, Crespi M, Colombo F, Troci A, Foschi D. Topic: Incisional Hernia — “Easy case” as daily case: open vs lap, where the mesh, which fixation…in center midline cases. Hernia 2015; 19 Suppl 1:S354. [DOI: 10.1007/bf03355390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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