Authors
Shevchenko Yu.L.1 , Nazyrov F.G.2 , Akbarov М.М.2 , Saydazimov Е.М.2 , Sirojiddinov К.К. 2
1. Federal State Public Institution “National Medical and Surgical Center named after N.I. Pirogov” of the Ministry of Healthcare of the Russian Federation Moscow.
2. Republican specialized scientific and practical medical center of surgery. acad. V.Vahidov, Tashkent, Uzbekistan.
Abstract
The basis for a research was 256 patients with the complicated liver echinococcosis: with intraparenchymal “hard-to-get” localization — 135 patients; breakthrough into the abdominal cavity — 85 patients; breakthrough into the pleural cavity — 11 patients; breakthrough into the bile ducts — 25 patients. All patients were distributed on two groups for a research: basic group — 140 patients (operated from 2012 to 2016 yy) and group of comparison — 116 patients (operated from 2007 to 2011 yy). Division of patients was based on introduction since 2012 of advanced medical and diagnostic tactics. One of ways of improvement of results of treatment of echinococcosis of a liver at hard-to-get cysts of a liver, was use of modern surgical technologies (an ultrasonic fragmentatora-aspirator “CUSA Excel®+”, an ultrasonic scalpel “Ultracision”, the electrothermal device “LigaSure” and also the ultrasonic intraoperative navigation) allowing to achieve practically in all cases complete liquidation of a parasitic cavity. The offered algorithm of the choice of tactics of treatment has shown high efficiency in respect of objective presurgical assessment and also in improvement of quality of the rendered surgical help. Improvement of tactical and technical aspects of surgical treatment of the complicated liver echinococcosis on the basis of the offered algorithm has allowed to increase a share of positive results from 70,7% to 87,9%, to reduce frequency specific intra and postoperative complications from 33,6% to 7,9%, lethality from 2,6% to 0,7% (P<0,001).
Keywords: liver echinococcosis, complications, surgical treatment, residual cavity, treatment-tactical algorithm.
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