Cystic echinococcosis of the liver in Kazakhstan: The effectiveness of the PAIR method in comparison with laparoscopic and open surgical methods
Nagasbekov M. Baimakhanov Z. Doskhanov M. Nurlanbayev E. Kaniyev S. Akhan O. Baimakhanov B. Fakhradiyev I.
November 2024Elsevier (Singapore) Pte Ltd
Asian Journal of Surgery
2024#47Issue 114711 - 4716 pp.
Background: One of the urgent problems of surgical parasitology in the Republic of Kazakhstan is liver cystic echinococcosis. The study aimed to analyze the effectiveness and safety of the percutaneous treatment with different techniques in comparison with the results of laparoscopic and “open” surgical methods. Methods: Retrospectively, we analyzed the outcome of 485 patients with active echinococcal cysts in the period from January 2017–July 2023. Indications for surgical treatment and the choice of the intervention method were based on this classification. Patients were conditionally divided into 3 groups: Laparoscopy–33, Laparotomy–319, PAIR-133. Results: The duration of the operation in the PAIR was significantly shorter compared to the Laparotomy and Laparoscopy groups (55.4vs.225.2 and 215.3, p = 0.0001). There was no intraoperative blood loss in PAIR, whereas in Laparotomy and Laparoscopy there were 146.0 and 111.0. The postoperative stay of patients in PAIR is significantly shorter than in Laparotomy and Laparoscopy (3.8 compared to 7.5 and 6.4, p = 0.0001). The follow–up time averaged 39.8 months ± 21. There were no statistically significant differences in relapses. Laparotomy and PAIR groups had 11 (3.5 %) and 6 (4.5 %) relapses, respectively. Conclusion: In cystic echinococcosis of the liver types CE1, CE3a regardless of the localization, the optimal volume is a PAIR is characterized by a shorter postoperative stay of the patient, early recovery and cure. In the CE2, CE3b stages, laparoscopic pericystectomy is the most effective and safe in individual patients. In case of an intimate arrangement of cysts to tubular structures, the safest method is laparotomy.
Echinococcosis , Kazakhstan , Laparoscopy , Laparotomy , Percutaneous aspiration-injection-respiration
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«Syzganov National Scientific Center of Surgery», Almaty, Kazakhstan
«S.D.Asfendiyarov Kazakh National Medical University», Almaty, Kazakhstan
«Hacettepe University», Faculty of Medicine, Department of Radiology, Ankara, Turkey
«Syzganov National Scientific Center of Surgery»
«S.D.Asfendiyarov Kazakh National Medical University»
«Hacettepe University»
10 лет помогаем публиковать статьи Международный издатель
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