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  Česky / Czech version Rozhl. Chir. , 2004, roč. 83, č. 6, s. 227-235
 
Echinococcus Cysts (Hydatids) 
Hájek M.1, Novák K.2, Chudáček Z.3 

1 Chirurgické oddělení Vojenské nemocnice v Plzni, přednosta pplk. MUDr. V. Kanos 2 Chirurgické oddělení Nemocnice v Berouně , přednosta MUDr. J. Beaufort 3 Radiodiagnostické oddělení FN Plzeň-Bory, přednosta MUDr. Z. Chudáček, Ph.D.
 


Summary:

       Introduction and Material: This work is based on rich experience of the first- stated author. During a three-year expertise in Botswana he operated 80 patients with hydatic cysts and he took part in treatment of other patients affected by the Echinococcus granulosus infection. In 59 cases the infectious focus was located in the liver, in 18 cases in the lungs, in 2 cases in the spleen and in one case the foci were multiple peritoneal. Methodology: During the expertise period, the patients were observed prospectively, throughout the diagnostic decision- making and the treatment. Prior to the surgical procedure, they had been, in a long-run, treated with albendazole. In 18 cases out of the total number of the liver cysts, the experts chose a two-step procedure followed by a secondary plombage of the reduced cavity of the cyst with the omentum. The rest of the cysts were removed. Miniinvasive methods were not applied. However, the authors discuss their risks. Results: None of the patients exited, in 3 cases a peroperational anaphylactic reaction was managed. Throughout the expertise, no cases of the echinococcus dissemination in the operated subjects were recorded. The team even managed to treat the hydatic cysts in patients who were HIV/AIDS positive and who were, originally, in a serious state of imunodeficiency. Five cases are presented in the form of brief case reviews. Conclusions: Benefits of the long-term preparation with albendazole – plombage operations are beneficial to be conducted in two steps – Betadin is the most suitable lavage solution – miniinvasive surgical prcedures (PAIR) may bring on specific complications.

        Key words: echinococcus cysts – plombage and resection methods – PAIR – management of complications
       

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