Background: Ecchinococcal disease is still a serious problem in certain parts of the world, with liver as the most affected organ. Surgery remains the mainstay of treatment of hydatidosis, but the optimal surgical pro...Background: Ecchinococcal disease is still a serious problem in certain parts of the world, with liver as the most affected organ. Surgery remains the mainstay of treatment of hydatidosis, but the optimal surgical procedure remains unsettled. Objective: Safety and efficacy of major hepatic resection in multiple and giant hepatic hydatidosis. Patients & Methods: 63 patients had hepatic hydatidosis associated with spleen, lung, and suprarenal hydatidosis were managed by major hepatic resection between April 2005 to April 2011. 43 (68%) males and 20 (32%) females, age range 8 - 56 years. Cysts were found in the liver only in 51 (81%) patients, liver with spleen in 5 (8%), liver, spleen with lung in 2 (3.1%), liver and lung in 4 (6.3%), liver and suprarenal in one patient (1.6%). Results: Multiple cysts were found in 38 (60%) and solitary cyst in 25 (40%) with Cysts diameter ≤5 cmin 22 (35%), 5 - 10 cm in 16 (25%), and 10 - 38 in 25 (40%). Right hepatectomy in 24 (38%), right trisectionectomy in 2 (3.2%), right hepatectomy with Segment III in 4 (6.3%), right hepatectomy with Segment I in 2 (3.2%), left hepatectomy in 12 (19%), left lateral sectionectomy in 6 (9.5%), left hepatectomy with Segment VI in 3 (4.8%), left lateral sectionectomy with right posterior sectionectomy in 2 (3.2%), right hepatectomy with splenectomy in 7 (11%) and right hepatectomy with right suprarenal in one (1.6%) patient were performed. Hospital stay was 4.2 (3 - 13 days) There was one mortality and 12 (19%) morbidities. No recurrence on follow up period (8 - 60 months) was observed. Conclusion: Radical procedure is safe and effective option for hepatic hydatidosis and should be performed when the entire lobe is diffusely involved by huge or multiple hydatidosis with little healthy liver tissue.展开更多
目的探讨三维可视化技术在复杂泡型肝包虫病治疗中的临床效果。方法收集阿坝藏族羌族自治州人民医院2019年1月至2022年7月收治的复杂泡型肝包虫病67例患者资料,并按照行标准肝包虫病根治术前是否行CT三维重建进行分组。研究组32例,术前...目的探讨三维可视化技术在复杂泡型肝包虫病治疗中的临床效果。方法收集阿坝藏族羌族自治州人民医院2019年1月至2022年7月收治的复杂泡型肝包虫病67例患者资料,并按照行标准肝包虫病根治术前是否行CT三维重建进行分组。研究组32例,术前利用免费软件行CT重建、模拟肝切除的三维可视化技术精准评估;对照组35例,术前进行CT二维增强扫描。比较两组患者的基线资料、围手术期相关指标、术后并发症发生情况,通过自制问卷调查术中情况与术前CT阅片满意度方面和医患沟通满意度。结果两组患者手术顺利,无围手术期死亡病例。研究组和对照组手术方式中转情况比较,差异有统计学意义(0 vs 14.29%,χ^(2)=4.940,P=0.026)。研究组的手术时间、术中出血量和术后住院时间较对照组明显减少(均P<0.05)。两组术后肺部感染、胸腔积液并发症均较多,研究组术后胆漏发生率低于对照组(0 vs 14.29%,χ^(2)=4.940,P=0.026)。研究组术中情况与术前CT阅片满意度评分为(94.22±3.39)分,显著高于对照组的(88.14±3.66)分,医患沟通满意度评分为(87.34±4.40)分,显著高于对照组的(80.71±5.02)分,差异均有统计学意义(t=-7.038、-5.726,均P<0.001)。结论三维可视化技术应用于复杂泡型肝包虫病的治疗,有利于制定更符合临床实际的手术方案,明显提高了医患沟通满意度,减少了手术时间、术中出血量和术后住院时间,满足临床需要,值得推广。展开更多
文摘Background: Ecchinococcal disease is still a serious problem in certain parts of the world, with liver as the most affected organ. Surgery remains the mainstay of treatment of hydatidosis, but the optimal surgical procedure remains unsettled. Objective: Safety and efficacy of major hepatic resection in multiple and giant hepatic hydatidosis. Patients & Methods: 63 patients had hepatic hydatidosis associated with spleen, lung, and suprarenal hydatidosis were managed by major hepatic resection between April 2005 to April 2011. 43 (68%) males and 20 (32%) females, age range 8 - 56 years. Cysts were found in the liver only in 51 (81%) patients, liver with spleen in 5 (8%), liver, spleen with lung in 2 (3.1%), liver and lung in 4 (6.3%), liver and suprarenal in one patient (1.6%). Results: Multiple cysts were found in 38 (60%) and solitary cyst in 25 (40%) with Cysts diameter ≤5 cmin 22 (35%), 5 - 10 cm in 16 (25%), and 10 - 38 in 25 (40%). Right hepatectomy in 24 (38%), right trisectionectomy in 2 (3.2%), right hepatectomy with Segment III in 4 (6.3%), right hepatectomy with Segment I in 2 (3.2%), left hepatectomy in 12 (19%), left lateral sectionectomy in 6 (9.5%), left hepatectomy with Segment VI in 3 (4.8%), left lateral sectionectomy with right posterior sectionectomy in 2 (3.2%), right hepatectomy with splenectomy in 7 (11%) and right hepatectomy with right suprarenal in one (1.6%) patient were performed. Hospital stay was 4.2 (3 - 13 days) There was one mortality and 12 (19%) morbidities. No recurrence on follow up period (8 - 60 months) was observed. Conclusion: Radical procedure is safe and effective option for hepatic hydatidosis and should be performed when the entire lobe is diffusely involved by huge or multiple hydatidosis with little healthy liver tissue.
文摘目的探讨三维可视化技术在复杂泡型肝包虫病治疗中的临床效果。方法收集阿坝藏族羌族自治州人民医院2019年1月至2022年7月收治的复杂泡型肝包虫病67例患者资料,并按照行标准肝包虫病根治术前是否行CT三维重建进行分组。研究组32例,术前利用免费软件行CT重建、模拟肝切除的三维可视化技术精准评估;对照组35例,术前进行CT二维增强扫描。比较两组患者的基线资料、围手术期相关指标、术后并发症发生情况,通过自制问卷调查术中情况与术前CT阅片满意度方面和医患沟通满意度。结果两组患者手术顺利,无围手术期死亡病例。研究组和对照组手术方式中转情况比较,差异有统计学意义(0 vs 14.29%,χ^(2)=4.940,P=0.026)。研究组的手术时间、术中出血量和术后住院时间较对照组明显减少(均P<0.05)。两组术后肺部感染、胸腔积液并发症均较多,研究组术后胆漏发生率低于对照组(0 vs 14.29%,χ^(2)=4.940,P=0.026)。研究组术中情况与术前CT阅片满意度评分为(94.22±3.39)分,显著高于对照组的(88.14±3.66)分,医患沟通满意度评分为(87.34±4.40)分,显著高于对照组的(80.71±5.02)分,差异均有统计学意义(t=-7.038、-5.726,均P<0.001)。结论三维可视化技术应用于复杂泡型肝包虫病的治疗,有利于制定更符合临床实际的手术方案,明显提高了医患沟通满意度,减少了手术时间、术中出血量和术后住院时间,满足临床需要,值得推广。
