Radical treatment of liver echinococcosis. State of art

Vishnevsky, V.; Икрамов, Р. З.; Кахаров, М. А.; Yefanov, M G

doi:10.20538/1682-0363-2007-3-22-26

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…In 2010, Prof. S.B. Imankulov for the first time proposed the use of NIFU as a mini-invasive method of treatment of hydatidosis and alveolar echinococcosis of the liver in conditions of continuing severe emidemiological situation and unsolved many issues of the course, diagnosis and treatment of hepatic echinococcosis [3][4][5]. The developed indications and contraindications for HIFU use in hepatic echinococcal lesions, permissible sizes of parasitic masses, selection of optimal HIFU power, analysis of immediate and long-term results, comparative assessment of traditional surgical intervention and HIFU ablation were the basis for positive results and effective treatment of alveolar and hydatid liver echinococcosis by HIFU ablation [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Morphology of echinococcal liver lesions during treatment with high-intensity focused ultrasound

Fedotovskikh¹,

Shaymardanova²,

Zhampeissov

2022

J CLIN MED KAZ

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The purpose of morphological studies was to study pathogenetic mechanisms of the therapeutic effect of HIFU ablation on hepatic echinococcosis.Material and methods: Ablation of echinococcal cysts and alveococcal liver lesions no larger than 5 cm in size with high-intensity focused ultrasound was performed on JC Focused Ultrasound Therapeutic System (China). Biopsy material of hepatic echinococcal masses in 37 patients after HIFU-ablation were taken for morphological light-optical and electron microscopic studies.Results: Protoscolexes lost their superficial syncytial layer, the parenchyma looked vacuolized, the disembodied heads with suckers and hooks were fragmented and separated from the body. Small vacuolization of hyaloplasm, homogenization of membranes and mitochondrial matrix, blurring of organelle contours in parenchymatous protoscolex cells were observed. Laminar shells of brood capsules and larvocysts of echinococcus were homogenized and ruptured, germinative cells were sloughed off. The laminar and germinal sheaths of the alveolar vesicles were irregularly thickened, unfolded, ruptured, and surrounded by necrotized liver cells and structureless masses. Destructively altered stem cells and calcareous calcium corpuscles of the laryngeal membrane were observed electron microscopically.Conclusion: Morphological data revealed destructive effect of HIFU ablation on mature and germinative forms of hydatid and alveolar echinococcus of the liver, as well as the safety of the selected optimal HIFU power on the surrounding hepatic tissue, which explains the absence of recurrence and confirms high effectiveness of HIFU ablation as a minimally invasive method of treatment of echinococcal growths of certain acceptable sizes.

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Section: Introductionmentioning

confidence: 99%

Morphology of echinococcal liver lesions during treatment with high-intensity focused ultrasound

Fedotovskikh¹,

Shaymardanova²,

Zhampeissov

2022

J CLIN MED KAZ

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“…Методы хирургического лечения могут быть условно разделены на паллиативные и радикальные. Тотальные перицистэктомии и атипичные резекции печени являются органосберегающими радикальными методиками, показывающими хорошие результаты лечения [3,4]. С развитием хирургических технологий вышеуказанные виды вмешательств все чаще применяются в лапароскопическом варианте исполнения в гепатологических центрах [5,6,7,8,9].…”

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“…мин, М ± σ (min-max):6,1 ± 3,3(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) Маневр Прингла, n (%) 14 (73,7) Длительность маневра Прингла, мин, М ± σ (min-max) 17,1 ± 7,5 (10-30)Рис. 1.…”

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Efficiency of new technologies in endovideosurgical treatment of liver echinococcosis

Krasnov¹,

Анищенко

Pachgin³

et al. 2023

Journal of Volgograd State Medical University

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Introduction: Surgical operations remain the main and most effective option for the treatment of liver echinococcosis. With the development and mastering of the method, laparoscopic operations are being used more and more widely. New technologies aimed at improving treatment outcomes are being developed and implemented in laparoscopic surgical methods. The purpose of the study is to present and evaluate the results of treatment of operated patients with liver echinococcosis using new technologies. Materials and methods: The results of treatment of 19 patients (9/47.4 % men, 10/52.6 % women) with liver echinococcosis, who were treated with organ-sparing laparoscopic resection techniques using new technologies in the surgical department No. M.A. Podgorbunsky. Results: There was no statistically significant advantage in dissection rate among the methods used (p = 0.74). In the group of patients with the applied hemostatic matrix Floseal, the time of hemostasis was significantly less than in the group without using the method (p = 0.001). In the group of patients with the improved laparoscopic Pringle maneuver, the blood loss was significantly less than in the group without using the technique (p = 0.00008). Findings: A new patented improved method of temporary hemostasis in laparoscopic resection interventions on the liver in the study proved its effectiveness. The use of the Floseal hemostatic matrix made it possible to reduce the time of hemostasis, and, accordingly, reduce the duration of the operation and reduce intraoperative blood loss in general. The laparoscopic method of surgical intervention using the above technologies is effective and safe in the treatment of medium-sized echinococcal liver cysts.

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“Complex” hepatic echinococcosis

et al. 2021

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Aim. To study the long-term results of surgical treatment in patients with “complex” hepatic echinococcosis.Materials and methods. The results of surgical treatment of 118 patients with hepatic echinococcosis from 2015 to 2020 at the A.V. Vishnevsky National Medical Research Center of Surgery were analyzed. The term “complex” hepatic echinococcosis has been proposed. A comparative analysis of the number and type of complications and surgical interferences 2 groups of patients was carried out: 66 patients with hepatic echinococcosis, 52 patients with complex hepatic echinococcosis.Results. During the observation period, no any recurrence was recorded. 55 (44%) of 118 patients had complex hepatic echinococcosis. Isolated liver damage was found in 74% of cases, combined liver and lung damage in 20% cases and with other organs – in 6%. In most cases, pericystectomy was performed (82%), 8% of patients underwent atypical hepatectomy, 4% – segmental resection, 3% – laparoscopic intervention, 3% – hemihepatectomy. Postoperative complications were recorded in 22 (18,6%) of cases. Accumulations of bile and biliary fistulas formed in 45% of cases, pneumotothorax or hydrothorax – in 23%, wound abscess – in 18%, hematomas in the hepatectomy zone – in 14% of the cases.Conclusion. Surgical treatment of complex hepatic echinococcosis requires an individual approach to the choice of the operation option. Preference should be given to parenchyma-preserving radical operations. When the liver lobe is totally replaced with a hydatid cyst and in case of cystobiliary fistulas hemihepatectomy should be performed, and it is acceptable to leave the fibrous capsule on large tubular structures.

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Radical treatment of liver echinococcosis. State of art

Cited by 4 publications

References 4 publications

Morphology of echinococcal liver lesions during treatment with high-intensity focused ultrasound

Morphology of echinococcal liver lesions during treatment with high-intensity focused ultrasound

Efficiency of new technologies in endovideosurgical treatment of liver echinococcosis

“Complex” hepatic echinococcosis

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