General Surgery

doi: 10.25005/2074-0581-2020-22-3-448-454
RESULTS OF THE USE OF MINIMALLY INVASIVE TECHNOLOGIES IN THE SURGICAL TREATMENT OF HEPATIC ECHINOCOCCOSIS AND ITS COMPLICATIONS

K.M. Kurbonov1, Z.A. Azizzoda1, M.G. Efanov2, K.R. Ruziboyzoda1

1Department of Surgical Diseases № 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Department of Hepatopancreatobiliary Surgery, Loginov Moscow Clinical Scientific Center, Moscow, Russian Federation

Objective: To evaluate the results of using minimally invasive technologies in the surgical treatment of hepatic echinococcosis (HE) and its complications.

Methods: The results of examination and surgical treatment of 165 patients with HE and its complications using minimally invasive technologies are presented.

Results: 77 patients with uncomplicated HE underwent: open echinococcectomy (EE) from various mini-accesses (n=37), laparoscopic EE (n=30), PAIR technology (n=6), hepatic resection using the da Vinci S robotic complex (n=4). In patients with suppurated hydatid cysts (n=49) a combination of percutaneous cyst puncture with laparoscopic (4) and open (5) EE; PAIR technology (5) and laparoscopic EE (35) were performed. All 39 patients with intrabiliary rupture of hydatid cysts underwent two-stage interventions: percutaneous transhepatic choledochostomy followed by laparoscopic (7) and traditional (4) EE; endoscopic papillosphincterotomy (EPST) followed by open EE (9); laparoscopic choledochostomy followed by open EE (3); EPST followed by laparoscopic total (2) and subtotal (14) pericystectomy. Postoperative complications were noted in 29 (17.5%), relapses of the disease – in 12 (10.9%), lethal outcome – in 1 (0.6%) cases. Based on the analysis of the study, an algorithm for choosing the method of surgical treatment for HE and its complications was developed.

Conclusion: The use of minimally invasive technology for hepatic echinococcosis can improve surgical treatment outcomes.

Keywords: Hepatic echinococcosis, diagnosis , minimally invasive technologies, surgical treatment, treatment results.

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References
  1. Sangov DS, Nazarov FN, Gulmuradov TG. Videoendoskopicheskaya khirurgiya ekhinokokkoza pecheni [Video endoscopic surgery of hepatic echinococcosis]. Zdravookhranenie Tadzhikistana. 2013;3:53-7.
  2. Usmanov NU, Shamsiev NSh, Baratov AK. Mnozhestvennyy oslozhnyonnyy ekhinokokkoz perikarda [Multiple complicated echinococcosis of pericardium]. Grudnaya i serdechno-sosudistaya khirurgiya. 2000;1:69.
  3. Kalmykov EL, Gulov MK, Kapustin BB, Mukhabbatov DK, Nematzoda O, Zardakov SM, i dr. K voprosu o mini-invazivnoy khirurgii echinokokkoza pecheni [To the question about mini-invasive surgery of liver echinococcosis]. Novosti khirurgii. 2019;27(5):563-73. Available from: https://doi.org/10.18484/2305- 0047.2019.5.563
  4. Anvarov KhE. Osobennosti diagnostiki i khirurgicheskogo lecheniya ekhinokokkoza pecheni i ego oslozhneniy [Features of the diagnosis and surgical treatment of liver echinococcosis and its complications]. Vestnik ekstrennoy meditsiny.2017;10(1):97-103.
  5. Durleshter VM, Andreev AV, Kulakov AA, Tokarenko EV. Lechenie retsidivnogo ekhinokokkoza bryushnoy polosti, zabryushinnogo prostranstva i sredosteniya s primeneniem chreskozhnykh miniinvazivnykh tekhnologiy [Treatment of recurrent echinococcosis of the abdominal cavity, retroperitoneal spaces and mediastinum with percutaneous minimally invasive technology]. Annaly khirurgicheskoy gepatologii. 2015;3:129-32.
  6. Molina T, Wu GY. Hepatic echinococcal cysts: a review. J Clin Transl Hepatol. 2016;4(1):39-46.
  7. Akhmedov SM, Ibrokhimov NK, Safarov BD, Rasulov NA, Tabarov ZV. Rezektsiya pecheni pri ekhinokokkoze [Liver resection for echinococcosis]. Annaly khirurgicheskoy gepatologii. 2014;2:49-54.
  8. Vishnevskiy VA, Efanov MG, Ikramov RZ, Nazarenko NA. Radikalnye operatsii pri pervichnom i rezidual’nom ehinokokkoze pecheni [Radical surgery for primary and residual echinococcosis liver]. Annaly khirurgicheskoy gepatologii. 2011;4:25-33.
  9. Shevchenko YuL, Nazyrov FG. Khirurgiya ekhinokokkoza [Echinococcosis surgery]. Moscow, RF: Izdatel’stvo «Dinastiya»; 2016. 288 p.
  10. Vetshev PS, Musaev GKh, Fatyanova AS. Ekhinokokkoz: osnovy diagnostiki i rol’ miniinvazivnykh tekhnologiy (obzor literatury) [Echinococcosis: the basics of diagnosis and the role of minimally invasive technologies (literature review)]. Annaly khirurgicheskoy gepatologii. 2015;3:47-53.
  11. Efanov MG, Alikhanov RB, Tsvirkun VV, Kazakov IV, Kim PP, Vankovich AN, i dr. Blizhayshie i otdalyonnye rezul’taty laparoskopicheskikh i robot-assistirovannykh rezektsiy pecheni. Otsenka opyta spetsializirovannogo tsentra [The immediate and long-term results of laparoscopic and robot-assisted liver resections. Assessment of the experience of a specialized center]. Annaly khirurgicheskoy gepatologii. 2018;23(1):38-46.
  12. Efanov MG, Alikhanov RB, Tsvirkun VV, Prostov MYu, Kazakov IV, Vankovich AN, i dr. Robot-assistirovannye rezektsii pecheni. Otsenka blizhayshikh rezul’tatov [Robot-assisted liver resections. Evaluation of immediate results]. Khirurgiya. 2018;11:24-30.
  13. Medzhidov RT, Khamidov MA, Khamidov TM, Sultanova RS. Aplatizatsiya kist pecheni i selezyonki maloinvazivnym sposobom [Aplatization of liver and spleen cysts in a minimally invasive way]. Endoskopicheskaya khirurgiya. 2015;6:12-7.
  14. Nazarov ShK, Rizoev VS. Rol’ sovremennykh tekhnologiy v diagnostike i khirurgicheskom lechenii ekhinokokkoza pecheni [The role of modern technologies in diagnostics and surgical treatments of hepatic echinococcosis]. Vestnik Akademii meditsinskikh nauk Tadzhikistana. 2016;2:3-9.
  15. Mukantaev TE. Laparoskopicheskaya ekhinokokkektomiya u patsientov s ekhinokokkozom pecheni [Laparoscopic echinococcectomy in patients with hepatic echinococcosis]. Kazanskiy meditsinskiy zhurnal. 2015;96(2):138-43.
  16. Prudkov MI, Amonov ShSh, Orlov OG. Operatsii iz mini-dostupa v khirurgicheskom lechenii ekhinokokkoza pecheni [Mini access surgery in the surgical treatment of liver echinococcosis]. Annaly khirurgicheskoy gepatologii. 2011;4:40-5.
  17. Chernousov AF, Mukantaev TE. Laparoskopicheskaya ekhinokokkektomiya pri proryve kisty pecheni v bryushnuyu polost’ [Laparoscopic echinococcectomy with a breakthrough of a liver cyst in the abdominal cavity]. Endoskopicheskaya khirurgiya. 2016;6:48-51.
  18. Anand S, Rajagopalan S, Mohan R. Management of liver hydatid cysts – current perspectives. Med J Armed Forces India. 2012;3:304-9.
  19. Skipenko OG, Parshin VD, Shatveryan GA, Bedzhanyan AL, Ratnikova NP, Ganiev FA, i dr. Ekhinokokkoz pecheni: sovremennye tendentsii v khirurgicheskoy taktike [Echinococcosis of the liver: current trends in surgical tactics]. Annaly khirurgicheskoy gepatologii. 2011;4:34-9.
  20. WHO. Informal Working Group. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop. 2003;85(2):253-61.

Author information:


Azizzoda Zubaydullo Abdullo
Candidate of Medical Sciences, Doctoral PhD Candidate, Department of Surgical Diseases № 1, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-5127-7355
SPIN: 8131-6832
Author ID: 623089
E-mail: azizov-med76@mail.ru

Efanov Mikhail Germanovich
Doctor of Medical Sciences, Head of the Department of Hepatopancreatobiliary Surgery, Loginov Moscow Clinical Scientific Center
ORCID ID: 0000-0003-0738-7642
SPIN: 2249-6620
Author ID: 703434
E-mail: m.efanov@mknc.ru

Ruziboyzoda Kakhramon Ruziboy
Candidate of Medical Sciences, Assistant of the Department of Surgical Diseases № 1, Avicenna Tajik State Medical University
ORCID ID: 0000-0001-8381-0364
SPIN: 7343-3380
Author ID: 1005844
E-mail: dr.hero85@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:


Azizzoda Zubaydullo Abdullo
Candidate of Medical Sciences, Doctoral PhD Candidate, Department of Surgical Diseases № 1, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (987) 217177

E-mail: azizov-med76@mail.ru

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