Abstract
Objective: To justify the choice of the optimal mini-access for echinococcectomy from the liver using computed tomography. Materials and Methods: In 126 patients, comparative results of preoperative prediction of the parameters of surgical approaches to liver segments for echinococcosis were analyzed according to computed tomography data. Results: The obtained data were compared with intraoperative findings. The sizes of the detected echinococcal liver cysts, determined by computed tomography, varied from 80 to 190 mm, averaging 96±13 mm (M±σ). With mini-approaches, the maximum depth of surgical access was 61 mm, but the instruments made it possible to operate at a depth of up to 150 mm. The angle of the endosurgical operating angle (OAE) with a mini-access was 1.5- 2 times (132° versus 81°) higher than the OAE with traditional approaches, the area of the accessibility zone was 3 times (135 cm² versus 45 cm²) greater than the area of the accessibility zone with traditional operations (p<0.05). The use of computed tomography before surgery made it possible to most accurately determine the size and location of the liver hydatid cyst, determine the depth of the cyst from different surgical approaches, the expected angle of the classical and endosurgical surgical approach, thereby facilitating the selection of the optimal mini access for echinococcectomy from the liver. Conclusion: Minimally invasive approaches in the vast majority of situations can provide adequate conditions for open echinococcectomy when single hydatid cysts are localized in any segment of the liver.
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