Did the COVID-19 Pandemic Negatively Affect Cystic Echinococcosis Patients?

Abstract

Objective: Cystic echinococcosis (CE) is a disease that is endemic in our country and is caused by the contamination of eggs of the parasite Echinococcus granulosus. Although elective surgeries can not be performed in certain periods during the pandemic period in our clinic, as in the whole country, from the date of the appearance of the Coronavirus Disease (COVID-19), it was aimed to examine the surgical and interventional procedures applied in the last 3 years and their results. Materials and Methods: Twenty-four patients admitted to our clinic with the diagnosis of CE disease between 2019 and 2021 were retrospectively analyzed in terms of demographic, clinical, operative and post-operative follow-ups. Results: Twelve of the patients were male and 12 were female. The mean age of the patients was 43.8 years (18-99 year). There were CE lesions in the right lobe in 15 patients, in the left lobe in 2, and in both lobes in 4 patients. Lesions compatible with type 3 hydatid cysts were mostly observed in the patients. 4 patients had more than one hydatid cyst in the liver. The mean cyst diameter was 11,5 cm (5-22cm) in the examination performed considering the largest cyst diameter of patients with multiple cystic lesions. The cyst was infected in 4 patients. In 1 patient, the liver cyst ruptured and was operated under emergency conditions. In the operation, cholecystectomy was performed in 5 patients and splenectomy was performed in 1 patient simultaneously. Intraoperative primary repair was performed in a total of 4 patients with intra-cyst biliary fistula. In the post operative period, intracystic abscess developed in 4 patients and percutaneous abscess drainage was performed. Concurrent appendiceal mucocele was present in 1 patient and appendectomy was added to the procedure. The mean hospital stay of the patients was 9.5 days (2-19 days). Mortality was not observed. Conclusion: As a result of delayed elective surgery in CE disease during the pandemic, cysts were encountered in complicated and advanced stages, which increased the number of hospitalizations and additional procedures to be performed.