Abstract
We present an analysis of the results of surgical treatment of 182 patients with pulmonary echinococcosis (126 patients with uncomplicated and 56 with complicated pulmonary echinococcosis). Of these, only in 23 patients out of 25 planned, it was possible to carry out echinococcectomy purely thoracoscopically through trocar punctures. In 134 cases, videothoracoscopic echinococectomy was performed using a mini-access. In case of bilateral localization of cysts, stage-by-stage operations were performed in 7 patients, and in 3 (36.36%) cases - single-stage echinococcectomy. Echinococcectomy from the lung was performed in 25 patients using a wide thoracotomy approach. In 134 cases, videothoracoscopic echinococectomy was performed using a mini-access. In case of bilateral localization of cysts, stage-by-stage operations were performed in 7 patients, and in 3 (36.36%) cases - single-stage echinococcectomy. Echinococcectomy from the lung was performed in 25 patients using a wide thoracotomy approach. All patients underwent anterolateral thoracotomy. Basically (97.67%) performed organ-preserving operations with the elimination of the residual cavity in the light suture plastics in various modifications. In 2 patients with marginal location and pneumocirrhosis, marginal resection of the lung with an echinococcal cyst was performed.With combined echinococcosis of the lungs and liver, 10 patients were operated on. 6 patients underwent surgical interventions on the lungs and liver through separate approaches at the same time. The use of minimally invasive techniques for pulmonary echinococcosis is possible in more than 2/3 of patients.
Highlights
According to WHO, in endemic areas, the human incidence of echinococcosis is 50 cases per 100,000 people per year, and in some parts, the prevalence rates can reach 5-10 %
We analyzed the data of surgical treatment of 182 patients with echinococcosis of the lungs (126 patients with uncomplicated and 56 patients with complicated echinococcosis of the lungs) conducted in our clinic in the period from 2005 to 2020
In 2 cases, intraoperative technical difficulties required the transition to a mini-thoracotomy
Summary
According to WHO, in endemic areas, the human incidence of echinococcosis is 50 cases per 100,000 people per year, and in some parts, the prevalence rates can reach 5-10 %. Parasites can infect various organs of the body, echinococcosis usually affects the liver and lungs. The lungs (18-35%) are the second most common localization of echinococcosis after the liver (50-70%). The mortality rate in echinococcosis reaches 2.5-7% [1, 5]. The introduction of endosurgical technology has eliminated one of the most significant drawbacks of traditional cavity surgery - the discrepancy between traumatic access and minimal intervention on the organ itself, and mini-invasive surgery has become a possible approach to the treatment of echinococcosis of the lungs. The wide development of operative endoscopy, low trauma rate and low complication rate, costeffectiveness and reduced rehabilitation time of patients allows us to review the principles of treatment of patients with echinococcosis of all localizations [2, 3, 4]
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