Treatment Of Hydatid Cysts Research Articles

Our approach to the treatment of pulmonary hydatid cyst

Our approach to the treatment of pulmonary hydatid cyst

Pelvic hydatid disease mimicking ovarian cyst

Hydatid disease is an anthropozoonosis. Hydatid disease is caused by Echinococcus granulosus in tropical countries. Humans are accidental intermediate hosts of Echinococcus. Liver is the most commonly involved organ (59-75%) followed by the lung (27%), kidney (03%), and musculoskeletal system (1-4%); any organ of the body may be affected but pelvic hydatid cyst is rarely reported. Preoperative diagnosis can be established by imaging studies such as ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI). Serology for Echinococcus is also helpful in the diagnosis. However, diagnosis of pelvic hydatid cyst in females is possible only after operation. Preoperative anthelmintic therapy followed by surgery is the preferred treatment for hydatid cyst. Here, a case is presented of pelvic hydatid in a young female who presented with recurrent episodes of urinary retention, along with a hypogastric lump that is an unusual presentation.

Laparoscopic Approach Versus Open Approach in the Treatment of Hydatid Cyst of the Liver, a Prospective Trial

Laparoscopic Approach Versus Open Approach in the Treatment of Hydatid Cyst of the Liver, a Prospective Trial

Paraspinal hydatid cyst with unusual presentation: a case report

Hydatid disease is a zoonotic infection most commonly caused by Echinococcus granulosis. Primary hydatid cysts of the skeletal muscles are extremely rare. In this paper, we present a case in which a patient had a hydatid cyst in the paraspinal muscle. A 19 years old female patient presented with a painless swelling over the left side on the back for the last two months. On local examination, a solitary, firm, non tender well defined, non movable, oval swelling was present over the left paraspinal region from T12 -L3. Provisional diagnosis of hydatid cyst was made on ultrasonography. Magnetic Resonance imaging revealed a well defined ovoid lesion measuring 4.3 × 4.54 × 2.3cm within the left erector spinae muscle. Operative intervention was planned and preoperative albendazole therapy (15 mg/kg/day) was given for two weeks. Hydatid disease is caused by the larval form of Echinococcus granulosus, It is most frequently located in the liver (75%) and lungs (15%). Musculo-skeletal involvement is secondary and uncommon. Spinal and paraspinal involvement is rare, with an incidence of less than 1%. Investigations for diagnosis include Ultrasonography, Computed tomography, Magnetic Resonance Imaging and Serologic tests. Surgical removal is the most effective treatment of hydatid cyst. Therapy with nontoxic scolocidal agents or combination chemotherapy with mebendazole is of therapeutic value. Albendazole is suggested to be given post operatively. Primary paraspinal echinococcosis must be considered in the preoperative differential diagnosis of the atypical presentation of paraspinal lesions in countries where Echinococcus infestation is endemic. Early diagnosis and radical surgery combined with antihelminthic therapy of sufficient duration are mandatory for the treatment of this disease.

Radical Surgery for Liver Hydatid Cyst

Background and aims: Surgery is the basic treatment for liver hydatid cyst (LHC). Radical procedures (pericystectomy (PK) and hepatic resection (HR)) offers better results in selected cases cases than conservative approaches. Aims of this study were to evaluate the results of Radical surgery for LHC and and to determine witch of these two procedures is safe in experienced hepato-biliary surgical unit in endemic countries. Methods: A retrospective cohort study of 143 patients with liver hydatid cyst who underwent radical procedures at a single surgical department in an endemic country were reviewed. Mortality, morbidity and recurrence rates have been analyzed. Results: Thirty-two patients (22.4%) had a HR and 111 patients (77.6%) had a PK. Mortality rate was 1.4% (n=2) in HR group. Overall morbidity rate was 18.9% and vs 28.1% respectively in PK and HR group (p=.26). Postoperative bleeding occurred in 1.8% in PK group vs 3.1% in HR group (p=.535) and specific LHC operative complication occurred in 17.1% in PK group vs 28.1% in HR group (p=.167). Recurrence rate of LHC was 6.3% in PK group vs 6.6% in HR group (p=.999) after a median follow up of 108 months (54-144) vs 89 months (44-135) respectively. Conclusion: Radical surgery for LHC is safe. Each of PK and HR had a specific indication. A good screening of patient's guarantied a good outcome. Keywords: Liver, Hydatid Cyst, Morocco, Radical Surgery.

Surgical treatment of pulmonary hydatidosis: a single-centre experience of four years

Background Hydatid disease is endemic in sheep-raising regions of the world. It is caused by the larval stage of a tapeworm Echinococcus granulosus. The lifecycle of Echinococcus revolves between sheep and dog. Humans get the infection by ingesting the eggs. Lungs are the second most common site of involvement after the liver. We review our 4-year experience of surgical treatment of pulmonary hydatid cysts.

Scolicidal effects of black cumin seed (Nigella sativa) essential oil on hydatid cysts.

Surgery remains the preferred treatment for hydatid cyst (cystic echinococcosis, CE). Various scolicidal agents have been used for inactivation of protoscolices during surgery, but most of them are associated with adverse side effects. The present study aimed to evaluate the in vitro scolicidal effect of Nigella sativa (Ranunculaceae) essential oil and also its active principle, thymoquinone, against protoscolices of hydatid cysts. Protoscolices were aseptically aspirated from sheep livers having hydatid cysts. Various concentrations of the essential oil (0.01-10 mg/ml) and thymoquinone (0.125-1.0 mg/ml) were used for 5 to 60 min. Viability of protoscolices was confirmed by 0.1% eosin staining. Furthermore, the components of the N. sativa essential oil were identified by gas chromatography/mass spectroscopy (GC/MS). Our study revealed that the essential oil of N. sativa at the concentration of 10 mg/ml and its main component, thymoquinone, at the concentration of 1 mg/ml had potent scolicidal activities against protoscolices of Echinococcus granulosus after 10 min exposure. Moreover, thymoquinone (42.4%), p-cymene (14.1%), carvacrol (10.3%), and longifolene (6.1%) were found to be the major components of N. sativa essential oil by GC/MS analysis. The results of this study indicated the potential of N. sativa as a natural source for production of a new scolicidal agent for use in hydatid cyst surgery. However, further studies will be needed to confirm these results by checking the essential oil and its active component in in vivo models.

PO-0249 Medical Treatment Of Hydatid Cysts: About 6 Cases

Background and aims Hydatidosis is a common parasitic disease which is still endemic in Tunisia. Treatment is usually surgical. Medical treatment is rarely recommended. The aim of our study is to evaluate follow-up and response to medical treatment in patients affected by hydatid cystis (HC). Methods We conducted a retrospective study about all cases of HC treated by albendazole in paediatrics department of Hedi Chaker University Hospital in Sfax over a period of 10 years (2004–2013). Results We report 6 cases of HC treated medically. Ages ranged between 2 and 8 years. Diagnosis was based on laboratory and imaging studies. Hydatid cystis had multiple localizations in all of cases: multiple hepatic HC (1 case), bilateral pulmonary HC (1 case), hepatic and pulmonary HC (1 case), hepatic and splenic HC, hepatic, splenic and renal HC and hepatic, pulmonary, cardiac and pancreatic HC. All patients were treated with Albendazole (10 mg/kg/day during 6 to 24 months). Surgical treatment was associated in 4 cases. The outcome was favourable in all cases. Conclusions Surgery remains the ideal treatment for hydatid cysts. However, medical treatment with albendazole can be efficient and can, in some circumstances, replace surgery especially in case of multiple locations.

Karaci̇ğer Ki̇st Hi̇dati̇ği̇ni̇n Cerrahi̇ ve Perkütan Tedavi̇ Sonuçlarının Karşılaştırılması

Objective: The aim of our study was to compare the outcomes of patients who had undergone surgery or percutaneous treatment for liver hydatid cyst (LHC) in our clinic. Material and Methods: A total of 114 patients treated for LHC between the years 1997 to 2013 were evaluated retrospectively from their fi les. Patients were evaluated in terms of demographic characteristics, complaints, cyst characteristics and complications. Results: There were 47 (41.2 %) males and 67 female (58.8%) aged between 6 and 16 years. The complaint was pain in 49% and abdominal swelling in 37.7%, while obstructive jaundice was present in 1 patient at the time of presentation. The cyst was found incidentally in 14 (12%) patients. Only one cyst was present in 90 patients (79%) and there were multiple cysts in 24 patients (maximum 10). The cyst was localized in the liver in 85 (74.6%) patients while there were other cysts, mostly in the lung in 29 (25.6%) patients. The cyst size was 3 to 16 cm. The mean cyst size in the patients undergoing surgery and percutaneous treatment was 96 mm and 70 mm respectively (p=0.001). Surgery was used in 82 (72%) patients and percutaneous treatment in 32 (28%). There were 4 recurrences (in the operated group), 3 cyst infections (in the operated group), and 3 prolonged biliary drainage cases (1 in the percutaneous treated group). Bile

Subadventitial cystectomy in the management of biliary fistula with liver hydatid disease

Biliary fistulas are the most common morbidity (8.2–26%) following hydatid liver surgery. The aim of this study was to evaluate the results of subadventitial cystectomy in the treatment of liver hydatid cyst associated with a biliocystic fistula. The medical records of 153 patients who underwent subadventitial cystectomy for a liver hydatid cyst between January 2006 and December 2010 were retrospectively reviewed. Cysts were located in the right lobe anterior segment 37 (24.2%) patients, right lobe posterior segment 59 (38.6%) patients, the left lobe in 26 (17.0%) patients, and both lobes in 6 (3.9%) patients. The surgical procedures performed were closed (non-incised) subadventitial total cystectomy in 74 patients (48.4%), open (incised) subadventitial total cystectomy in 30 patients (19.6%), and subadventitial subtotal cystectomy in 49 patients (32.0%). Biliocystic communication was found in 52 patients (34.0%), and 21 patients (13.7%) were treated with T-tube drainage. Two patients had performed biliodigestive anastomosis. Biliary fistula was detected in 9 patients after subtotal subadventitial cystectomy. Biliary fistulas closed spontaneously within 10 days and 61 days respectively and the amount of drainage varying between 50 and 400ml after the procedure. Postoperative complication and recurrence rates were 19.0% and 0.7%, respectively. The mortality rate was 0%. Subadventitial cystectomy should be the surgical treatment of choice for this disease because of its feasibility and low rates of recurrence, complications of the residual cavity, and incidence of associated biliary fistula.

Predictive factors of morbidity after surgical treatment of hydatid cyst of the liver

Background and study aimsHepatic hydatid cyst is a major health problem in endemic areas. Surgery is still the best choice for treatment of the hydatid cyst of the liver. However, it is still associated with high mortality and morbidity.The aim of the study was to evaluate the predictive factors for specific morbidity after conservative surgical treatment of the hydatid cyst of the liver. Patients and methodsA total of 120 patients who underwent conservative surgical treatment between 2001 and 2011 were evaluated retrospectively. ResultsOf the 120 patients, 64 were female subjects and 56 male subjects; the median age was 33years (14–83years). The mortality rate was 0%. The overall morbidity rate was 26.6%. The specific morbidity rate was 16.6%. The major specific complications were infection of the residual cavity in 10 cases and an external biliary fistula in eight cases. The predictive factors of morbidity in univariate analysis were bilious cyst content, location of the cyst in the hepatic dome, and size >10cm. After multivariate analysis, only the size of the cyst was an independent predictive factor of morbidity. ConclusionThe size of the cyst was the significant predictor of morbidity of conservative surgery for liver hydatid cyst.

Radical versus conservative surgical treatment of liver hydatid cysts (Br J Surg 2014; 101: 669-675).

Radical versus conservative surgical treatment of liver hydatid cysts (Br J Surg 2014; 101: 669-675).

Surgical treatment of giant liver hydatid cysts: comparison of cystojejunostomy and partial cystectomy

The aim of this study was to compare partial cystectomy and internal drainage of the cyst cavity with cystojejunostomy for the surgical treatment of giant hepatic hydatid cysts. Patients who underwent any type of surgical treatment between March 2009 and May 2013 for giant hepatic hydatid cysts were retrospectively evaluated. The data collected included demographic variables, diagnostic methods, surgical procedures, morbidity and mortality rates. Twenty-eight patients who underwent surgery for giant hepatic hydatid cysts were included. There were 16 (57 %) female patients, with a mean age of 32.8 years. The diagnostic methods primarily included abdominal ultrasonography and computed tomography, which were performed in 62 % of the patients. The patients were divided into two groups with respect to the treatment modality: Group A (n = 13) treated with cystojejunostomy and Group B (n = 15) treated with partial cystectomy. The overall rate of cavity-related complications was 25 % in Group B, whereas none of the patients in Group A had a cavity-related complication during the follow-up period (p < 0.05). Cystojejunostomy is an effective and safe surgical approach for the treatment of giant hepatic hydatid cysts, with a lower rate of morbidity than partial cystectomy, and thus may be the surgical treatment of choice for giant hepatic hydatid cysts.

Is the Adjuvant Albendazole Treatment Really Needed with PAIR in the Management of Liver Hydatid Cysts? A Prospective, Randomized Trial with Short-Term Follow-Up Results

The purpose of this study was to determine the safety and efficacy of adjuvant albendazole medication in percutaneous liver hydatid cyst treatment with puncture, aspiration, injection, and reaspiration (PAIR) method. Between November 2007 and May 2011, total of 39 patients with newly diagnosed liver hydatid cyst (total of 77 cysts) were prospectively randomized and enrolled in 3 groups. In the first group, cysts (n = 14) were treated with PAIR without albendazole. In the second (n = 16) and third groups (n = 47), cysts were treated with PAIR with albendazole 1 week before and 1 month after the procedure, with albendazole 1 week before and 3 months after the procedure respectively. Technical and clinical success rates were 100 and 96.1% respectively. In 3 of 77 cysts (3.9%), findings of recurrence were detected on US imaging. All recurrent cysts were in group 1 and recurrence rates in this group were statistically different from cysts of second and third groups (p = 0.005). Side effects of albendazole were detected in 7 of 29 patients (24.1%), and no statistically significant difference was observed between the second (15.3%) and third (38.4%) groups (p = 0.378). Use of albendazole medication as an adjuvant to percutaneous treatment of liver hydatid cyst decreases the recurrence rate. Although there is no statistically significant difference between groups 2 and 3 in terms of efficacy and recurrence rate, patients in group 3 had a higher rate of side effect. Therefore, we conclude that albendazole treatment 1 week before and 1 month after PAIR treatment is sufficient to reduce/prevent recurrences.

A cardiac hydatid cyst in the interventricular septum

Cardiac hydatid cyst is a very rarely seen. It primarily involves the lungs and liver. Treatment of cardiac hydatid cysts is surgical and subsequent medical therapy with albendazole to prevent relapses. Herein, we report a 14-year-old male case who underwent a surgical operation six months ago due to a hydatid cyst in the liver and developed cardiac hydatid cyst in the interventricular septum despite postoperative albendazole therapy.

Torakal yaklaşım ile akciğer, karaciğer ve dalak kist hidatiklerinin cerrahi tedavisi

Torakal yaklaşım ile akciğer, karaciğer ve dalak kist hidatiklerinin cerrahi tedavisi

Surgical treatment and outcomes of hydatid cyst of the spleen

Aim: Discuss the different modalities of surgical treatment of splenic hydatid cyst and outcomes after treatment. Patients and Methods: Retrospectively, 14 patients were operated in our institution between 2002 and 2011. Results: A total splenectomy was performed in 8 cases. A conservative treatment was preferred in 6 cases: 2 patients underwent partiel splenctomy and two patients underwent partial cystectomy. The duration of hospitalization ranged from 5 to 15 days. The morbidity rate was 14%. One patient presented a recurrent hemorrhage and one patient developed a left pneumonia. There is no death in our series. The mean duration follow-up was 20 months and there is no recurrence. Conclusion: Management of a splenic hydatid cyst is not consensual. Surgery remains the treatment of choice to avoid serious complications. Total splenectomy is optimal because it provides definitive treatment. However, spleen-preserving surgery is the preferred treatment in some selected patients.

What is the Current Concept for the Treatment of Liver Hydatid Disease?

Hydatid disease of the liver caused by the larval form of Echinococcus granulosus still remains a common and challenging problem in Turkey. Operative treatment is the most common and well known option. Percutaneous aspiration, injection and reaspiration (PAIR) has resulted as an alternative treatment to sur¬gery and is becoming popular. Therefore, the treatment of hydatid cyst has been shifted from traditional surgical approach to less invasive PAIR. Large cysts with multiple daughter cysts, cysts communicating with the biliary tree, cysts exerting pressure on vital organs and single superficial hepatic cysts are indications for surgical treatment. While preoperative albendazol treatment is planned to decrease the cyst viability before surgery or percutanaeous drainage, postoperative chemotherapy is administered to reduce recurrence rates. PAIR is a promising treatment approach but randomised clinical trials with long follow-up are required to decide its efficiency. The aim of this study is to evaluate the effectiveness and indications of different treatment modalities in the management of liver hydatid cyst.

Long-term disseminated recurrence in spinal hydatid cyst: a case report.

The spinal column is rarely affected by hydatid cyst; however, when involved, it has higher rates of recurrence particularly in case of osseous and paravertebral extensions. We report a 36-year-old patient. The patient was operated previously for hydatid cyst through laminectomy 13 years ago. After 13 years of surgery, the patient was admitted to our clinic with progressive paraparesis. Radiological evaluation revealed multicystic lesions affecting T4 and T5 vertebrae as well as the posterior thoracic wall and paravertebral musculature. Serological findings were also compatible with a hydatid cyst. The patient underwent surgical treatment; the cystic lesions were removed, and vertebral stabilization was provided. The treatment of hydatid cyst in the spine is challenging. Particularly in cases with vertebral involvement, spinal instability and recurrence are the main handicap. Preoperative and postoperative antihelminthic treatment as well as close clinical, radiological and serological follow up in postoperative period is important to avoid recurrence risk.

Evaluation of the effect of pulmonary hydatid cyst location on the surgical technique approaches.

Purpose:A hydatid cyst is the most common lung parasitic disease and is endemic in Iran. A hydatid cyst is more common in the right lung and lower lobes.Objective:The aim of this study was to assess surgical treatment of pulmonary hydatid cysts and whether the location of cyst affects surgical technique approaches.Materials and Methods:This study was performed on 87 patients with a pulmonary hydatid cyst who were referred to Qaem Hospital from 2010 to 2012. Selection of surgical technique was according to size, location, and the number of cysts. Patients were divided into two groups: (1) surgery with preserving lung parenchyma and (2) lobectomy. Afterward, the relationship between the location of cyst and surgical technique approaches was evaluated. Data was analyzed by Chi-square and Fisher exact tests.Results:In this study, no significant relation was found between the size (P = 0.682) and number (P = 0.344) of cysts and lobectomy necessity. But, there was a significant relation between the occurrence of cyst in middle lobe and lobectomy necessity (P = 0.016).Conclusions:According to the results, type of surgical technique does not depend on the size and number of cysts, but it may be related to the location of the cyst and the ratio of lung destruction.