[Improvement of surgical treatment of echinococcosis]

A hydatid disease is a serious public health problem in Kazakhstan. Surgical treatment is the main treatment of hepatic echinococcosis. Considering high rate of recurrence of the disease the search for new methods of surgical treatment remains relevant. The aim of the study was to improve the efficiency and safety of surgical treatment of hepatic echinococcosis; to develop a new physical method for cleaning residual cyst cavity. Experimental and clinical investigation of IED effects on hydadtid cyst embryonic element was studied. In order to monitor the effectiveness of developed method the morphological study of histological material was done. В It is experimentally proved that the optimal mode of impact of IED on germinal elements of hydatid cysts at which their complete destruction, is the exposure 120 seconds by 200 ml of liquid or 0,6 seconds per 1 ml volume. The method of cleaning of residual cavity with IED was developed. By this method for the years 2007-2013, 25 patients were operated on, of which there were 13 (52,0%) men, 12 (48,0%) women. The mean age was 37,8В±0,8. Single cysts observed in 16 (64.0 %) cases, multiple in 9 (36.0%). Primary cysts were observed in 20 (80.0%) cases, recurrent 5 (20.0%). Size up to 10 cm cyst verified in 8 (32.0%) cases, from 10cm to 20 cm in 15 (60.0 %) cases, 20 cm or more - 2 ( 8.0%). To localize the left lobe of the liver was struck in 24.0% of cases, the right to 76.0%. The cysts were located in the right lobe of the liver in 76,0%, left lobe in 24,0%. Echinococcectomy was performed in 22 (53.0%) patients, resection-2 (12.0%), pericystectomy-1 (6.0%). Average estimated blood loss was 320.6 ml. Blood transfusion was performed in only 1 (4.0%) patients. Postoperative complications in the form of left-hand reactive pleuritis were marked in 3 (12.0%) cases. Average period of hospitalization amounted to 12,8В±2,2 bed-days. Echinococcectomy supplemented by cleaning of the residual cavity impulse electric discharge may be an alternative to radical methods of surgical treatment of hepatic echinococcosis, due to the fact that IED has a destructive effect against Echinococcus germinal elements, simple to use, safe.