Combined medical and surgical therapy: a new approach to abdominal hydatidosis

The experience with 28 patients affected by hepatic and abdominal hydatidosis and treated by combined medical and surgical therapy is reported. All the patients were subject to preoperative and postoperative medical therapy with mebendazole (50 mg/kg/daily). The percentage of living scolices in hydatid fluid obtained during surgery, evaluated microscopically and by mice inoculation, was lower in patients treated medically than in patients operated on without pre and postoperative medical therapy. These data support the efficacy of the preoperative medical therapy in order to decrease the biological activity of the parasite and, consequently the risk of secondary localization due to intraoperative dissemination. Two ultrasound proved recurrences (7.1%) were observed only in patients with multiple or diffuse hydatidosis. In these cases it is uncertain whether it was a relapsing or residual disease. No toxic or collateral effects, following the schedule of dosage and timing of the drugs used, were observed in these patients. It is concluded that, at the present time the combined medical and surgical therapy, is considered the most effective therapeutical approach to abdominal hydatidosis.