Novosti
Khirurgii

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Year 2019 Vol. 27 No 5

REVIEWS

E.L. KALMYKOV1, M.K. GULOV2, B.B. KAPUSTIN3, D.K. MUHABBATOV2, O. NEMATZODA4, S.M. ZARDAKOV2, A.R. KODIROV2

TO THE QUESTION ABOUT MINI-INVASIVE SURGERY OF LIVER ECHINOCOCCOSIS

University Hospital Cologne1, Cologne, Germany,
Avicenna Tajik State Medical University2, Dushanbe, The Republic of Tajikistan
Izhevsk State Medical Academy3, Izhevsk, The Russian Federation
Republican Scientific Centre for Cardiovascular Surgery 4, Dushanbe,
The Republic of Tajikistan

The possibilities of using mini-invasive technologies (laparoscopic echinococcectomy, PAIR technology, removal of an echinococcus cyst from the mini-access) in treating patients with the liver echinococcosis have been analyzed in the review. Currently, there is a tendency to expand the indications for laparoscopic echinococtectomy, both in case of “difficult” localization and in the presence of complicated cysts. The main danger in laparoscopic echinococcectomy is the rupture of a cyst and the discharge of its contents into the abdominal cavity with the development of anaphylactic shock and dissemination of the parasite, bleeding. The frequency of postoperative complications is 6-22% of cases, mortality approaches zero. Relapses are practically not observed.
The success of the PAIR procedure reaches 97%; the frequency of deaths and complications is 0-1% and 8.5-32%, respectively. The recurrence rate also varies considerably from 0 to 48%. However, a sufficiently large number of applications of this technology, a small number of patients included in the research, as well as limited indications for its use, do not allow us concluding about the comparative effectiveness of the method.
The difficulty of comparing the advantages and disadvantages of using echinococcectomy from mini-access is due to the small number of observations, the lack of comparative studies, and the short observation period in the postoperative period. The frequency of postoperative complications reaches 7%, the mortality rate approaches zero.
The choice of the method of minimally invasive treatment of the liver echinococcosis is based on the size and localization of the cyst, the presence of cysto-biliary communications, as well as the presence of a complicated course of the disease or the lack thereof.
Complicated cysts and cysts of complex localization remain unsolved issues in the treatment of the liver echinococcosis with the use of mini-invasive methods of surgical treatment

Keywords: liver hydatidosis, PAIR, laparoscopic echinococcectomy, mini-access, complications
p. 563-573 of the original issue
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Address for correspondence:
734003, The Republic of Tajikistan,
Dushanbe, Sanoi Str., 33,
Republican Scientific
Centre for Cardiovascular Surgery.
Tel.: +992 91 525 00 55,
e-mail: sadriev_o_n@mail.ru,
Nematzoda Okildjon
Information about the authors:
Kalmykov Egan L., PhD, Research Assistant of the Vascular and Endovascular Surgery Unit, University Hospital Cologne, Cologne, Germany.
https://orcid.org/0000-0001-6784-2243
Gulov Mahmadsho K., MD, Professor of the General Surgery Department ¹1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan.
https://orcid.org/0000-0001-5151-937X
Kapustin Boris B., MD, Professor, Head of the Hospital Surgery Department, Izhevsk State Medical Academy, Izhevsk, Russian Federation.
https://orcid.org/0000-0003-4076-9466
Mukhabbatov Dzhiyonhon K., MD, Assistant of the General Surgery Department ¹1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan.
https://orcid.org/0000-0002-2100-310X
Nematzoda Okildjon, PhD, Leading Researcher, Republican Scientific Centre for Cardiovascular Surgery, Dushanbe, Republic of Tajikistan.
https://orcid.org/0000-0001-7602-7611
Zardakov Sorbon M., Post-Graduate Student of the General Surgery Department ¹1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
https://orcid.org/0000-0002-8233-2732
Kodirov Abdurauf R., PhD, Assistant of the General Surgery Department ¹2, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan.
https://orcid.org/0000-0001-8982-2243
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