The Efficiency of Minimally Invasive Surgery for Hard-To-Reach Hydatid Cysts of The Liver

Abstract

To improve the results of surgical treatment for hard-to-reach echinococcal cysts of the liver through the use of minimally invasive methods. Material and methods: From 2013 to 2018, 303 patients with echinococcal cysts located in the VII-VIII segments of the liver were surgically treated at the planned surgery department of the city clinic No. 1 (Tashkent, Uzbekistan). With respect to the methods of surgical treatment, these patients were divided into two groups: the first group consisted of 159 patients in whom echinococcal cysts up to 7 cm diameter located intrahepatically in the VII-VIII segments were punctured; The second group comprised of 144 patients in whom there were echinococcal cysts more than 7 cm diameter, located along the edge of the liver in the VII-VIII segments, were performed a videoassisted minimally invasive thoraco-phreno-laparotomy with an incision up to 7 cm length. Results: Minimally invasive interventions for liver echinococcosis, which include cyst puncture under the ultrasound control and video-assisted minimally invasive thoraco-phrenolaparotomy, have an extremely significant advantage over conventional surgeries: low trauma, reduction in the number of postoperative complications and patient treatment costs associated with it. However, proper patient selection should be strictly individualized and reasonable in terms of this treatment method. Conclusions: punctureaspiration echinococcectomy is a relatively safe intervention in patients with uncomplicated cysts in the VII-VIII liver segments with a size up to 7 cm. The application of the method facilitates to reduce the number of postoperative complications. The obtained results allow us to consider this surgical technique as a radical intervention in hepatic hydatid echinococcosis. Undoubtedly, the use of the video-assisted minimally invasive thoraco-phreno-laparotomy is an effective method in patients with a large marginal in the VII-VIII segments of the liver placed echinococcal cyst