scholarly journals Management of Liver Hydatid Cysts: A Cross-Sectional Retrospective Analysis of 293 Cases From Southern Iran

2021 ◽  
Author(s):  
Amirhossein Erfani ◽  
Reza shahriarirad ◽  
Mehrdad Eskandarisani ◽  
Mohammad Rastegarian ◽  
Bahador Sarkari
Keyword(s):  
Hydatid Cyst ◽  
Radical Surgery ◽  
Conservative Surgery ◽  
Fars Province ◽  
Hydatid Cysts ◽  
Cross Sectional ◽  
Liver Hydatid Cyst ◽  
Southern Iran ◽  
The Mean ◽  
Clinical Records

Abstract Background: The current study aimed to evaluate the therapeutic features and complications of liver hydatid cyst in patients who underwent surgery for CE in Fars province, southern Iran.Methods: A total of 293 patients who underwent surgery for liver hydatid cyst from 2004 to 2018 in Fars Province, southern Iran, were retrospectively evaluated. The clinical records of patients were reviewed and the demographic and clinical characteristics of each patient were assessed.Results: Of the total of 293 cases, 178 (60.9%) were females and 115 (39.1%) were males. The mean age of the subjects was 37.22 (±20.55) years. The mean size of the liver hydatid cyst was 9.18 (± 4.365). Of the 293 patients studied, 227 (77.4%) had hydatid cysts only in the liver, while 55 (9.4%) had both liver and lung cysts. More than half of the liver cysts (65.9%) were located in the right portion of the liver (segment 5 to 8). Of the 293 cases, 52 (17.7%) underwent radical surgery while 241 (82.3%) underwent conservative surgery. Recurrence of hydatid cyst was recorded in 46 (15%) of cases. Patients who were treated with radical surgery in comparison with those who had conservative surgery had a lower recurrence rate but a longer duration of hospital stay (p<0.05). Conclusion: Recurrence remains as one of the major challenges in the management of hydatid cyst. Radical surgery reduces the chance of recurrence, although this procedure increases the length of hospital stay.This study was registered at Clinicaltrials.gov with registration ID of NCT04363151. https://clinicaltrials.gov/ct2/show/NCT04363151?cntry=IR&city=Shiraz&draw=2&rank=1

scholarly journals Uncommon Locations of Cystic Echinococcosis: A Report of 46 Cases from Southern Iran

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Reza Shahriarirad ◽  
Amirhossein Erfani ◽  
Mehrdad Eskandarisani ◽  
Mohammad Rastegarian ◽  
Bahador Sarkari
Keyword(s):  
Hydatid Cyst ◽  
Hydatid Disease ◽  
Cystic Echinococcosis ◽  
The Body ◽  
Pelvic Cavity ◽  
Fars Province ◽  
Hydatid Cysts ◽  
Unusual Location ◽  
Southern Iran ◽  
Demographical Data

Background. Most cases of hydatid cysts form in the liver and lung and other tissues are considered as unusual locations in hydatid cysts. The current study aimed to find out the rate and features of hydatid cysts in uncommon locations in Fars Province, Southern Iran, over a 15-year period. Methods. The hospital records of patients who underwent surgery for hydatid cysts in university-affiliated hospitals in Fars Province, Southern Iran, from 2004 to 2018, were retrospectively reviewed. For each patient, clinical and demographical data were recorded. Results. During a 15-year period, a total of 501 patients were surgically treated for hydatid cysts, and out of these, 46 (9.2%) were presented with the unusual locations of hydatid disease. Males constituted 28 (60.9%) of these patients while 18 (39.1%) of the patients were females. The patients’ age ranged from 5 to 80 years (mean = 40.49; SD = 20.37). The size of the cysts ranged from 2 to 20 cm (mean = 8.69, SD = 4.59). The most common unusual location for the hydatid cyst was the spleen with 30.4% of cases, followed by the pelvic cavity (15.2%). Out of 46 cases with unusual location of the hydatid cyst, 10 (21.7%) cases had lung, 22 (47.8%) cases had liver, and 5 (10.9%) cases had both liver and lung hydatid cysts, simultaneously with cysts in unusual locations. Conclusion. In cystic echinococcosis- (CE) endemic areas, hydatid disease can affect any organ, from head to toe, in humans. The disease should be considered in the differential diagnosis of any cystic entities anywhere in the body.

scholarly journals Conservative Surgical Management for Pulmonary Hydatid Cyst: Analysis and Outcome of 148 Cases

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Mohammed Aldahmashi ◽  
Mohamed Alassal ◽  
Ibrahim Kasb ◽  
Hany Elrakhawy
Keyword(s):  
Hydatid Cyst ◽  
Bronchopleural Fistula ◽  
Complete Removal ◽  
Conservative Surgery ◽  
Hydatid Cysts ◽  
Rural Regions ◽  
Purse String ◽  
Lung Cysts ◽  
Surgical Methods ◽  
Pulmonary Hydatid Cyst

Background. Hydatid cyst (HC) disease is endemic in many developing countries, like Yemen, Egypt, and Saudi Arabia, especially in the rural regions. The disease has a variable clinical courses and even might be asymptomatic for many years.Objectives. In giant and large pulmonary hydatid cysts, pulmonary resection is the usual method of surgical treatment. In this study, we aimed to evaluate the lung conservative surgery in treatment of cases with giant and large hydatid lung cysts, as an effective method of management.Patients and Methods. Between January 2009 and August 2014, a total of 148 patients with pulmonary hydatid cysts were operated and their data was reviewed retrospectively and analyzed. Out of these cases, 52 (35.14%) cysts with more than 10 cm in diameter and 36 (24.32%) cysts with 5–9 cm were regarded as giant and large hydatid lung cysts, respectively. The small cysts less than 5 cm were presented in 8 (5.4%) cases only; other cases had ruptured cysts. Preservation of the lung tissues during surgery by cystotomy and Capitonnage was our conservative surgical methods of choice.Results. Eight patients developed bronchopleural fistula (BPF); of them, 4 BPFs have healed with chest tube and physiotherapy, but in the other 4 patients reoperation was done for the closure of persistent BPF. No mortality was observed in the present study.Conclusion. We conclude that conservative surgical procedure can achieve complete removal of the pulmonary hydatid cyst. Enucleation of the intact huge cysts is safe. Careful and secured closure of the bronchial communication should be done by purse string or figure-of-8 sutures, with or without Teflon pledgets. These simple procedures are safe, reliable, and successful.

scholarly journals Management of Ectopic Pregnancy in a Tertiary Care Hospital by Surgery

2016 ◽  
Vol 28 (1) ◽  
pp. 21-25
Author(s):  
Saida Akter ◽  
Sharmin Sultana
Keyword(s):  
Physical Examination ◽  
Ectopic Pregnancy ◽  
Radical Surgery ◽  
Tertiary Care ◽  
Total Abdominal Hysterectomy ◽  
Conservative Surgery ◽  
Diagnostic Tools ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional

Introduction: Tubal ectopics if large, uncontrollably bleeding or severely damaged need radical surgery (salpingectomy), otherwise conservative surgery (salpingotomy, salpingostomy) is the way of operative management. Laparoscopic surgery usually done in case of haemodynamically stable condition.Objective: To explore the different ways of surgical management of ectopic pregnancy in a tertiary care hospital.Materials and methods: This cross sectional study was carried out in the Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Hospital and Dhaka Medical College Hospital during August 2005 and June 2006. The study population consisted of 50 women with ectopic pregnancy. Selected women underwent meticulous history taking and physical examinations. Some investigations like ultrasonography, culdocentesis, urine for pregnancy tests were done. Patients were treated by either radical or conservative surgery.Results: All (100%) women had abdominal tenderness. Ectopic pregnancy was diagnosed by history, physical examination and culdocentesis (84%), ultrasonography (12%) and laparotomy (4%). Two (4%) women were treated by conservative surgery, while the rest by radical surgery; 40 (80%) underwent unilateral salpingectomy, 3 (6%) unilateral salpingectomy with contralateral tubectomy, 2 (4%) unilateral salpingo oophorectomy, 1 (2%) total abdominal hysterectomy and 2 (4%) resection of rudimentary horn.Conclusion: Most common diagnostic tools were by history, physical examination and culdocentesis and common management was unilateral salpingectomy.Bangladesh J Obstet Gynaecol, 2013; Vol. 28(1) : 21-25

scholarly journals In Vivo Therapeutic Effect of Triclabendazole + Levamisole on Hydatid Cyst in Rats

2020 ◽  
Vol 1 (1) ◽  
pp. 18-20
Author(s):  
Peyman Sadeghi ◽  
Yagoob Garedaghi ◽  
Mirhadi Khayatnouri ◽  
Hosein Hashemzade Farhang ◽  
Ramin Kaffash Elahi
Keyword(s):  
Hydatid Cyst ◽  
Close Contact ◽  
Control Group ◽  
Case Group ◽  
Hydatid Cysts ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
And Control

Introduction: Hydatidosis is a global disease and one of the most dangerous zoonotic diseases which is found in areas where humans, dogs, and herbivores are in close contact with each other. Methods: In this study, a total of 64 rats were divided into control and case groups, and then 3000 protoscolices were injected into the peritoneal cavity. After 2 months, rats in the case group were given triclabendazole + levamisole at a dose of 6 mg + 4.41 mg/mL orally for 60 days, respectively. Then, after 6 months of infection, the rats of the control and case groups were killed by anesthesia and then an autopsy was performed and the viscera were carefully examined for hydatid cyst infection. Results: The results showed that in the control group, 3 cysts were observed in the liver, 10 in the kidney, and 88 in the lung. The mean number of hydatid cysts in this group was determined to be 33.6. In the case group, 2 cysts were observed in the liver, 6 in the kidney, and 64 in the lungs. The mean number of hydatid cysts in the viscera was 24 in the case group. Conclusions: Statistical analysis of the results obtained from the case and control groups showed that the therapeutic efficacy of triclabendazole + levamisole was 31%, which is not enough to treat cases of hydatid cyst.

scholarly journals The Economic Burden of Coronavirus Disease 2019 (COVID-19): Evidence from Iran

2020 ◽  
Author(s):  
Mohsen Ghaffari Darab ◽  
Khosro Keshavarz ◽  
Elnaz Sadeghi ◽  
Javad Shahmohamadi ◽  
Zahra Kavosi
Keyword(s):  
Economic Burden ◽  
Indirect Costs ◽  
Premature Death ◽  
University Hospital ◽  
Fars Province ◽  
Income Loss ◽  
Cross Sectional ◽  
Accounting Information Systems ◽  
Economic Production ◽  
The Mean

Abstract This study aimed to estimate both direct medical and indirect costs of treating the Coronavirus disease 2019 (COVID-19) from a societal perspective in the patients at a referral hospital in Fars province as well as the economic burden of COVID-19 in Iran in 2020.Methods:This is a partial economic evaluation and a cross-sectional cost-description study conducted descriptively-analytically and based on the data of the COVID-19 patients referred to a referral university hospital in Fars province between March and July 2020. The data were collected by examining the patients' records and accounting information systems. The subjects included all the inpatients with COVID-19 (477 individuals) who admitted to the medical centre during the four months. Bottom-up costing, incidence-based and income-based human capital approaches were used as the main methodological features of this study.Results: The mean direct medical costs were estimated 28,240,025,968 Rials ($ 1,791,172) in total and 59,203,409 Rials ($ 3,755) per person, a significant part of which (41 %) was that of intensive and general care beds (11,596,217,487 Rials equal to $ 735,510. (The second to which were the costs of medicines and medical consumables (28 %). The mean indirect costs including income loss due to premature death, economic production loss due to hospitalization and job absenteeism during recovery course were estimated 129,870,974 Rials ($ 11634) per person. Furthermore, the economic burden of the disease in the country for inpatient cases with the definitive diagnosis was 22,688,925,933,095 Rial equal to $ 1,439,083,784.Conclusion: The results of this study showed that the severe status of the disease would bring about the extremely high cost of illness in this case. It is estimated that the high prevalence rate of COVID-19 has been imposing a heavy economic burden on the country and health system directly that may result in rationing or painful cost-control approaches.

scholarly journals Laparoscopic Approach for Management of Hydatid Cyst of Liver

2017 ◽  
Vol 15 (1) ◽  
pp. 67-70
Author(s):  
Suman Kumar Shrestha ◽  
Prabin Bikram Thapa ◽  
Dhiresh Kumar Maharjan ◽  
Tseten Yonjan Tamang
Keyword(s):  
Hydatid Cyst ◽  
Bile Leak ◽  
Laparoscopic Approach ◽  
Operation Time ◽  
Cross Sectional Study ◽  
Hepatic Hydatid Cyst ◽  
Cross Sectional ◽  
Laparoscopic Management ◽  
Laparoscopy Surgery ◽  
The Mean

Background: Laparoscopy surgery trials are small and unconvincing at present and are limited to higher centers. The objective of the study is to determine the clinical features, prevalence of site of hydatid cyst and complications of this modality of this treatment.Methods: A cross sectional study was carried out in all patients with one or two hepatic hydatid cyst who underwent laparoscopic management in KMCTH from January 2013 to March 2015 were included in the study. Aspiration, deroofing and evacuation of the hydatid cyst were done.Results: Twenty six patients underwent laparoscopic management for liver hydatid cysts. Males were seven (65.38%) and females were 9(34.61%).The mean age was 35.5±13.1 years (range 21-55years.) The commonest complaint was pain and discomfort in 13(50%) patients and lump in 6(13.06%) patients. Twenty four (92.3%) patients were successfully treated with laparoscopic approach. Two (7.69%) patients had to be converted to laparotomy because of dense adhesions and bleeding. Mean operation time was 43.6±10.6 minutes. Two (7.69%) patients had port site infection. One (3.84%) patient had bile leak and no recurrence and mortality in our series.Conclusions: Laparoscopic management of liver hydatid cyst was safe and effective in selective group of patients in equipped hospital.

Risk Factors for Development of Biliary Complications after Surgery for Solitary Liver Hydatid Cyst

2017 ◽  
Vol 83 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Ali Surmelioglu ◽  
Ilter Ozer ◽  
Enver Reyhan ◽  
Tahsin Dalgic ◽  
Yilmaz Ozdemir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hydatid Cyst ◽  
Significant Risk ◽  
Conservative Surgery ◽  
World Health ◽  
Biliary Leakage ◽  
Liver Hydatid Cyst ◽  
Related Risk ◽  
Solitary Liver ◽  
Health Organization

Biliary leakage (BL) is the most common cause of postoperative morbidity after conservative liver hydatid cyst surgery. The objective of this study was to determine incidence of BL and related risk factors in patients with solitary liver hydatid cyst who underwent conservative surgery. A total of 186 patients were included in this study. Age, gender, cyst recurrence, diameter, and localization, World Health Organization Informal Working Group on Echinococcosis (WHO-IWGE) classification, cavity management techniques, cyst content, and alkaline phosphatase (ALP) levels were evaluated with univariate and multivariate analyses. Of these patients 104 were female and 82 were male. The mean age was 43.5 ± 14.7 years. Postoperative BL was detected in 36 (19.4%) patients. Cyst diameter (P = 0.019), cyst localization (P = 0.007), WHO-IWGE classification (P = 0.017), and ALP level (P = 0.001) were the most significant risk factors for BL. Independent risk factors for BL were perihilar localization, large cyst diameter, high ALP level, and advanced age according to WHO-IWGE classification.

scholarly journals Hydatid cysts of the liver rupture into the peritoneal cavity: Fifteen cases and review of the literature

2021 ◽  
Author(s):  
Atef MEJRI ◽  
Khaoula ARFAOUI ◽  
Sarra SAAD ◽  
Jasser RCHIDI ◽  
Ahmed OMRI ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Hydatid Cyst ◽  
Peritoneal Cavity ◽  
Cyst Wall ◽  
Anaphylactic Shock ◽  
Acute Abdominal Pain ◽  
Abdominal Cavity ◽  
Surgical Care ◽  
Liver Hydatid Cyst ◽  
The Mean

Abstract BackgroundHydatid cyst is an infectious disease caused mainly by E. Granulosus, which is generally considered benign, however, the rupture of the hepatic Hydatid Cyst to the abdominal cavity is a life-threatening incident that requires urgent and multidisciplinary management (emergency physician, radiologists, aneasthetists and surgeons). This study aims to describe the various clinical and paraclinical features of ruptured liver hydatid cyst in the peritoneal cavity, and to detail the appropriate treatment.Materials and MethodsFifteen cases of ruptured liver hydatid cyst into the abdominal cavity that underwent urgent surgery were collected over a period of eight years. Results There were nine men and six women. The average age was 38 years. Two patients were admitted with abdominal trauma. All patients presented with acute abdominal pain. Only one patient had anaphylactic shock. Abdominal ultrasound showed discontinuous cyst wall and intraperitoneal fluid in 100% of cases. Abdominal computed tomography (CT) showed discontinuous cyst wall with intraperitoneal fluid in 100% of cases. Intraoperatively, the intraperitoneal fluid was clear in thirteen cases and purulent in two. All patients underwent unroofing procedure associated with intra-operative peritoneal lavage and external drainage. The mean hospital stay was 6.11 days and the mean follow-up was 19 months. No case of recurrence was reported among the patients.ConclusionRupture of a hydatid cyst in the abdominal cavity should be considered as a differential diagnosis in every case of an acute abdominal pain, especially in endemic areas and in presence of an allergic reaction or signs of anaphylactic shock. Combined medical and surgical care starting in the emergency room is the only guarantee of a good outcome.

scholarly journals Radical Surgery Reduces Risk of Recurrence in Liver Hydatid Cyst

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S169
Author(s):  
P. Tasar ◽  
K. Senol ◽  
I. Tirnova ◽  
B. Bakar ◽  
E. Kaya ◽  
...  
Keyword(s):  
Hydatid Cyst ◽  
Radical Surgery ◽  
Risk Of Recurrence ◽  
Liver Hydatid Cyst
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