Control of Problems Encountered in the Management of Thoracic and Other Forms of Echinococcosis
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- Category: Vol. 81, December 2013
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Control of Problems Encountered in the Management of Thoracic and Other Forms of Echinococcosis, HAMDY D. ELAYOUTY, MAGDI E. WAHDAN, DHAFIR D. SULIEMAN and SAYED LABIB
Abstract
Background: Three decades ago, cystic Ecchinococcosis treatment was strictly surgical with significant morbidity and mortality and recurrence rate of 16-20%. Mortality was due to anaphylaxis or peri-operative complications. Thence, use of effective adjunct local and systemic scolicidal agents, has improved the outcome. However, management pitfalls still exist and form the focus of this study.
Objectives: This study was designed to identify manage-ment of problems, their precipitating factors and how to achieve successful endpoints.
Methods: We present a retrospective study of management of difficult cases of thoracic and other hydatid cysts confronted by the authors, between 2001-2010 in Egypt, Yemen and Jazan, KSA.
Results: A total of 125 cases were treated surgically with the use of intra-operative hydrogen peroxide 3% as a local scolicidal agent and post-operative systemic scolicidal drug (Albendazole) we encountered difficult situations in 32% of our cases. Difficulties were due to difficult anatomical sites, emergency situations, multiple or bilateral cysts and/or evolv-ing complications. These were controlled without mortality or recurrences.
Conclusions: Most of the problems can be successfully managed with specific medical and surgical lines. Cases with expected problems need specialized expertise. Further research is needed for safer systemic scolicidal drugs used for a short course and efforts to eradicate this parasite.