SPLENIC HYDATID DISEASE: FEATURES OF DIAGNOSTICS AND SURGICAL TREATMENT

Aim. To analyze the results of diagnostics and treatment of patients with splenic echinococcosis and to determine the criteria for selection of surgery. Material and Methods. The analysis included 51 patients with splenic echinococcosis. There were 33 women and 18 men aged 14–78 years (mean 49 ± 4.2 years). Three patients were previously operated in other hospitals for splenic echinococcosis. Isolated splenic lesion was noted in 22 (43.13%) cases. Combined lesions were also identified: spleen and liver (15), spleen and abdominal cavity (4), spleen and retroperitoneal fat (4), spleen, liver and lungs (2), spleen, liver and kidney (1) and spleen and lungs (1). In most cases dimensions of parasitic cysts were 5-15 cm. Total and multiple hydatid splenic lesion was noted in 12 (23.53%) cases. Laparotomy was performed in 86.27%: splenectomy (25), pericystectomy (11), perfect echinococcectomy (8). Laparoscopic pericystectomy was made in 4 cases, splenectomy – in 2 cases. US-assisted percutaneous drainage was made in 1 (1.96%) case. Results. Spleen was preserved in 24 (47.5%) cases. RFA has been applied for splenic resection (Cool-Tip). Ultrasonic cavitation and cryodestruction were used for residual cavity processing after chitin shell removal. We evaluated immediate and long-term results. Recurrent echinococcosis was noted in 1 patient. Conclusion. “Ideal” echinococcectomy or pericystectomy should be preferred for splenic hydatid disease. Organ-sparing spleen resection may be considered if previous interventions are impossible. Current surgical techniques (cryoablation, radiofrequency ablation) are able to avoid recurrences.