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A Retrospective Evaluation of Spleen Hydatid Cyst Treatments: The Spleen-Preserving Conservative Approach is Preferable to Splenectomy
Objective: Cystic echinococcosis (CE) is rarely encountered in the spleen, even in areas where the disease is endemic. There is no consensus in the literature concerning the treatment of splenic cystic echinococcosis. This study was intended to compare the treatment results and factors affecting the...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Atatürk University School of Medicine
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9634871/ https://www.ncbi.nlm.nih.gov/pubmed/35703520 http://dx.doi.org/10.5152/eurasianjmed.2022.20367 |
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author | Korkut, Ercan Aksungur, Nurhak Öztürk, Gürkan |
author_facet | Korkut, Ercan Aksungur, Nurhak Öztürk, Gürkan |
author_sort | Korkut, Ercan |
collection | PubMed |
description | Objective: Cystic echinococcosis (CE) is rarely encountered in the spleen, even in areas where the disease is endemic. There is no consensus in the literature concerning the treatment of splenic cystic echinococcosis. This study was intended to compare the treatment results and factors affecting the selection of the spleen-preserving approach or splenectomy in treatment. Materials and Methods: Four hundred and seventy patients operated for cystic echinococcosis at a university clinic between January 2010 and December 2019 were retrospectively evaluated. Splenic cystic echinococcosis was identified in 22 patients (4.7%). Demographic features as well as clinical and laboratory findings of patients who underwent splenectomy or spleen-preserving operations were compared between the groups. Results: Spleen-preserving cystotomy was performed on 18 patients (81.8%), and splenectomy on 4 (18.2%). Eleven patients (50%) had isolated cystic echinococcosis in the spleen, while another 11 (50%) had hepatic and splenic cystic echinococcosis. The median cyst size was 10.0 cm (min: 3, max: 20). Splenectomy patients had significantly larger cyst sizes (median, min-max; 8.0 cm, 3-15 cm vs. 15.0 cm, 10-20) (Z = 2.071, P = .042). Postoperatively, 1 patient from the splenectomy group (25.0%) developed deep vein thrombosis, and another from the cystotomy group (5.5%) developed pulmonary embolism. No other serious complications, re-operation requirements, or recurrence were observed after a median follow-up period of 27.0 months (min: 5, max: 92). Conclusion: Since no collections or recurrence were observed, and splenic functions were preserved in patients who underwent spleen-preserving cystotomy, we recommend the use of spleen-protective cystotomy. Splenectomy should be employed in patients with cyst diameters exceeding 10 cm, with a central location, and in cases with difficult cavity management and a high risk of developing postoperative collections. |
format | Online Article Text |
id | pubmed-9634871 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Atatürk University School of Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-96348712022-11-04 A Retrospective Evaluation of Spleen Hydatid Cyst Treatments: The Spleen-Preserving Conservative Approach is Preferable to Splenectomy Korkut, Ercan Aksungur, Nurhak Öztürk, Gürkan Eurasian J Med Original Article General Surgery Objective: Cystic echinococcosis (CE) is rarely encountered in the spleen, even in areas where the disease is endemic. There is no consensus in the literature concerning the treatment of splenic cystic echinococcosis. This study was intended to compare the treatment results and factors affecting the selection of the spleen-preserving approach or splenectomy in treatment. Materials and Methods: Four hundred and seventy patients operated for cystic echinococcosis at a university clinic between January 2010 and December 2019 were retrospectively evaluated. Splenic cystic echinococcosis was identified in 22 patients (4.7%). Demographic features as well as clinical and laboratory findings of patients who underwent splenectomy or spleen-preserving operations were compared between the groups. Results: Spleen-preserving cystotomy was performed on 18 patients (81.8%), and splenectomy on 4 (18.2%). Eleven patients (50%) had isolated cystic echinococcosis in the spleen, while another 11 (50%) had hepatic and splenic cystic echinococcosis. The median cyst size was 10.0 cm (min: 3, max: 20). Splenectomy patients had significantly larger cyst sizes (median, min-max; 8.0 cm, 3-15 cm vs. 15.0 cm, 10-20) (Z = 2.071, P = .042). Postoperatively, 1 patient from the splenectomy group (25.0%) developed deep vein thrombosis, and another from the cystotomy group (5.5%) developed pulmonary embolism. No other serious complications, re-operation requirements, or recurrence were observed after a median follow-up period of 27.0 months (min: 5, max: 92). Conclusion: Since no collections or recurrence were observed, and splenic functions were preserved in patients who underwent spleen-preserving cystotomy, we recommend the use of spleen-protective cystotomy. Splenectomy should be employed in patients with cyst diameters exceeding 10 cm, with a central location, and in cases with difficult cavity management and a high risk of developing postoperative collections. Atatürk University School of Medicine 2022-06-01 /pmc/articles/PMC9634871/ /pubmed/35703520 http://dx.doi.org/10.5152/eurasianjmed.2022.20367 Text en © Copyright 2022 authors https://creativecommons.org/licenses/by/4.0/ Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | Original Article General Surgery Korkut, Ercan Aksungur, Nurhak Öztürk, Gürkan A Retrospective Evaluation of Spleen Hydatid Cyst Treatments: The Spleen-Preserving Conservative Approach is Preferable to Splenectomy |
title | A Retrospective Evaluation of Spleen Hydatid Cyst Treatments: The Spleen-Preserving Conservative Approach is Preferable to Splenectomy |
title_full | A Retrospective Evaluation of Spleen Hydatid Cyst Treatments: The Spleen-Preserving Conservative Approach is Preferable to Splenectomy |
title_fullStr | A Retrospective Evaluation of Spleen Hydatid Cyst Treatments: The Spleen-Preserving Conservative Approach is Preferable to Splenectomy |
title_full_unstemmed | A Retrospective Evaluation of Spleen Hydatid Cyst Treatments: The Spleen-Preserving Conservative Approach is Preferable to Splenectomy |
title_short | A Retrospective Evaluation of Spleen Hydatid Cyst Treatments: The Spleen-Preserving Conservative Approach is Preferable to Splenectomy |
title_sort | retrospective evaluation of spleen hydatid cyst treatments: the spleen-preserving conservative approach is preferable to splenectomy |
topic | Original Article General Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9634871/ https://www.ncbi.nlm.nih.gov/pubmed/35703520 http://dx.doi.org/10.5152/eurasianjmed.2022.20367 |
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