[Metastatic pulmonary echinococcosis].
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This research has included 111 pulmonary echinococcosis patients in the billy-mountainous, more cattle raising region of Western Herzegovina. Since 1969, the prevalence of pulmonary echinococcosis, which was 27 (0.15%) at the time, has had a slow declining tendency after the application of various epidemiological-preventive measures synchronized by the veterinarian and the medical services. It was not until 1998 the prevalence result fell down to 1 (0.01%). This study describes the therapy approach of surgery results with 82 patients who were operated on, as well as the prognosis of 29 other echinococcosis patients who rejected surgery but were regularly checked up. Apart form the progress in healing this disease, which is still found and presents a problem in the Mediterranean part of Herzegovina, because of its frequency and the difficulty in diagnostics; and particularly because of possible complications of this zoonosis. The possibility and the way of the albendazolom drug treatment have also been described here.
Results of operative treatment of 824 patients with pulmonary echinococcosis over the last 25 years were analyzed. In most often encountered oval shaped cysts cappitonage with vertical half-pursestring sutures was the most simple and effective method of residual cavity elimination with the least postoperative complications rate. In 43 patients with cysts of difficult configuration combined method of parasite bed closure with 2-3 surgical methods was used. Differentiated approach to residual cavity elimination has permitted to increase organ-saving surgeries rate from 79.2 to 92.4% that is very important for medical and social rehabilitation of patients.
178 patients were operated over 18 years for pulmonary echinococcosis, 100 of them with standard methods, 78--with plasma technologies (surgical device SUPR-2M). Close echinococcectomy was performed in 22.5% patients, open--in 69.1%, combination of these operations--in 8.4% patients. Plasma technologies were used at pneumolysis, cysts section, antiparasitic treatment of residual cavities, fibrous capsule resection (pericystectomy) or cystpericystectomy, marginal resection of the lung with cyst, bronchotomy, sanation of pleural cavity, zone of operation and margins of operative wound. It is demonstrated that postoperative complications were seen in 34% patients operated by standard methods and in 8.9% patients operated with plasma technologies, lethal outcomes were in 2 (2%) and 1 (1.3%) patients, respectively. Plasma technologies permitted to reduce postoperative complications rate 3.8 times and postoperative treatment by 9.8 bed days or by 45.8%. Long-term results were studied in 61 (78.2%) operated patients followed from 1 month to 7 years, there were no recurrence of echinococcosis.
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