Medical News of North Caucasus

Human echinococcosis refers to severe parasitic diseases that affect different strata of the population and different age groups. Registration of this helminthiasis started in the USSR in 1983. According to the WHO, in some endemic areas, incidence rates of hydatid cysts fluctuate between 5%–10% of the total population per year. Modern epidemiology of the disease is characterized by infection among people who are engaged in livestock production, as well as increasingly more frequent infection among urban populations. The clinical importance of hydatid cysts is related to the severe clinical manifestations with multiple lesions of various organs, leading to long-term disability and death [1].

In the work [2] present findings of a multicenter study investigating incidence of hydatid cysts in endemic regions of the Community of Independent States (CIS). Transmission of hydatid cysts depends on agricultural activity. The highest incidence in the CIS was observed in Yamal-Nenets Autonomous District (4.2±0.36 and 4.5±1.1 per 00,0001 adults) and Republic of Uzbekistan (4.9±0.45 and 4.3±0.5 per 100,000 children). Among adults, hydatid cysts were more common among those aged 18– 40 years and in men (56.3–64.5 %), except in Stavropol Territory (43.4 %). Among children, boys (56.8–77.6 %) and children aged 10–14 years had higher incidence. Krasnodar Territory had the highest number of meat samples contaminated with Echinococcus cysts. Incidence of hydatid cysts showed different structures and frequencies throughout the CIS; incidence is likely underestimated in the official statistics. The data obtained indicate the need to improve specialized services, including creation of a population register, for the study of hydatid cysts.

In the local epidemiologic study [3] the incidence of echinococcosis in Stavropol Region. In 2000–2015 the incidence of echinococcosis grew by 9% (vs. 1985–2000). Epidemics were registered in fifteen districts of Stavropol Region; a lot of cases of echinococcosis were recorded in Arzgirskiy, Budyonnovsky, Neftekumsky, and Trunovsky districts. When analyzing the distribution by the age and the form of the disease the following was observed: most often the disease occurs in adults older than 30 years (61.7%), with the hepatic form of the disease recorded in 57.2% of cases; and in children of 7–12 years old (78.8%), where the hepatic form of echinococcosis was seen in 63.5%. Some sex-related characteristics were observed: in adults, females had the disease more often (56.6%), while boys were prevailing in the paediatric population (56.5%). The results of the conducted study show varying prevalence and inhomogeneous incidence of echinococcosis in Stavropol Region. Prevention actions and population education are required in the areas with the highest incidence rates.

On the other hand, discussion about laporoscopic or open surgery is open. In the paper [4] discribe about the laparoscopic technique has profoundly changed the surgery. The advantages of laparoscopic surgery, including less pain, decreased length of stay, and small scars, have progressively and definitively involved all fields of surgery. For some diseases, this technique has become, after a long period of observation, the technique of choice. In conclutions, the patients with a cyst located in the left lobe of the liver would be better treated with a total cistopericistectomy or even a left bisegmentectomy. These techniques can definitively treat the patients without any risk of spillage and related recurrence.

In the paper [5] the present experience of laparoscopic treatment of hydatid cysts of the liver in children according to the results of our multicenter study showed that the effectiveness of this treatment is comparable with that of open surgical interventions. However, we will consider the noted weaknesses in laparoscopy in the analysis of our article when we perform further studies of hydatid cysts of the liver in children.

 

Referances:

1. Minaev S. V., Gerasimenko I. N., Kirgizov I. V., Shamsiev A. M., Bykov N. I. [et al.] Laparoscopic Treatment in Children with Hydatid Cyst of the Liver. World J. Surg. 2017;41(12):3218-3223. https://doi.org/10.1007/s00268-017-4129-x
2. Minaev S. V., Razin M. P., Axelrov M. A., Aydemirov A. N., Shamsiev A. M., Poluxov R. Sh., Tarakanov V. A. [et al.]HYDATID CYST MORBIDITY IN ENDEMIC REGIONS OF COUNTRIES OF THE COMMUNITY OF INDEPENDENT STATES: A MULTICENTER STUDY. Medical News of the North Caucasus. 2018;13(3):453-458.  https://doi.org/10.14300/mnnc.2018.13076
3. Minaev S. V., Mashchenko A. N., Aydemirov А. N., Anisimov I. N., Gerasimenko I. N., Rubanova М. F. Epidemiological Characteristics of Echinococcosis in Adults and Paediatric Populations of Stavropol Region. Doctor.Ru. 2018; 7(151): 35–38. http://doi.org/10.31550/1727-2378-2018-151-7-35-38
4.  Toro A., Schembari E., Mattone E. [et al.] Hydatid cyst of the liver: a challenge that can be amplified shifting from open to laparoscopic surgery World J Surg 2018;42: 3054-3055. https://doi.org/10.1007/s00268-018-4484-2
5. Minaev, S.V. & Gerasimenko, I.N. Hydatid Cyst of the Liver: A Challenge That Can Be Amplified Shifting from Open to Laparoscopic Surgery: Reply World J Surg 2018;42: 3056-3057. https://doi.org/10.1007/s00268-018-4542-9

Tags: #children, adults, echinococcosis, hydatid cyst, morbidity