Spillage and recurrence in surgical management of hydatid cyst of the liver

Tedavi modalitelerindeki gelismelere ragmen kist hidatik hastaliginda nuks onemini korumaktadir. Konservatif cerrahi esnasinda kist elamanlarinin dokulmesi (spillage) extrahepatikmultifokalnukslerle sonuclanabilir. Nuks vakalarda adezyonlar ve multifokal kistler nedeniyle cerrahi prosedur komplekslesir, morbidite ve nuks oranlari artar. Bu nedenle primer cerrahi esnasinda dokulmelerin onlenmesine yonelik tum tedbirler alinmalidir. Altmis dort yasinda kadin hastada spillage nedeniyle gelisen multifokal, semptomatiknukshidatik kist nedeniyle cerrahi tedavi uygulandi. Abdominal duvar, intrabdominal, subdiafragmatik kistlere total kistektomi, karacigerdeki kiste parasiyelkistektomi+drenaj+omentoplasti yapildi. Perioperatifalbendazol kullanimi, kistte rupturolusturulmamasi, cerrahi alanin skolosidal ajanlarca korumaya alinmasi ve rezidu kist elamanlarinin birakilmamasi nuks gelisimini onlemede oldukca onemlidir.

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