General Surgery

doi: 10.25005/2074-0581-2021-23-4-553-566
CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OF PATIENTS WITH UNCOMPLICATED LIVER ECHINOCOCCOSIS

M.K. Gulov1, A.I. Dzhaborov2, J.S. Dodkhoev3, D.K. Mukhabbatov1, E.L. Kalmykov4

1Department of General Surgery № 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Department of Topographic Anatomy and Operative Surgery, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
3Department of Pediatric Diseases № 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
4Clinic of Vascular and Endovascular Surgery, St. Katharina Hospital, Frechen, Germany

Objective: Analysis of clinical and demographic parameters of patients with uncomplicated liver echinococcosis (LE).

Methods: The study included 182 patients who underwent only open surgery for LE. Primary LE was detected in 39.6% of patients, recurrence of the disease – in 40.1%, combined echinococcosis (CE) – in 20.3%. Clinical and demographic parameters such as gender, age, incidence of comorbidities, location of residence, and cyst size were considered.

Results: Among the patients enrolled in the study 44.5% were males and 55.5% were females. The average age was 36.0±1.2 years. The average duration of the disease among male and female patients was 5.5±0.7 and 4.9±0.5 years, respectively (p>0.05). The width of the cysts was significantly larger in female patients compared to the male ones (p<0.05; Z=2.04). There were significantly more comorbidities in the female than in the male patients (p<0.05), however, there were no significant difference in the incidence of any concomitant disease. In the majority of patients (47.2%) cysts were <9 cm in size; followed by the cysts 9-15 cm wide (39%), and exceeding 15 cm (13.9%). In female patients’ cysts <9 cm were found significantly more often than of any other size (p<0.001). Cysts <9 cm prevailed in residents of urban areas (p<0.01), while in rural areas predominance of cysts ≥9 cm was observed (p<0.01). CE was diagnosed in 70% of female patients, allowing us to consider female gender as a risk factor for the development of this form of the disease. In male patients with combined cysts their diameter in the liver <9 cm was found significantly more often (p<0.05) than cysts of larger size; while the incidence of the cysts <9 cm and ≥9 cm in diameter did not differ in male and female patients. Patients with recurrent form of LE in 50% of cases applied for surgical treatment of cysts ≥9 cm. In rural areas, the number of patients with recurrent cysts <9 cm prevailed over cysts of ≥9 (p<0.001), while in city dwellers recurrent cysts ≥9 tended to predominate.Conclusion: The study demonstrated that young age is predominantly affected by LE. Frequency of surgical visits of patients with large and giant cysts is high. The female gender may be considered to be a risk factor for CE.

Conclusion: The study demonstrated that young age is predominantly affected by LE. Frequency of surgical visits of patients with large and giant cysts is high. The female gender may be considered to be a risk factor for CE.

Keywords: Uncomplicated liver echinococcosis, primary echinococcosis, recurrent echinococcosis, combined echinococcosis, clinical and demographic characteristics, risk factors.

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References
  1. Shevchenko YuL, Nazyrov FG. Khirurgiya ekhinokokkoza [Surgery for echinococcosis]. Moscow, RF: Dinastiya; 2016. 288 p.
  2. Gulov MK, Kalmykov EL, Zardakov SM, Mukhabbatov DK, Sadriev ON. Ekhinokokkoz pecheni: rol' komp'yuternoy tomografii i morfologicheskoy diagnostiki sostoyaniya tkani pecheni [Echinococcosis of the liver: The role of computed tomography and morphological diagnosis of the state of the liver tissue]. Rossiyskiy mediko-biologicheskiy vestnik imeni akademika I.P. Pavlova. 2016;24(4):104-11.
  3. Azizzoda ZA, Kurbonov KM, Ruziboyzoda KR, Rasulov NA, Ali-Zade SG. Znachenie laboratornykh pokazateley v diagnostike oslozhnyonnogo ekhinokokkoza pecheni [The value of laboratory parameters in the diagnosis of complicated liver echinococcosis]. Vestnik Avitsenny [Avicenna Bulletin]. 2019;21(4):655-60. Available from: https://doi.org/10.25005/2074-0581-2019-21-4-655-660
  4. Vishnevskiy VA, Efanov MG, Ikramov RZ, Nazarenko NA, Zhao AV. Ekhinokokkoz pecheni. Khirurgicheskoe lechenie [Echinococcosis of the liver. Surgery]. Dokazatel'naya gastroenterologiya. 2013;2(2):18-25.
  5. Usmanov NU, Shamsiev NSh, Baratov AK. Mnozhestvennyy oslozhnyonnyy ekhinokokkoz perikarda [Multiple complicated echinococcosis of the pericardium]. Grudnaya i serdechno-sosudistaya khirurgiya. 2000;1:69-70.
  6. Gaibov AD, Kamolov AN, Mirzoev SA, Kalmykov EL, Aminov RS. Emboliya bifurkatsii aorty, vyzvannaya razorvavsheysya ekhinokokkovoy kistoy serdtsa [Aortic bifurcation embolism caused by a ruptured echinococcal cyst of the heart]. Kardiologiya i serdechno-sosudistaya khirurgiya. 2009;2(5):89-92.
  7. Kalmykov EL, Gaibov AD, Sadriev ON, Safarova AN. Pervichnaya ekhinokokkovaya kista myshts poyasnichnoy oblasti [Primary echinococcal cyst of the muscles of the lumbar region]. Novosti khirurgii. 2016;24(6):610-6.
  8. Kaniev ShA, Baymakhanov ZhB, Doskhanov MO, Nurlanbaev EK, Serikuly E, Birzhanbekov NN, i dr. Sovremennye podkhody k lecheniyu ekhinokokkoza pecheni (obzor literatury) [Modern approaches to the treatment of liver echinococcosis (literature review)]. Annaly khirurgicheskoy gepatologii. 2018;23(3):47-56.
  9. Chyngyshova ZhA, Tilekov EA, Bigishiev MM. Anesteziologicheskoe obespechenie operatsiy s parazitarnymi zabolevaniyami pecheni v usloviyakh natsional'nogo khirurgicheskogo tsentra MZ KR [Anesthetic support of operations with parasitic diseases of the liver in the conditions of the National Surgical Center MH of the Kyrgyz Republic]. Zdravookhranenie Kyrgyzstana. 2014;2:113-4.
  10. Kalmykov EL, Gulov MK, Kapustin BB, Mukhabbatov DK, Nematzoda O, Zardakov SM, i dr. K voprosu o mini-invazivnoy khirurgii ekhinokokkoza pecheni [On the issue of minimally invasive surgery for liver echinococcosis]. Novosti khirurgii. 2019;27(5):563-73.
  11. Kurbonov KM, Azizov ZA. Rasprostranyonnost' i sostoyanie meditsinskoy pomoshchi bol'nym s ekhinokokkovoy bolezn'yu v Respublike Tadzhikistan [The prevalence and state of medical care for patients with echinococcal disease in the Republic of Tajikistan]. Zdravookhranenie Tadzhikistana. 2017;1:67-71.
  12. Symeonidis N, Pavlidis T, Baltatzis M, Ballas K, Psarras K, Marakis G, Sakantamis A. Complicated liver echinococcosis: 30 years of experience from an endemic area. Scand J Surg. 2013;102(3):171-7. Available from: https://doi. org/10.1177/1457496913491877
  13. Joshi U, Subedi R, Jayswal A, Agrawal V. Clinical characteristics and management of the hydatid cyst of the liver. A study from a Tertiary Care Center in Nepal. J Parasitol Res. 2020;9:8867744. Available from: https://doi. org/10.1155/2020/8867744
  14. Vahedi A, Vahedi L. Demographics of patients with surgical and nonsurgical cystic echinococcosis in East Azerbaijan from 2001 to 2012. Pak J Biol Sci. 2012;15(4):186-91. Available from: https://doi.org/10.3923/ pjbs.2012.186.191
  15. Shabunin AV, Tavobilov MM, Karpov AA, Drozdov PA, Lebedev SS, Ozerova DS, i dr. Rol' peritsistektomii v lechenii bol'nykh ekhinokokkozom pecheni [The role of pericystectomy in the treatment of patients with liver echinococcosis]. Vestnik khirurgicheskoy gastroenterologii. 2019;1:35-40.
  16. Laura EV, Fernando S, Adrián SM, José ME, Elena S, Ariadna R, et al. Retrospective study of cystic echinococcosis in a recent cohort of a Referral Center for Liver Surgery. J Gastrointest Surg. 2019;23(6):1148-56. Available from: https:// doi.org/10.1007/s11605-018-3971-y
  17. Haluk M, Hüdai G, Cengiz T. Assessment of liver hydatid cyst cases – 10 years’ experience in Turkey. TropDoc. 2007;37(1):54-56. Available from: https://doi. org/10.1258/004947507779951943
  18. Akkaya Işık S, Seyman D, Zerdali E, Ayan S, Kakaliçoğlu D, Ayaz T, et al. Evaluation of 170 followed-up cases treated for hydatid disease: A multicentre study. Turkiye Parazitol Derg. 2020;44(4):197-202. Available from https://doi. org/10.4274/tpd.galenos.2020.6737
  19. Tishchenko AM, Mushenko EV, Smachilo RM, Brovkin VYu, Ivanenko OV. Ekhinokokkoz pecheni: kakomu metodu lecheniya sleduet otdat' predpochtenie? [Echinococcosis of the liver: What method of treatment should be preferred?]. Khirurgiya Ukrainy. 2019;4:60-7.
  20. Dany T, Thomas S, Ruffin N, Jean-Pierre M, Michel B, Yves VL. The liver involvement of the hydatid disease: A systematic review designed for the hepato-gastroenterologist. Acta Gastroenterol Belg. 2013;76(2):210-8.
  21. Zarivchatskiy MF, Mugatarov IN, Kamenskikh ED, Kolyvanova MV, Teplykh NS. Khirurgicheskoe lechenie ekhinokokkoza pecheni [Surgical treatment of liver echinococcosis]. Permskiy meditsinskiy zhurnal. 2021;38(3):32-40.
  22. Florin Z, Dana B, Lucian M, Roxana Z, Cornel I, Claudiu T. Open or laparoscopic treatment for hydatid disease of the liver? A 10-year single-institution experience. Comparative Study Surg Endosc. 2013;27(6):2110-6. Available from https://doi.org/10.1007/s00464-012-2719-0
  23. Shamsiev AM, Shamsiev ZhA, Rakhmanov KE, Davlatov SS. Differentsirovannaya lechebnaya taktika v khirurgii ekhinokokkoza pecheni [Differentiated therapeutic tactics in surgery for liver echinococcosis]. Eksperimental'naya i klinicheskaya gastroenterologiya. 2020;5:72-7.

Author information:


Gulov Makhmadshokh Kurbonalievich
Doctor of Medical Sciences, Full Professor, Professor of the Department of General Surgery № 1, Avicenna Tajik State Medical University
Researcher ID: D-7916-2018
Scopus ID: 6507730145
ORCID ID: 0000-0001-5151-937X
SPIN: 5463-6781
Author ID: 305733
E-mail: gulov_m@mail.ru

Dzhaborov Abdugaffor Ibragimdzhonovich
Postgraduate Student, Department of Topographic Anatomy and Operative Surgery, Avicenna Tajik State Medical University
ORCID ID: 0000-0003-2736-8932
SPIN: 5318-3839
Author ID: 1066892
E-mail: jaborov_1987@mail.ru

Dodkhoev Jamshed Saidboboevich
Doctor of Medical Sciences, Associate Professor, Professor of the Department Pediatric Diseases № 1, Avicenna Tajik State Medical University
Researcher ID: AAA-5497-2020
Scopus ID: 6505977054
ORCID ID: 0000-0002-9228-8544
SPIN: 6609-4501
Author ID: 843620
E-mail: jamshedsd@yandex.ru

Mukhabbatov Dzhiyonkhon Kurbonovich
Doctor of Medical Sciences, Professor of the Department of General Surgery № 1, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-2100-310X
SPIN: 8407-5820
Author ID: 390576
E-mail: mukhabbatov67@mail.ru

Kalmykov Egan Leonidovich
Candidate of Medical Sciences, Surgeon, Clinic of Vascular and Endovascular Surgery, St. Katharina Hospital, Frechen, Germany
Researcher ID: K-9827-2013
Scopus ID: 36172240400
ORCID ID: 0000-0001-6784-2243
SPIN: 8623-8897
Author ID: 843609
E-mail: egan0428@mail.ru

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The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:


Dzhaborov Abdugaffor Ibragimdzhonovich
Postgraduate Student, Department of Topographic Anatomy and Operative Surgery, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (938) 782787

E-mail: jaborov_1987@mail.ru

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