Euromedica 2011 H.I. Ibodov A.M. Sharipov B.Dz. Azizov choice of method of surgical treatment in children with echinococcosis lung"

H.I. Ibodov A.M. Sharipov B.Dz. Azizov	CHOICE OF METHOD OF SURGICAL TREATMENT IN CHILDREN WITH ECHINOCOCCOSIS LUNG
	Tajik Institute of Postgraduate Medical Training, Dushanbe, Tajikistan

Objectives of the study. Improved results of surgical treatment of children with various forms of echinococcosis of the lungs

Materials and methods. Over the last 10 years in the Department of Paediatric Surgery of the Tajik Institute after graduation training of medical personnel were on the treatment of 152 patients with lung echinococсis. (EL) in various forms. Children aged 2-7years were 52.8-10 years-33 ,11-15 years-67. Solitary echinococcal cyst 144 (94,7%). Bilateral lesion in 8 (5.3%) children. In 16 (10,5%) patients had pulmonary hydatid cyst combined with lesion of the liver. Right-sided localization (59), left-handed (41%). According to the location in tissue lung echinococcus more (126) and other central located, less (26) on the periphery.

Depending on the size and scope of the EC (in the classiﬁcation of A.T. Pulatova) were. small amount of 10-100ml, diameter of the residual cavity of 4-7cm (6), medium -100-250 ml, diameter-7-10 cm (24), large and huge volumes of 500 or more (71). Among the complicated forms of echinococcosis patients with a breakthrough in the bronchus was 42, in the pleural cavity 4, a breakthrough in the bronchus and the pleural cavity-2, suppuration of the residual cavity of the EC-3, re cystic inﬂammation -15. In the diagnosis of the disease was mainly used radio logic method of investigation (152). In 106 observations for the diagnosis, the timing and extent of surgical intervention was used ultrasound (U.S.).

Results and discussion. We used two-stage disclosure of thoracic injuries in 71 patients with large and giant cyst of the lungs. It consisted of the following: ﬁrst produced torakotsentez dissection of parietal pleura in the course of the wound for 5-10 cm Surgeon ﬁnger bluntly and gently detaches contiguous portion of the ﬁbrous capsule, given that it was possible to separate the edge of 4-5 cm and thereby partially exposing cyst. Then sucked all the way to puncture echinococcus ﬂuid, then dissected and removed ﬁbrous capsule chitinous shell. Cavity of the ﬁbrous capsule is disinfected and loose plugging. Easy fully released from adhesions. In order to prevent recurrence of echinococcosis There are many ways is the use of 1-5% formalin solution. We have 20 (30,4%) patients in the control group was used 2% formalin solution. In this case, bronchospasm, we observed in 5 patients, cardiac arrhythmias (bradycardia) in 4 patients. In the clinic of pediatric surgery until 1996 when centrally located cyst easily applied method, developed by AT Pulatov in 1982 - is the creation of artiﬁcial interlobar or intersegmental grooves. In this procedure, operated on 56 out of 152 patients, including 13 with complications. In this case, 14% of the 56 patients had complications in the postoperative period in the form of education residual cavity in 2 patients and neparaziterial cyst in one patient. We have been modiﬁed to create an artiﬁcial interlobar or intersegmental grooves. In this method, operated on 90 children from 152 patients. Complicated by pulmonary EC were 38, the average EC in 16, large lung EC were 20, a giant 16. The technique is as follows: after the disclosure of the residual cavity formed in the hemisphere, further dissected ﬁbrous capsule with minimal thin layer of lung tissue in the course of vessels and bronchi to the bottom within a functioning lung tissue to 2 3 cm excised edge of the ﬁbrous capsule is imposed several eight-shaped, nonabsorbable hemo and aerostatic seams. formed three additional artiﬁcial interlobar or intersegmental ﬁssure. When inﬂating the lung surface of all the ﬁbrous capsule are closed, as the concave surface on the ﬁbrous capsule is completely eliminated. Thus echinococcectomy with various forms of lung EC children, our technique is more efﬁcient surgical treatment, postoperative complications of this technique is 9% against 14.8% for traditional ones.