O‘PKA EXINOKOKKOZI JARROHLIGI
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Relevance. Surgery still remains the main method of treating echinococcosis of the lungs and liver. Alternative conservative treatment is not very effective. The main aim of this study is to evaluate minimally invasive surgical interventions in the treatment of echinococcal cysts of the lungs and liver. Material and methods. This work includes the results of the surgical treatment of 112 patients with combined echinococcosis of the lungs and liver at the clinic of the department of general surgery of Samarkand State Medical University. The clinical material was divided into three groups: in the first group (control group) there were 36 (32,14%) patients, in whom the cysts of the lungs and liver were operated on through separate wide incisions. Among them, in 34 (94,44%) patients the operations were performed step by step with an interval of 4-6 weeks, while in 2 (5,56%) patients echinococcectomy was carried out in one stage, that is, simultaneously from the lungs and the liver through separate incisions; in the second group, in 29 (25,89%) patients the echinococcal cysts were removed from the right lung and the liver simultaneously by means of thoracophrenolaparotomy; in the third group, in 47 (41,97%) patients the removal of the cysts from the lungs and liver was carried out step by step. Of these, in 35 (74,47%) cases, at certain stages of echinococcectomy, we used the video-assisted mini-incisions developed by ourselves, and in 12 (25,53%) cases all thoracic and abdominal approaches were performed using only mini-incisions. In 7 patients the surgical interventions for the cysts of the lungs and liver were performed simultaneously in one stage through separate mini-approaches, while in 5 patients the cysts were removed from the lungs and liver step by step with an interval of four weeks. The use of minimally invasive approaches and simultaneous operations helped to reduce early postoperative complications from 13,89% (control group) to 9,21% (main group), that is, almost by a factor of 2. Conclusion: this study showed that the use of endovisual technology makes it possible to perform operations through minimally invasive approaches even in the combined localization of cysts in the lungs and liver, and does not lead to an increase in the number of postoperative complications compared with operations performed by the traditional thoracotomy and laparotomy methods.
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