Comparison of Traditional and New Methods of Obliterating Residual Space After Echinococcectomy
DOI:
https://doi.org/10.4314/njpar.v46i1.12Keywords:
Echinococcectomy, Fibrous Capsule, Laparoscopic Echinococcectomy, PAIR, FarGALSAbstract
In the surgery of liver echinococcosis in the Republic of Uzbekistan, organpreserving minimally invasive and traditional interventions continue to dominate in clinics with various levels of healthcare. Against this background, one of the urgent issues remains the option of treating the residual cavity after echinococcectomy, implying both antiparasitic efficacy and the possibility of accelerating the process of obliteration of the fibrous capsule. This study highlights the results of echinococcectomy of the liver, considering the method of treatment of residual cavities with elastic and rigid fibrous capsules. It was determined that an improved method of treating the residual cavity in uncomplicated forms of liver echinococcosis in the presence of an elastic fibrous capsule that subsides after parasite extraction includes laser radiation. This provides the possibility of treating cavities of any configuration and inhibiting the
growth of the pathogenic flora. When combined with the powdered composition "HEMOBEN" this method promotes local hemo and lymphostasis, sealing of microspheres bile ducts and increased obliteration of the walls of the fibrous capsule both during suturing and vacuum drainage. In another method, the use of high-energy laser exposure results in the destruction of a dense, rigid (nondisintegrating) fibrous capsule, ensuring not only the pliability of its walls by creating folds in the zones of induced destruction (by the type of pleating) but also the formation of zones of enhanced regeneration. Sanitisation of the residual cavity with FarGALS solution after preliminary laser destruction provides additional antiparasitic chemical effects owing to the penetration of the antiseptic
into the deep layers of the thickened capsule. Thus, this method can be used as an alternative to pericystectomy and liver resection.
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