The Republican scientific-practical center of miniinvasive and endovisual surgery of children’s age, Tashkent Мedical Akademy

In the Republican scientific-practical center of miniinvasive and endovisual surgery of children’s age during the period from 2012 to 2017, 11 children at the age from 7 till 15 years with diagnosis of associated echinococcosis of the right lung and liver were operated.

The diagnosis has been established according to survey radiography of a thorax in two projections, US of organs of thoracic, an abdominal cavity. In obscure cases for establishing of diagnosis or for definition of localization, cyst volume CT, МSCT were used.

Results. The position of echinococcos cysts in liver - the single echinococcosis of liver and the right lung are detected in 7 (63,6 %) patients, multiple (two and more cysts) – in 4 patients (36,4 %). All 11 children have been operated. In 6 (54,5 %) cases operative treatment has been executed. In associated echinococcosis preferred firstly excision of parasitogenic cysts of lung. The difference between planned operations of a thoracoscopy and a laparoscopy was no more than 3 weeks. In 5 (45,5 %) cases was executed endovisual single-step echinococcectomy, including videothoracoscopic and laparoscopic echinococcectomy from visceral segments of a liver in 2 (18,2 %) cases. In 2 (18,2 %) cases thoracoscopic echinococcectomy with the subsequent phrenicotomy, echinococcectomy with subphrenic segments of a liver (VII - VIII segments of a liver). In 1 (9,1 %) a case In associated echinococcosis of the lower lobe of the right lung, the right and left lobes of a liver. Thoracoscopic echinococcectomy was executed with the subsequent phrenicotomy, echinococcectomy from phrenic segments of a liver (VII - VIII segments of a liver) with the subsequent one step laparoscopic echinococcectomy from 2-3 segments of a liver. During interventions weren’t detected intra and postoperational complications . Patients were discharge from the hospital on 7-8 days (7,2±1,2 n/d) after a surgical intervention in a satisfactory condition on an outpatient observation.

Conclusion: Our experience shows that in associated echinococcosis of lung and liver endovideosurgical echinococcectomy, possessing the same radicalism as well as traditional operative measures, but with low traumatism, allows to enlarge operative measure volumes, excepting a long time interval between stages of echinococcectomy from the lung and the liver. Frequency rate of an operative measure is reduced, the expense of medicines, terms of stay of patients in a hospital considerably decreases, especially during the postoperative period (7,2±1,2 n/d), terms of restoration of physical activity of the patient, the good cosmetic effect becomes perceptible.

In treatment of associated echinococcosis of lungs and liver single-step endovideosurgical echinococcectomy should be priority.