Splenic Surgery for Hydatid Spleen in Single Institutional Experience

Study Overview
=================
Brief Summary
-----------------
Splenic-preserving surgery in hydatid spleen: Single intuitional experience

Detailed Description
-----------------
Background: Although hydatid disease affects many organs in the human body, splenic hydatid represents about 0.8-4% of all human echinococcosis cases. Until recently, splenectomy was the recommended surgical procedure for splenic hydatid. Since 1980 there has been an increasing tendency to use conservative option to deal with such pathology. Aim of the study: To evaluate our experience in open splenic-preserving surgery for splenic hydatid in a single institutional study. Patient and methods: A retrospective study. Ten patients with splenic hydatid were operated upon from August 2013 to January 2018 in our medical centre. Spleen has affected alone in 7 cases, liver and spleen were affected in 3 cases, and one of them had intraperitoneal cyst affection in addition. The diagnosis confirmed mainly by ultrasonography. In some cases, it computed tomography CT scan, and magnetic resonance imaging MRI were needed. Chest X-ray had taken for all patients to exclude pulmonary hydatid. The open surgical procedure used. Isolation of the field, aspiration of cystic fluid and injection of 1% cetrimide solution, re-aspiration, endocystectomy, suturing of cystic edges over intracystic tube drain. All surgery did under cover of albendazole pre and postoperative 15mg/kg/day. Results: No significant intraoperative and postoperative complications. No reoperation was needed. Hospital stays 3-5 days. No recurrence after (1-3) year follow-up. However, three patients missed follow-up after two years. Conclusion: Our experience in splenic hydatid encourages us to use splenic-preserving surgery whenever possible instead of splenectomy.

Official Title
-----------------
Splenic Preserving Surgery in Hydatid Spleen

Conditions
-----------------
Spleen; Cyst, Hydatid (Manifestation)

Intervention / Treatment
-----------------
* Procedure: Cystic enculation of spleen hydatid


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Single hydatid spleen Primary spleen hydatid - Exclusion Criteria: Multiple splenic hydatid Rupture hydatid spleen

Ages Eligible for Study
-----------------
Minimum Age: 16 Years
Maximum Age: 65 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Cystic enculation of spleen hydatid|Preoperative preparation did according to the general condition of the patient and fitness for anaesthesia. Laparotomy did under general anaesthesia, supine position, the abdomen opened either by midline or left subcostal incision. Identification of splenic hydatid cyst. Exploration of the peritoneal cavity for undetected hepatic or peritoneal hydatid preoperatively. Isolation of operative field by packs socked with hypertonic solution (20 -30 % hypertonic saline). Aspiration of the cyst fluid. Injection of suitable amount about 5 ml of (1 % of cetramid) solution and waiting for at least 5 minutes and then re-aspiration. The spleen is not needed to mobilize. Extraction of the endocyst and washing of the cavity with normal saline. Occupying the cystic cavity intracystic drain. Perioperative and postoperative close observation of the patient for an anaphylactic reaction or any other complication. Follow-up of the patient until discharge from hospital on (3th - 5th) days.|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| splenic sparing surgery for hydatid spleen | Six of them males and four females, their age range from 5- 40 years (mean 23.6 years). Hydatid spleen alone was found in seven cases while splenic and liver hydatid was found in three cases one of them had peritoneal hydatid affection in addition. Hospital stay was ranged from 3-5 days. | 3 year | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Preserving surgery, Spleen, Hydatid cyst, Surgery