Splenectomy versus spleen-preserving surgery for splenic echinococcosis.
OBJECTIVE
The spleen is the third most common location of hydatid disease after liver and lung. The aim of this study was to analyse the long-term outcome of surgical treatment of patients with splenic echinococcosis comparing splenectomy with spleen-preserving surgery.


METHODS
During a period of 25 years (1976-2001), 19 (5.4%) patients with splenic echinococcosis were treated in our department out of 349 patients with abdominal hydatid disease. In 16 patients the spleen was the only organ involved, while in 3 patients the liver was also affected.


RESULTS
Eleven patients had splenectomy and in the other 8 the spleen was preserved: enucleation (n = 4), partial cystectomy and omentoplasty (n = 2) and cystojejunal Roux-en-Y anastomosis (n = 2). One (6%) patient died in the early postoperative period and 5 (29%) patients had postoperative complications. There was no significant difference between the splenectomy and spleen-preserving groups concerning median hospital stay and postoperative complication rate. The median follow-up in 15 patients was 52 (range 6-300) months. Two patients (13%) developed recurrence of the disease requiring re-operation at 2 and 3 years, respectively. Recurrence occurred in 1 (12%) patient in the splenectomy group and in 1 (14%) out of 7 patients in the spleen-preserving group.


CONCLUSIONS
In the present series it was possible to preserve the spleen in 8 (42%) of 19 patients, without significant increase of recurrent echinococcosis.
Atmatzidis
K
K
2nd Surgical Clinic of the Aristotle University of Thessaloniki, Thessaloniki, Greece.
Papaziogas
B
B
Mirelis
C
C
Pavlidis
T
T
Papaziogas
T
T
D000328:Adult; D000368:Aged; D004443:Echinococcosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013154:Spleen / Q000601:surgery*; D013156:Splenectomy / Q000379:methods*; D013158:Splenic Diseases / Q000469:parasitology / Q000601:surgery*; D016896:Treatment Outcome