SU1393406A1 - Method of hydatidectomy of liver and lung - Google Patents

Abstract

This invention relates to medicine, more specifically to surgery, as concerns ECHINOCOCCTOMY. The purpose of the invention is to prevent the recurrence of residual cavities by eliminating the residual cavity of the fibrous capsule with medical glue and antiparaeitic treatment with 5% tincture of iodine, followed by neutralization with a 30% solution of sodium thiosulfate. After applying the adhesive, mutually opposite cavities are pressed together and held for 3-5 minutes. During this time, the provisional ligatures are held behind the cavity of the fibrous capsule and tightened after the cavity has been treated. Into the subhepatic space for 2 days, the vinyl chloride drainage was placed and the wound was sutured in layers. 3 il.j

Description

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The invention relates to medicine, namely to surgery, and can be used in echinococcectomy.

The purpose of the invention is to prevent the recurrence of residual cavities by firmly touching the walls of the cavity.

FIG. 1 shows carrying out of provisional ligatures; FIG. 2 — treatment of the cavity of the fibrous capsule; in fig. 3 - closing of provisional ligatures.

Example 1. Patient H, 42 years old, was admitted with a diagnosis of liver echinococcus. With upper median laparotomy, an enlarged left lobe of the liver with a central location in it of hydatide up to 10 cm in diameter is attached to the wound. Hydatide is localized in the anterocentral surface of the liver. The ventral surface of the liver with napkins is isolated from the abdominal floor. At the point of transition of the fibrous capsule, 2 choke holders are applied to the liver parenchyma. Echinococcectomy was produced with parasitic cyst extractor (EPA-01), sanitized to 600 ml of turbid contents with daughter bladders (hydatid with a dead parasite and an early period of post-mortem changes). Widely dissected.

4. Then the surgeon, using three disposable syringes, presses the glue 5 — MK-6 — onto the cavity walls and the assistant with a spatula-spoon 6 applies the glue to the entire surface, including the two cavities of the fibrous capsule, in an even layer. After applying the glue, the surgeon presses the opposing planes against each other and holds the instructor with moderate tension for 3-5 minutes during this time, all provisional ones: 11y7. Toilet of the operation site. In the subhepatic space for 2 days postv.evlen vinyl chloride drainage and surgical wound are sewn up in layers.

The postoperative period proceeded without (complications. Stitches were removed on day 7, on day 1 I was discharged under the supervision of a polyclinic surgeon. Examined after three months. He is healthy and works on his previous work.

Example 2. Ill K., 22 years old was admitted with a diagnosis of pulmonary echinococcosis. Under endotracheal combination 1: disintegration. In position on the left side of the thoracotomy along the sixth intercostal space to the right by lateral access. After separation of the lower lobe with the costal and diaphragmatic pleura, the revision showed that in the lower lobe, occupying half of its area, there is an echinococcus hydatid

fibrous capsule and cuticle p- removed from the membrane attached to the diaphragmatic surface. The cavity has a shape of 16–10 cm. On a fibrous band, 10x9 cm in size. Antipzrasitic treatment with 5% iodine tincture followed

Two silk holders are superimposed on the lung tissue at the place of its transition. The diaphragm and lower surface by neutralization with a 30% solution of the thio-40 lobe are injected into and under the wound.

sodium sulfate. The audit showed that the fibrous capsule was preserved on the entire surface of the fibrous cavity, it is of moderate thickness without omnipotent areas with well-pronounced elasticity. A needle with a curvature of 180 held three silk threads 1 behind the fibrous capsule 2 to the bottom of the cavity, after the needle emerged, the thread was stretched, then the needle was pricked at the place of extraction, and it was held behind the fibrous capsule upwards through the second semicircle. The thread is brought out. The fourth-silk thread was held at the ventral edge of the liver with a straight needle, 15 cm long, in the form of a U-shaped suture. The walls of the fibrous cavity are thoroughly rubbed with alcohol 3, then ethyl-dried twice

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put a wet napkin. In the wound, the dol is also fenced off with wet marlevichch napkins and ekhinokok produced: -Ectomy EPK-01. After a wide dissection of the fibrous capsule, residues of the hydatide were removed (a cyst with a dead parasite in the period of early post-mortem changes). Three functioning ones are stitched; twice with ether, the walls of the wall were sprayed with MK-6, which was applied to the bed surface with a spatula - a spoon in an even layer

hydatides. After the MK-6 is uniformly applied, the surgeon mutually protrudes opposite planes to each other, and the assistant, with moderate tightening, calls up the provisional devices. After the toilet and drainage, the pleural cavity is closed until tightness.

Drainage was removed on the second day, the PIC leoperative period was uneventful. During the current x-ray examinations, in the first days after the operation, moderate infiltration of the lung tissue occurred at the hydatid site, which passed after 7 days.

The patient was examined after 3 years, her condition is good. Works in the same specialty. X-ray examinations of the chest cavity confirmed the good results of treatment.

According to the developed technique, 37 echinococcectomies were performed, including 15 with liver echinococcosis and 22 with lung echinococcosis. Worthy

In the proposed method of echinococcectomy with the use of medical glue and provisional sutures, the size of the hydra and the period of the vital activity of the parasite are not a contraindication to its use. Rarely applied provisional sutures reliably hold the glued walls of the fibrous capsule with subsequent fusion of the walls, reliably preventing the formation of residual cavities and other complications.

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) 5 Formula of invention

The method of hepatic and lung echinococcectomy, including the elimination of the residual cavity of the fibrous capsule with medical adhesive, characterized in that, in order to prevent the recurrence of residual cavities by firmly touching the walls of the cavity, the provisional ligatures behind the cavity of the fibrous capsule are drawn and tightened after the cavity has been processed.

FIG.

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Claims (1)

Claim A method of echinococcectomy of the liver and lung, including the elimination of the residual cavity of the fibrous capsule with medical glue, characterized in that, in order to prevent recurrence of the residual cavities by firmly touching the walls of the cavity, provisional ligatures are performed behind the cavity of the fibrous capsule and tighten them after processing the cavity. Fig 2 Phi J