Kist Hidatik Hastaligi Nedeniyle Takip ve Tedavi Edilen 170 Olgunun Irdelenmesi: Cok Merkezli Bir Calisma/Evaluation of 170 Followed-up Cases Treated for Hydatid Disease: A Multicentre Study

• Published in: Türkiye parazitolojii dergisi Vol. 44; no. 4; p. 197
• Main Authors: Isik, Sinem Akkaya, Seyman, Derya, Zerdali, Esra, Ayan, Saliha, Kakaliçoglu, Deniz, Ayaz, Tunahan, Ünlü, Esra Canbolat, Çetinkaya, Riza Aytaç, Yenilmez, Ercan, Görenek, Levent, Köse, Sükran
• Format: Journal Article
• Language: English
• Published: AVES 01-12-2020
• Subjects: Anemia; Diagnostic imaging; Health aspects; Liver; Medical research; Medicine, Experimental
• ISSN: 1300-6320
• DOI: 10.4274/tpd.galenos.2020.6737

Amaç: Ülkemizde kist hidatik hastaligi yüksek endemisite göstermektedir. Bu çalismada kistik ekinokokkoz hastalarinin klinik özellikleri ve tani-tedavi yaklasimlarinin ortaya konulmasi amaçlanmistir. Yöntemler: Çok merkezli, retrospektif olarak planlanan bu çalismaya alti merkezin son bes yil içerisinde kist hidatik tanisi konmus hastalari dahil edilmistir.. Bulgular: Çalismaya alinan 170 hastanin %54,7'si kadin olup, tüm olgularin yas ortalamasi 45,4[+ or -]17,4 yildi. En sik basvuru sikayeti karin agrisi ve bulanti-kusma; en sik fizik muayene bulgusu ise batinda hassasiyetti. Hastalarin çogu, sikayeti basladiktan 2 ila 6 ay sonra tani almisti. Tedavi öncesi bakilan laboratuvar tetkiklerinde anemi en sik saptanan bulguydu ve eozinofili ikinci sirada yer almaktaydi. En sik tutulan organ ise karacigerdi (n=153, %90). Tani koymak için uygulanan görüntüleme tetkikleri incelendiginde 125 olguda (%73,5) ultrasonografi çekildigi tespit edildi. Tani sirasinda tespit edilen en büyük kist 160x170 mm boyutlarinda ve karacigerde olup, evre 4'tü. Indirekt hemaglütinasyon testi için negatif, süpheli pozitif ve pozitiflik oranlari sirasiyla %9,4, %8,8 ve %81,8'di. Cerrahi + medikal tedavi, PAIR + medikal tedavi uygulamasindan daha yaygindi (n=72 %42,4, n=14 %8,2). Nüks görülen 47 hastanin 22'sinde (%46,8) kist hidatik tedavi hikayesi mevcuttu. Sonuç: Çalismamizin sonuçlari göstermektedir ki, ülkemizde endemik olan kist hidatik hastaliginin tanisi geç konulabilmekte ve serolojik testler hastaligin tanisinda yaniltici olabilmektedir. Farkli evre ve boyutlarda kistleri olan hastalarda tedavi seçimlerine göre nüks oranlarini karsilastirmak mümkün olmamistir. Anahtar Kelimeler: Kist hidatik, çok merkezli çalisma, Türkiye Objective: To determine the clinical characteristics of patients with cystic echinococcosis and the diagnostic and therapeutic approaches used. Methods: This is a multicentre, retrospective study. Patients from six centres who were diagnosed with hydatid cysts in the last five years were evaluated. Results: The mean age was 45.4[+ or -]17.4 years, and 54.7% were female. The most common complaints were abdominal pain, nausea and vomiting, and the most common physical examination finding was abdominal tenderness. Most patients were diagnosed within 2-6 months. Anaemia and eosinophilia were the most common laboratory findings. The liver was the most commonly involved organ (n=153, 90%). One hundred twenty-five (73.5%) patients underwent ultrasonography. The largest cyst was present in the liver at stage four, and its diameter was 160x170 mm. The rates of the negative, grey zone and positive results were 9.4%, 8.8% and 81.8%. Surgery was more common (n=72, 42.4%) than puncture, aspiration, injection, and re-aspiration treatments (n=14, 8.2%). Of the 47 patients who had a recurrence, 22 (46.8%) had a history of hydatid cyst treatment. Conclusion: Hydatid disease, which is endemic in our country, is diagnosed at a late stage. In terms of disease diagnosis, serological tests may be misleading. It was not possible to compare the success rates according to the treatment choices because of the lack of randomisation of stages and sizes of the lesions. Keywords: Hydatid cyst, multicentre study, Turkey