PAIR vs Örmeci technique for the treatment of hydatid cyst
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Abstract
Hydatid disease is caused by the larval stages of Echinococcus Granulosus. Most patients with hydatid disease <span style="font-size: 12px;">have no symptoms, unless there is compression of vital organs such as the hepatic veins, portal vein, hepatic artery </span><span style="font-size: 12px;">in the liver, bronchia in the lungs or the brain, resulting in life threatening complications like anaphylactic shock </span><span style="font-size: 12px;">and sudden death. There are four treatment strategies for cystic echinococcosis (CE)- surgery, percutaneous methods,</span><span style="font-size: 12px;">medical treatments and watch and wait strategies. </span>
<span style="font-size: 12px;">Medical treatment with albendazol, mebendazole or prazyquentel may cure only 2/3 of patients with CE. More </span><span style="font-size: 12px;">than 30% of patients will reoccur after stopping the treatment. Watch and wait strategy is followed for asymptomatic </span><span style="font-size: 12px;">and small cysts or CE type IV and Type V cysts. Surgical treatments were the gold standard for treatment of CE </span><span style="font-size: 12px;">until the last 30 years. Consequently, surgical methods decreased while percutaneous methods of treatment increased. </span><span style="font-size: 12px;">Due to higher mortality, morbidity, recurrence rates, longer hospital stays and higher costs in comparison </span><span style="font-size: 12px;">to percutaneous methods like PAIR and ÖRMECİ technique, surgical treatment must be limited for the complicated </span><span style="font-size: 12px;">hydatid cyst. Both the PAIR and Örmeci techniques are safe and effective. However, the Örmeci technique offers a </span><span style="font-size: 12px;">simpler, inexpensive method of treatment, with no mortality, lower morbidity, low recurrence rate, while being out </span><span style="font-size: 12px;">patient based. It can be used as the first choice of treatment modality in patients with cysts type CE type one, CE</span><span style="font-size: 12px;">type two, CE Type 3A and CE Type 3B.</span>
In this review, treatment modalities for CE, but mainly percutaneous treatment, will be discussed.
<span style="font-size: 12px;">Medical treatment with albendazol, mebendazole or prazyquentel may cure only 2/3 of patients with CE. More </span><span style="font-size: 12px;">than 30% of patients will reoccur after stopping the treatment. Watch and wait strategy is followed for asymptomatic </span><span style="font-size: 12px;">and small cysts or CE type IV and Type V cysts. Surgical treatments were the gold standard for treatment of CE </span><span style="font-size: 12px;">until the last 30 years. Consequently, surgical methods decreased while percutaneous methods of treatment increased. </span><span style="font-size: 12px;">Due to higher mortality, morbidity, recurrence rates, longer hospital stays and higher costs in comparison </span><span style="font-size: 12px;">to percutaneous methods like PAIR and ÖRMECİ technique, surgical treatment must be limited for the complicated </span><span style="font-size: 12px;">hydatid cyst. Both the PAIR and Örmeci techniques are safe and effective. However, the Örmeci technique offers a </span><span style="font-size: 12px;">simpler, inexpensive method of treatment, with no mortality, lower morbidity, low recurrence rate, while being out </span><span style="font-size: 12px;">patient based. It can be used as the first choice of treatment modality in patients with cysts type CE type one, CE</span><span style="font-size: 12px;">type two, CE Type 3A and CE Type 3B.</span>
In this review, treatment modalities for CE, but mainly percutaneous treatment, will be discussed.