Abstract

ABSTRACT:
BACKGROUND:
Hydatid disease is a zoonotic infection caused by the larval stage of a tapeworm particularly Echinococcus granulosus. It is considered an important public health problem in many areas of the world. It is one of a serious endemic parasitic diseases in Iraq.
OBJECTIVE:
We report our experience in management of 29 case of isolated hydatid cysts of the kidney over an 18-year period in Anbar Governorate- West of Iraq .
PATIENTS AND METHODS:
Twenty- nine patients with isolated renal hydatid cyst were surgically treated from 1994 to 2011 in Al-Ramadi teaching Hospital, Anbar / Iraq. Clinical, laboratory, radiological data, and surgical findings are analyzed.
RESULTS:
Out of the 29 patients included in this series;15 were males and 14 were females. Mean age was 22.5years.The main clinical symptom was flank pain in 24patients (82.7%),hydatidurea in 3 patients(10.3%),and palpable flank mass only in one(3.5%). The cyst was asymptomatic in one (3.5%) .All patients were treated by open surgery. Nephrectomy was performed in one patient, partial nephrectomy in 2, and total cystopericystectomy in 2 . All others 24 cases were treated by modified partial cystopericystectomy. No recurrence reported during the follow up period from 19 to 28 months(mean :23 months) in18 patients, and 11 patients were lost from follow up after 6months of surgery.
CONCLUSION:
The exact incidence of isolated renal hydatid cyst is unknown in Iraq. It is of equal incidence in both sexes, and more in young age .Preoperative diagnosis could be done depending on ultrasonography ,intravenous urography ,and computerized tomography. The pressure difference between the renal pelvis and inside the cyst will determined the fluid movement at site of communication. Subtotal cystopericystectomy (Modified partial cystopericystectoy) is kidney-sparing surgery with minimal morbidity