Analysis Of The Risk Factors Of Laparoscopic Radical Surgery For Hepatic Cystic Hydatid Disease In The Transition To Laparotomy

Objective:To investigate the risk factors of conversion to laparotomy in the treatment of hepatic cystic echinococcosis(HCE)by laparoscopic radical surgery,and to conduct related clinical analysis.Methods:This study retrospectively analyzed from January 2007 to December 2019 were analyzed in the first affiliated hospital of xinjiang medical university liver ce parallel laparoscopic radical operation of the clinical data of86 patients,and divided into according to whether the transfer laparotomy laparoscopic surgery group(group A)and laparotomy group(group B),the single factor analysis of the relationship between the related clinical data and transfer laparotomy,and uses the multi-factor logistic regression analysis of the independent risk factors of transfer laparotomy.Results:86 patients,46 cases transfer laparotomy,single factor analysis of two groups in BMI(P=0.044),the size of the lesions(P=0.001),the operation time(P=0.029),the bleeding(P=0.048),gender(P=0.023),Takealbendazole history(P=0.043),the lesions located in 1 proposal(P=0.001),hydatid clingy portal vein and hepatic artery,hepatic vein and inferior vena cava(P=0.036),there are large blood vessels and bile duct into the hydatid cavity(P=0.003),the lesions located in the left lobe(P=0.012),abdominal cavity adhesion degree(P=0.001),The hydatid classification(P=0.012)and the frequency of abdominal surgery(P=0.005)were statistically significant.Multi-factor analysis results indicate: BMI,lesion size,lesion located atⅠ、Ⅶ、Ⅷ,hydatid against hepatic vein,portal vein and hepatic artery and inferior vena cava,abdominal cavity adhesiondegree(Ⅳ)(OR=1.68,2.32,3.51,3.42,1.50;95%CI=1.00-2.81,1.18-4.53,1.48-8.31,1.13-1.78,1.13-1.98;P=0.049,0.014,0.004,0.017,0.025)was an independent risk factor,while the location of the lesion in the left lateral lobe was a protective factor(OR=0.54,95%CI=0.30-0.96,P=0.034).Conclusion:For HCE patients,when BMI is high,the lesion is too large,the lesion is located in liver segment Ⅰ、Ⅶ、Ⅷ,and hydatid lesion is close to important large vessels and obvious adhesion to abdominal cavity is difficult to separate,laparoscopic radical surgery is easier to be converted to open,while the lesion is located in the left lateral lobe is more conducive to the implementation of laparoscopic radical surgery.Combined with these factors,preoperative evaluation of HCE patients can be more accurate,preoperative preparation can be improved,and determine whether laparoscopic radical surgery can be performed,reduce the conversion rate of open surgery.