5 year pair experience – indications, modifications, problems
Aim: Report of 5 year PAIR experience for treatment of cystic echinococcosis.
Material and methods: 190 patients (85 males and 105 females) with 347 CE1 and CE3 WHO type liver and extraliver hydatid cysts, mean size 7.2cm (range 4 and 20cm) were treated with PAIR under US control according to the WHO recommendations. 95% alcohol and 25% NaCl were used as scolecidals. Classic PAIR technique, different PAIR modifications and percutaneous drainage with Seldinger approach of residual cavities were performed.
Results: After the sixth month, double size reduction was obtained in 90.78% of the cysts. 64.84% showed complete, almost complete or partial heterogeneous solid cyst content, 10.08% completely disappeared. Persisting significant liquid structure was observed in 27.66%. At 12 month follow up different stages of heterogeneous solid cyst content were obtained in 85.30% and no solidification inside the cyst in 5.48%. No significant size reduction and change of the structure were observed in 9.22% of the cysts, all WHO type CE3. Post-manipulation complications developed in 23.68% of the patients, severe anaphylactic reaction in two of them (1.05%).
Discussion: Problems connected with the indications, therapeutic efficacy and complications of PAIR are discussed.