efficacy of current scolicidal agents in surgically removed hydatid cysts

ABSTRACT

Context The spillage of hydatid material, during surgery for hydatid cysts, may lead to secondary cyst formation due to the implantation of the protoscolices, A number of chemical scolicidal agents are injected into the hydatid cyst prior to its surgical removal as a prophylactic measures against the cyst material implantation, To measure the efficacy of four commonly used chemical scolicidal agents in rendering the contents of the hydatid cyst unviable, Design: Descriptive case-series with in-vitro measurement of viability of protoscolices in surgically removed, scolicidal injected hydatid cysts. Participants and setting: Thirty-four fresh fertile hydatid cysts from liver, lung and kidney were obtained following surgical removal in Al-Zahrawy teaching hospital between September 1995 and September 1996.The parasitological work was conducted in the Parasitology Laboratory, College of Medicine University of Mosul. Main outcome measures: The 34 cysts were categorized into four groups according to the scolicidal agent injected in the cysts before their surgical removal. The scolicidal used are 1% hibitane, 10% formalin, 30% hypertonic saline and 50% hydrogen peroxide. All 34 specimens were examined at 1 hour, as well as 12, 24, 48, 60, and 72 hours to count the cysts with viable protoscolices 1% hibitane and 10% formalin succeeded in reducing the number of viable protoscolices to about one third within one hour, 30% hypertonic saline and 50% hydrogen peroxide were less efficacious of the four scolicidals, 1% hibitane and 10% formalin used as scolicidal agents showed a minimal survival rate of the protoscolices [SR 38%], while the use of 30% hypertonic saline and 50% hydrogen peroxide. showed a maximal protoscolices survival rate [SR 67%], Thus, the use of hibitane and formalin solutions have high scolicidal effect