Percutaneous drainage of echinococcal cysts (PAIR---puncture, aspiration, injection, reaspiration): results of a worldwide survey for assessment of its safety and efficacy Reply

Abstract

Editor,—In 1996 a letter ( Gut 1996; 38 :936) about the use of PAIR ( p uncture, a spiration, i njection of a scolecidal agent, r easpiration) raised a criticism of Dr Morris, a leading expert on the treatment of echinococcosis.1 At the same time the WHO Informal Working Group on Echinococcosis launched a survey to evaluate the status of this procedure. A number of centres around the world known to be active in this field were requested to complete forms for patients treated with PAIR: 765 abdominal cysts, mostly hepatic, treated with this technique were reported from various countries. We report the results of this survey (table 1). View this table: Table 1 Results of the survey on PAIR by the WHO Informal Working Group on Echinococcosis Either needles (18–22 gauge) or catheters (5–9 French gauge), depending on the size and location of the cysts, were used. Scolecidal agents were mainly 20% hypertonic saline and 95% ethanol solution. After aspiration and parasitological control of the fluid, a quantity of scolecidal agent, approximately equivalent to one third of the amount aspirated, was injected into the cysts and left for a time varying from 5 to 30 minutes, and then reaspirated: only in the cases … Professor D Morris. Email: David.Morris{at}unsw.edu.au