Outcomes After Liver Resection for Hepatic Alveolar Echinococcosis: A Single-Center Cohort Study.

Details

Serval ID
serval:BIB_3D794CEFC72C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Outcomes After Liver Resection for Hepatic Alveolar Echinococcosis: A Single-Center Cohort Study.
Journal
World Journal of Surgery
Author(s)
Joliat G.R., Melloul E., Petermann D., Demartines N., Gillet M., Uldry E., Halkic N.
ISSN
1432-2323 (Electronic)
ISSN-L
0364-2313
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
39
Number
10
Pages
2529-2534
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
BACKGROUND: Switzerland is a region in which alveolar echinococcosis (AE) is endemic. Studies evaluating outcomes after liver resection (LR) for AE are scarce. The aim of this study was to assess the short- and long-term outcomes of AE patients after LR in a single tertiary referral center.
METHODS: We retrospectively analyzed data pertaining to all patients with liver AE who were treated with LR at our institution between January 1992 and December 2013. Patient demographics, intraoperative data, extent of LR procedures (major vs. minor LR), postoperative outcomes, and negative histological margin (R0) resection rate were recorded in a database. Recurrence rates after LR were analyzed.
RESULTS: LR was performed in 59 patients diagnosed with hepatic AE (56 complete surgeries, 3 reduction surgeries). Postoperative morbidity and mortality were observed in 34 % (25 % grade I-II, 9 % grade III-IV) and 2 % of the patients, respectively. R0 (complete) resection rate was 71 % (n = 42), and R1/R2 resection rate was 29 % (n = 17). Extra-hepatic recurrence occurred in 1 case (lung) after R0 resection. In cases of R1/R2 resection, 7 intra-hepatic disease progressions occurred with a median time of 10 months (IQR 6-11 months). Long-term (more than 1 year) benzimidazole treatment stabilized the disease in 64 % (9/14) of patients with R1 status. The overall survival rate was 97 %.
CONCLUSIONS: Liver AE can be safely and definitively treated with LR, provided that R0 resection is achieved. In cases of R1 resection, benzimidazole therapy seems to be effective in stabilizing the intra-hepatic disease and preventing extra-hepatic recurrence.
Keywords
Aged, Anthelmintics/therapeutic use, Benzimidazoles/therapeutic use, Chemotherapy, Adjuvant, Disease Progression, Echinococcosis, Hepatic/drug therapy, Echinococcosis, Hepatic/surgery, Female, Hepatectomy/adverse effects, Humans, Male, Middle Aged, Recurrence, Retrospective Studies, Survival Rate, Switzerland, Time Factors, Treatment Outcome
Pubmed
Web of science
Create date
27/10/2015 18:20
Last modification date
20/08/2019 14:33
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