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Standardized endocystectomy technique for surgical treatment of uncomplicated hepatic cystic echinococcosis

BACKGROUND: Two surgical options are available for cystic echinococcosis (CE). The two principal approaches are radical (resection of the cyst) and conservative (evacuation of the cyst content and partial removal of the cyst capsule). Here, we describe a standardized endocystectomy technique for hep...

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Autores principales: Al-Saeedi, Mohammed, Khajeh, Elias, Hoffmann, Katrin, Ghamarnejad, Omid, Stojkovic, Marija, Weber, Tim F., Golriz, Mohammad, Strobel, Oliver, Junghanss, Thomas, Büchler, Markus W., Mehrabi, Arianeb
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6608982/
https://www.ncbi.nlm.nih.gov/pubmed/31226109
http://dx.doi.org/10.1371/journal.pntd.0007516
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author Al-Saeedi, Mohammed
Khajeh, Elias
Hoffmann, Katrin
Ghamarnejad, Omid
Stojkovic, Marija
Weber, Tim F.
Golriz, Mohammad
Strobel, Oliver
Junghanss, Thomas
Büchler, Markus W.
Mehrabi, Arianeb
author_facet Al-Saeedi, Mohammed
Khajeh, Elias
Hoffmann, Katrin
Ghamarnejad, Omid
Stojkovic, Marija
Weber, Tim F.
Golriz, Mohammad
Strobel, Oliver
Junghanss, Thomas
Büchler, Markus W.
Mehrabi, Arianeb
author_sort Al-Saeedi, Mohammed
collection PubMed
description BACKGROUND: Two surgical options are available for cystic echinococcosis (CE). The two principal approaches are radical (resection of the cyst) and conservative (evacuation of the cyst content and partial removal of the cyst capsule). Here, we describe a standardized endocystectomy technique for hepatic echinococcosis. SUBJECTS AND METHODS: Twenty-one patients (male/female: 4/3; median age: 28 years) with uncomplicated, isolated hepatic CE (cyst stages WHO CE1, 2, 3a, and 3b) that were treated with the standardized endocystectomy described in this paper. Before the operation and during the follow-up period (mean: 33.8 months, median: 24 months), patients underwent clinical and sonographical and/or magnetic resonance imaging assessment during regular visits managed by an interdisciplinary team. RESULTS: Forty-seven cysts were treated with the standardized endocystectomy technique. The median number of cysts per patient was two (range: 1–8). Nine patients (43%) had a single cystic lesion. The median operation time was 165 minutes and the median intraoperative bleeding volume was 200 mL. The median hospital stay was nine days (range: 6–28 days). Morbidity (Clavien-Dindo III) occurred in four patients (19%). No mortality and no recurrence were found during the median follow-up time of 24 months. CONCLUSIONS: The standardized endocystectomy technique presented is a safe procedure with acceptable morbidity, no mortality, and without recurrences in our patient series. Important components of our CE management are interdisciplinary patient care, adequate diagnostic work-ups, and regular pre- and postoperative visits, including long-term follow-up for early and reliable capture of recurrences.
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spelling pubmed-66089822019-07-12 Standardized endocystectomy technique for surgical treatment of uncomplicated hepatic cystic echinococcosis Al-Saeedi, Mohammed Khajeh, Elias Hoffmann, Katrin Ghamarnejad, Omid Stojkovic, Marija Weber, Tim F. Golriz, Mohammad Strobel, Oliver Junghanss, Thomas Büchler, Markus W. Mehrabi, Arianeb PLoS Negl Trop Dis Research Article BACKGROUND: Two surgical options are available for cystic echinococcosis (CE). The two principal approaches are radical (resection of the cyst) and conservative (evacuation of the cyst content and partial removal of the cyst capsule). Here, we describe a standardized endocystectomy technique for hepatic echinococcosis. SUBJECTS AND METHODS: Twenty-one patients (male/female: 4/3; median age: 28 years) with uncomplicated, isolated hepatic CE (cyst stages WHO CE1, 2, 3a, and 3b) that were treated with the standardized endocystectomy described in this paper. Before the operation and during the follow-up period (mean: 33.8 months, median: 24 months), patients underwent clinical and sonographical and/or magnetic resonance imaging assessment during regular visits managed by an interdisciplinary team. RESULTS: Forty-seven cysts were treated with the standardized endocystectomy technique. The median number of cysts per patient was two (range: 1–8). Nine patients (43%) had a single cystic lesion. The median operation time was 165 minutes and the median intraoperative bleeding volume was 200 mL. The median hospital stay was nine days (range: 6–28 days). Morbidity (Clavien-Dindo III) occurred in four patients (19%). No mortality and no recurrence were found during the median follow-up time of 24 months. CONCLUSIONS: The standardized endocystectomy technique presented is a safe procedure with acceptable morbidity, no mortality, and without recurrences in our patient series. Important components of our CE management are interdisciplinary patient care, adequate diagnostic work-ups, and regular pre- and postoperative visits, including long-term follow-up for early and reliable capture of recurrences. Public Library of Science 2019-06-21 /pmc/articles/PMC6608982/ /pubmed/31226109 http://dx.doi.org/10.1371/journal.pntd.0007516 Text en © 2019 Al-Saeedi et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Al-Saeedi, Mohammed
Khajeh, Elias
Hoffmann, Katrin
Ghamarnejad, Omid
Stojkovic, Marija
Weber, Tim F.
Golriz, Mohammad
Strobel, Oliver
Junghanss, Thomas
Büchler, Markus W.
Mehrabi, Arianeb
Standardized endocystectomy technique for surgical treatment of uncomplicated hepatic cystic echinococcosis
title Standardized endocystectomy technique for surgical treatment of uncomplicated hepatic cystic echinococcosis
title_full Standardized endocystectomy technique for surgical treatment of uncomplicated hepatic cystic echinococcosis
title_fullStr Standardized endocystectomy technique for surgical treatment of uncomplicated hepatic cystic echinococcosis
title_full_unstemmed Standardized endocystectomy technique for surgical treatment of uncomplicated hepatic cystic echinococcosis
title_short Standardized endocystectomy technique for surgical treatment of uncomplicated hepatic cystic echinococcosis
title_sort standardized endocystectomy technique for surgical treatment of uncomplicated hepatic cystic echinococcosis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6608982/
https://www.ncbi.nlm.nih.gov/pubmed/31226109
http://dx.doi.org/10.1371/journal.pntd.0007516
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