Clément Julien1,2, Yves Patrice Le Treut3,4, Stéphane Bourgouin5, Anaïs Palen3,4, Jean Hardwigsen3,4. 1. Department of Surgery and Liver Transplantation, Hôpital de la Timone, Marseille, France. clementjulien@live.fr. 2. Department of Surgery, Hôpital Sainte Anne, Toulon, France. clementjulien@live.fr. 3. Department of Surgery and Liver Transplantation, Hôpital de la Timone, Marseille, France. 4. Aix Marseille University, 13284, Marseille, France. 5. Department of Surgery, Hôpital Sainte Anne, Toulon, France.
Abstract
BACKGROUND: Although radical resections are recommended for the surgical management of liver hydatid disease (LHD), whether closed (CCR) or opened (OCR) cyst resections should be performed remains unclear. The aim of this study was to compare the postoperative and long-term outcomes of CCR and OCR for primary and recurrent LHD. MATERIALS AND METHODS: Medical charts of patients who underwent surgery at a single centre were retrospectively reviewed and compared with respect to major postoperative complications and recurrence rates. RESULTS: Seventy-nine CCRs and 37 OCRs were included. The major morbidity rates were 19% and 5% in the OCR and CCR groups, respectively (P = 0.036). In multivariate analysis, OCR (P = 0.030, OR = 5.37) and the operative time (P < 0.001, OR = 18.88) were the only independent predictors of major complications. The 5-year and 10-year recurrence rates were both 0% in the CCR group compared to 18% and 27%, respectively, in the OCR group (P < 0.001). The mean time to recurrence was 10.5 (± 8) years. DISCUSSION: Closed cyst resection for LHD is a safe and effective approach with a low risk of recurrence. Considering that recurrence could appear more than 10 years after surgery, follow-up of patients should be adapted.
BACKGROUND: Although radical resections are recommended for the surgical management of liver hydatid disease (LHD), whether closed (CCR) or opened (OCR) cyst resections should be performed remains unclear. The aim of this study was to compare the postoperative and long-term outcomes of CCR and OCR for primary and recurrent LHD. MATERIALS AND METHODS: Medical charts of patients who underwent surgery at a single centre were retrospectively reviewed and compared with respect to major postoperative complications and recurrence rates. RESULTS: Seventy-nine CCRs and 37 OCRs were included. The major morbidity rates were 19% and 5% in the OCR and CCR groups, respectively (P = 0.036). In multivariate analysis, OCR (P = 0.030, OR = 5.37) and the operative time (P < 0.001, OR = 18.88) were the only independent predictors of major complications. The 5-year and 10-year recurrence rates were both 0% in the CCR group compared to 18% and 27%, respectively, in the OCR group (P < 0.001). The mean time to recurrence was 10.5 (± 8) years. DISCUSSION: Closed cyst resection for LHD is a safe and effective approach with a low risk of recurrence. Considering that recurrence could appear more than 10 years after surgery, follow-up of patients should be adapted.
Authors: B Gollackner; F Längle; H Auer; A Maier; M Mittlböck; I Agstner; J Karner; F Langer; H Aspöck; H Loidolt; S Rockenschaub; R Steininger Journal: World J Surg Date: 2000-06 Impact factor: 3.352
Authors: Mario A Secchi; Ricardo Pettinari; Carlos Mercapide; Ricardo Bracco; Carlos Castilla; Eduardo Cassone; Pablo Sisco; Oscar Andriani; Leonardo Rossi; Jorge Grondona; Lisandro Quadrelli; Raúl Cabral; Nicolás Rodríguez León; Carlos Ledesma Journal: Liver Int Date: 2009-09-11 Impact factor: 5.828
Authors: Paul R Torgerson; Brecht Devleesschauwer; Nicolas Praet; Niko Speybroeck; Arve Lee Willingham; Fumiko Kasuga; Mohammad B Rokni; Xiao-Nong Zhou; Eric M Fèvre; Banchob Sripa; Neyla Gargouri; Thomas Fürst; Christine M Budke; Hélène Carabin; Martyn D Kirk; Frederick J Angulo; Arie Havelaar; Nilanthi de Silva Journal: PLoS Med Date: 2015-12-03 Impact factor: 11.069