Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province.
Department of Hepatobiliary & Pancreatic Surgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, P. R. China.
Medicine (Baltimore). 2021 Feb 26;100(8):e24744. doi: 10.1097/MD.0000000000024744.
Retroperitoneal echinococcosis (RE) is a rare condition that is associated with a high mortality and disability rate. It is associated with a high rate of misdiagnosis, a high risk of surgery, and is extremely difficult to manage. There is no uniform standard for determining the exact form of surgical method and the timing of surgery.This was a retrospective analysis of the characteristics and surgical management of patients diagnosed with RE in our hospital between 2012 and 2019.Between 2012 and 2019, 1257 cases of echinococcosis and 121 cases of RE were diagnosed in our hospital. Of these, 68 cases involved surgical treatment, 53 involved non-surgical treatment, and 12 cases were lost to follow-up (4 cases in the surgical group and 8 cases in the non-surgical group). Thus, 109 cases were followed-up. RE cases were divided according to different treatment methods into a radical resection group (Group A, 31 cases), a non-radical resection group (Group B, 37 cases), and a non-surgical group (Group C, 53 cases). We carried out a detailed analysis of the 109 cases experiencing surgical intervention with effective follow-up.Our analysis found that radical resection is the first line of treatment of RE, although non-radical surgery can benefit most patients. It is important to emphasize the importance of the first round of surgery, particularly in cases involving hepatic echinococcosis. If the lesion can be removed radically during the first round of surgery, then radical surgery should be performed.
腹膜后包虫病 (RE) 是一种罕见的疾病,其死亡率和致残率很高。它与误诊率高、手术风险高且极难管理有关。目前,对于确定手术方式的确切形式和手术时机还没有统一的标准。这是对 2012 年至 2019 年期间我院诊断为 RE 的患者的特征和手术治疗进行的回顾性分析。2012 年至 2019 年间,我院共诊断出 1257 例包虫病和 121 例 RE。其中,68 例患者接受了手术治疗,53 例患者接受了非手术治疗,12 例患者失访(手术组 4 例,非手术组 8 例)。因此,有 109 例得到随访。根据不同的治疗方法,RE 病例被分为根治性切除术组(A 组,31 例)、非根治性切除术组(B 组,37 例)和非手术组(C 组,53 例)。我们对 109 例接受有效随访的手术干预患者进行了详细分析。我们的分析发现,根治性切除术是 RE 的一线治疗方法,尽管非根治性手术可以使大多数患者受益。强调首轮手术的重要性非常重要,特别是对于肝包虫病。如果在首轮手术中可以彻底切除病变,则应进行根治性手术。