Department of Gastrointestinal Surgery, Sahloul Hospital, Sousse, Tunisia.
Department of Gastrointestinal Surgery, Synergy Institute of Medical Sciences, Dehradun, India.
Am J Surg. 2022 Jul;224(1 Pt A):190-195. doi: 10.1016/j.amjsurg.2021.12.014. Epub 2021 Dec 16.
The management of liver hydatid cysts (LHC) is complex and includes surgery, percutaneous drainage, chemotherapy and observation. Broadly, there are two types of surgical treatment for LHC - conservative surgery (CS) and radical surgery (RS). The purpose of this study was to compare the outcome of RS and CS.
Data from all patients with LHC treated in Sahloul Hospital, between January 2000 and December 2019, were retrieved. To minimize selection bias, paired comparison analysis (PCA) was performed.
A total of 914 patients were included in this study. RS and CS were performed in 284 and 630 patients, respectively. After PCA, 206 patients were included in each group. The incidence of intraoperative bleeding was significantly higher in the RS group. The overall morbidity was significantly lower in the RS group. Thity-four patients developed recurrence with significantly higher recurrence in CS group.
RS is associated with fewer postoperative complications and lower recurrence rate compared to CS. RS may be the preferred procedure for LHC if the expertise is available.
肝包虫囊肿（LHC）的治疗较为复杂，包括手术、经皮引流、化疗和观察。广义上，LHC 的手术治疗有两种类型——保守手术（CS）和根治性手术（RS）。本研究旨在比较 RS 和 CS 的治疗结果。
检索了 2000 年 1 月至 2019 年 12 月在 Sahloul 医院治疗的所有 LHC 患者的数据。为了最大程度地减少选择偏倚，进行了配对比较分析（PCA）。
本研究共纳入 914 例患者。RS 和 CS 分别在 284 例和 630 例患者中进行。PCA 后，每组纳入 206 例患者。RS 组术中出血量明显较高。RS 组总体并发症发生率明显较低。34 例患者复发，CS 组复发率明显较高。
与 CS 相比，RS 术后并发症发生率较低，复发率较低。如果具备专业知识，RS 可能是 LHC 的首选治疗方法。
