Steinkraus Kira Carlotta, Birgin Emrullah, Zaimi Marin, Grüner Beate, Rahbari Nuh, Kornmann Marko
Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany.
Department of General, Visceral, and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Visc Med. 2025 Apr 3:1-8. doi: 10.1159/000545413.
Alveolar echinococcosis (AE) is a significant health concern worldwide, primarily affecting the liver. The standard treatment of surgical removal faces significant challenges due to the complex nature of AE. Despite advancements in pharmacological treatments, surgery complemented by at least 2 years of adjuvant medical treatment post-surgery remains the primary curative approach for AE.
The introduction of minimally invasive techniques, such as laparoscopic and robot-assisted surgery, has expanded surgical options, offering reduced recovery times and minimized surgical trauma while maintaining efficacy and safety comparable to traditional open surgery. Robotic surgery, known for its enhanced precision and visualization, emerges as a preferable method for complex resections in AE treatment, despite challenges such as high costs and the need for specialized training.
The decision on the surgical approach is influenced by several factors, including parasite size, patient health, and technology availability. However, there is a clear preference for robotic procedures for their potential to offer better outcomes, though long-term data on outcomes and recurrence rates are needed. The treatment of AE, therefore, underscores the importance of an interdisciplinary approach and the advantages of minimally invasive surgery, advocating for its application in high-volume centers to optimize patient outcomes.
肺泡型棘球蚴病（AE）是全球范围内一个重要的健康问题，主要影响肝脏。由于AE的复杂性，手术切除的标准治疗面临重大挑战。尽管药物治疗取得了进展，但手术辅以术后至少2年的辅助药物治疗仍然是AE的主要治愈方法。
腹腔镜和机器人辅助手术等微创技术的引入扩大了手术选择，在保持与传统开放手术相当的疗效和安全性的同时，缩短了恢复时间并减少了手术创伤。机器人手术以其更高的精度和可视化而闻名，尽管存在成本高和需要专门培训等挑战，但它已成为AE治疗中复杂切除的首选方法。
手术方式的选择受多种因素影响，包括寄生虫大小、患者健康状况和技术可用性。然而，尽管需要关于手术效果和复发率的长期数据，但由于机器人手术有可能提供更好的结果，因此明显更倾向于选择机器人手术。因此，AE的治疗凸显了多学科方法的重要性以及微创手术的优势，提倡在大型中心应用微创手术以优化患者治疗效果。
