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肝-肾双器官肺泡或囊性棘球蚴病同期联合手术:一项回顾性研究。

Simultaneous combined surgery for hepatic-renal double organ alveolar or cystic echinococcosis: A retrospective study.

作者信息

Tulahong Alimu, Zhu Da-Long, Liu Chang, Jiang Tie-Min, Zhang Rui-Qing, Tuergan Talaiti, Aji Tuerganaili, Shao Ying-Mei

机构信息

Department of Hepatobiliary and Echinococcosis Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.

出版信息

World J Gastrointest Surg. 2025 Jun 27;17(6):105007. doi: 10.4240/wjgs.v17.i6.105007.

Abstract

BACKGROUND

Alveolar and cystic echinococcoses are lethal zoonotic diseases caused by and infections, leading to alveolar echinococcosis (AE) or cystic echinococcosis (CE), respectively. No study has hitherto reported effective treatment approaches for AE or CE with concurrent hepatorenal involvement.

AIM

To investigate the feasibility and efficacy of simultaneous combined surgery (SCS) as a comprehensive treatment approach for patients with hepatorenal echinococcosis.

METHODS

Clinical datasets of hepatorenal AE ( = 10) and CE ( = 11) patients were retrospectively collected and systematically analyzed. The SCS approach was introduced, and surgical outcomes, complications, and prognoses were documented in detail.

RESULTS

The SCS approach incorporated hybridized techniques, including partial hepatectomy, partial or total nephrectomy, liver resection and autotransplantation, and total or subtotal cystectomy with endocystectomy. Radical SCS was achieved in 100% of AE patients and 63.6% of CE patients. All surgeries were completed without intraoperative complications. The short-term complication rate was 28.6% (Clavien-Dindo classification: AE-1 IIIb, 3 IIIa; CE-2 II), while the long-term complication rate was 4.8% (Clavien-Dindo classification: AE-1 IIIb). Patients were followed up for a median of 37 months (AE: 6-81 months; CE: 34-123 months), with no reported deaths or disease relapses.

CONCLUSION

CS appears to be a feasible and effective treatment method for patients with hepatorenal involvement of AE or CE. It fulfills the management criteria for advanced AE or CE cases, aiming to maximize patient benefits.

摘要

背景

肺泡型和囊型棘球蚴病是由 和 感染引起的致命性人畜共患病,分别导致肺泡型棘球蚴病(AE)或囊型棘球蚴病(CE)。迄今为止,尚无研究报道针对合并肝肾功能受累的AE或CE的有效治疗方法。

目的

探讨同期联合手术(SCS)作为肝肾棘球蚴病患者综合治疗方法的可行性和疗效。

方法

回顾性收集并系统分析肝肾AE患者( = 10)和CE患者( = 11)的临床数据集。引入SCS方法,并详细记录手术结果、并发症和预后情况。

结果

SCS方法采用了多种联合技术,包括肝部分切除术、部分或全肾切除术、 肝切除术及自体肝移植,以及囊肿全切除或次全切除并内囊摘除术。100%的AE患者和63.6%的CE患者实现了根治性SCS。所有手术均无术中并发症。短期并发症发生率为28.6%(Clavien-Dindo分类:AE - 1例Ⅲb级,3例Ⅲa级;CE - 2例Ⅱ级),长期并发症发生率为4.8%(Clavien-Dindo分类:AE - 1例Ⅲb级)。患者中位随访37个月(AE:6 - 81个月;CE:34 - 123个月),无死亡或疾病复发报告。

结论

SCS似乎是治疗合并肝肾功能受累的AE或CE患者的一种可行且有效的治疗方法。它符合晚期AE或CE病例的管理标准,旨在使患者受益最大化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39cf/12188600/3f3473035d07/wjgs-17-6-105007-g001.jpg

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