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Surgical approaches for definitive treatment of hepatic alveolar echinococcosis: results of a survey in 178 patients

机译：肝脏肺炎间能的明确治疗手术方法：178例患者调查结果

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Hepatic alveolar echinococcosis (HAE) is a potentially fatal disease caused by the larval growth of Echinococcus multilocularis. We analysed the clinical data of 178 consecutive HAE patients treated with definitive radical surgery at our institution. According to the surgical approach: group A patients underwent direct radical hepatic resection; group B patients first underwent percutaneous puncture external drainage, followed by radical hepatic resection 2 months later; group C patients underwent a two-step hepatic resection; and group D patients underwent liver transplantation. The baseline characteristics, mortality, postoperative complications and recurrence rates were evaluated. Symptoms were present in 79.8% (142/178) patients. Bi-lobar lesion was found in 34 (19.1%, 34/178) patients, 47.2% (84/178) of whom had ?2 lesions each. There were no intraoperative deaths. The postoperative mortality was 2.29% in group A, 8.62% in group D and 0% in groups B and C. The main cause of death was a serious postoperative complication (Clavien–Dindo grades III–V). Patients were followed-up systematically for a median of 35.8 months (8–72) without recurrence. Active HAE should be treated by radical liver resection, and the complicated alveolar echinococcosis of the liver has been managed whenever possible using principles of radical liver resection by experienced hepatic surgeons.
机译：肝脏肺泡棘球凸（HAE）是因呼吸能球菌多包幼虫的幼虫生长引起的潜在致命疾病。我们分析了在我们机构的最终自由基手术治疗的178名连续HAE患者的临床资料。根据外科手术方法：组患者接受直接肝切除术; B组患者首先经过经皮穿刺外引流，其次2个月后肝切除术; C组患者经历了两步肝切除术;和D组接受肝移植的患者。评估基线特征，死亡率，术后并发症和复发率。 79.8％（142/178）患者中存在症状。 Bi-Lobar病变被发现在34名（19.1％，34/178）患者中，47.2％（84/178），其中2个病变。没有术中死亡。 A组术后死亡率为2.29％，d群D.62％和B组，B和C组。死亡的主要原因是一个严重的术后并发症（Clavien-dindo等级III-V）。患者被系统地随访35.8个月（8-72），没有复发。活性HAE应通过自由基肝切除治疗，并且只要使用经验丰富的肝外科医生使用自由基肝切除原理，肝脏的复杂性肺泡显色病程已经管理。

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