Recent advances in surgical strategies for alveolar echinococcosis of the liver

Kamiyama, Toshiya

doi:10.1007/s00595-019-01922-6

Cited by 30 publications

(20 citation statements)

References 48 publications

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“…In the study by Joliet and colleagues [12], the probability of minor and major complications was even higher, at 25% (15/59) and 9% (5/59), respectively. At the same time, a study has shown that the mortality rate of HAE patients undergoing radical surgery is 0-3.5% [24]. But, in our study, the rate of minor complications after MWA was 11.1% (5/45), and there were no serious complications and deaths.…”

Section: Discussioncontrasting

confidence: 57%

Effectiveness and Safety of Ultrasound-guided Percutaneous Microwave Ablation for Hepatic Alveolar Echinococcosis

Deng

Wang

et al. 2021

Preprint

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BackgroundMicrowave ablation (MWA) is a popular therapy for liver malignant tumor in recent years. Few studies have been conducted on its use in the treatment of hepatic alveolar echinococcosis (HAE). The study aims to evaluate the efficacy and safety of MWA in the treatment of HAE.MethodsThis study analyzed the data of 45 patients (mean age,38 ±2 years; 24 males) diagnosed with HAE and underwent MWA treatment between June 2014 to December 2019. The patients after MWA were examined by CT or MRI to determine whether the lesions were relapsed and to evaluate the therapeutic effect of MWA. The safety of MWA was evaluated by monitoring postoperative complications. Clinical data, such as patient demographics, imaging features of the lesions, relevant findings of laboratory tests before and after ablation, and information related to ablation, were collected and analyzed. Paired-sample t tests and paired-sample Wilcoxon signed-rank tests were used to compare relevant laboratory indicators before and after MWA. ResultsMWA was applied to 57 HAE lesions in 45 patients. The median size of lesions was 3.42 cm (IQR2.85-4.41). The rate of complete ablation was 100% (57/57). The median follow-up time was 32 months (IQR 23–48.5). The recurrence rate was 13% (6/45), and the median time of recurrence was 22 months. The rate of minor complications was 11.1% (5/45), and there were no major complications and deaths. Compared to preoperative, ALB, RBC, HBG, and PLT were decreased (p<0.001); ALT, TB, DB, and WBC were increased (p<0.001); and no statistically difference in PT, APTT, and INR (p＞0.05).ConclusionsMWA is a safe and effective way to cure HAE. Meanwhile, it provides a new option and a new way of thinking about the treatment modality for patients with lesions ≤ 5 cm in diameter.

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Section: Discussioncontrasting

confidence: 57%

Effectiveness and Safety of Ultrasound-guided Percutaneous Microwave Ablation for Hepatic Alveolar Echinococcosis

Deng

Wang

et al. 2021

Preprint

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“…After surgery and the start of benzimidazole therapy, e.g., with albendazole, surveillance for 10 years to detect possible recurrence is strongly advised. In palliative situations, interventional procedures are to be favored over palliative surgery, which is to be avoided in any situation possible (2)(3)(4)(5).…”

Section: Discussionmentioning

confidence: 99%

“…There are two treatment options: (1) parasitostatic treatment with benzimidazoles, which is indicated in cases where curative resection is not possible or suitable, and (2) radical resection with safety margins of 2 cm. However, safety margins of 1 mm have also been tolerated without recurrence of disease (2)(3)(4)(5). Following an R0 resection, albendazole treatment is recommended for at least 2 years.…”

Section: Introductionmentioning

confidence: 99%

Case Report: Successful DaVinci-Assisted Major Liver Resection for Alveolar Echinococcosis

et al. 2021

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We report a case of successful robot-assisted major liver resection in a patient with liver alveolar echinococcosis (AE). A 62-year-old male patient was incidentally diagnosed with a large infiltrative lesion in the right liver lobe suspicious for AE. A radical surgical resection as a right-sided hemihepatectomy was indicated. The operation was carried out via a robotic-assisted procedure using the DaVinci Xi Surgical System. The tumor measured 12.4 × 8.8 cm and was successfully resected through a suprapubic incision of 13 cm. The patient was free of pain after the second post-operative day. A fluid collection near the resection plate was easily drained without bile leakage. The patient had no surgical complications. Radical resection is inevitable for adequate curative therapy of AE and provides clear margins. Robotic surgery is a relatively new and safe option for curative resection of AE lesions, with remarkable advantages for patients and surgeons.

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“…Besides, achieving 2 cm resection margin for every single lesion is not possible in most advanced cases as recommended [3,4,28,30]. For excessive vascular in ltrated lesion or with severe comorbidities, only liver transplantation or ex vivo liver resection and autotransplantation could be selected from the perspective surgical treatment [11,[31][32][33][34][35][36][37][38][39][40]. Our data indicated that, different lesion types had different immune cell in ltrated belt.…”

Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of range and metabolic activity of hepatic alveolar echinococcosis lesion microenvironment using PET/CT and multi-site sampling method

Aini

Yimingjiang

Yasen

et al. 2020

Preprint

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Background: Alveolar echinococcosis (AE) lesion microenvironment (LME) is crucial site where parasite-host interactions happen and of great significance during surgery and obtaining liver samples for basic research targeting immunology. However, little is known about quantification of LME range and its’ metabolic activity regarding different lesion types.Methods: A prospective analysis of LME from consecutive surgical AE cases with relevant imaging results was performed. Patients (n=39) received abdominal computed tomography (CT) and position emission tomography/computed tomography using 18F-fluodeoxyglucose (18F-FDG-PET/CT) within one week prior to surgery. Tumor to background ratios (TBRs) of standard uptake value (SUV) in PET/CT was calculated for corresponding LME regions. Multi-site sampling method (MSS, n=26) was introduced to obtain histological slides from LME at different levels off the lesion to evaluate immune cell infiltrative ranges quantitatively. At last, data was statistically analyzed from the perspective of different lesion types.Results: Altogether six major lesion categories have been identified based on different morphology and calcification pattern (A: non-calcified uniform density lesion; B: diffuse calcified solid lesion; C: half necrotic and half solid lesion with minor calcification; D: half necrotic and half solid lesion with obvious calcification; E: subtotal necrotic lesion with minor calcification; F: total necrotic lesion with obvious calcification). Statistical significances were resulted from TBRs calculation (A>B, A>D, A>F, B<C, B<E, A+C+E>B+D+F, etc.). Less calcified lesions were evidenced with higher TBRs, however, not much was valuable for necrosis. The 95% CI of LME ranges were (10.0, 12.1) mm and (9.9, 14.0) mm by PET/CT and MSS. And, weak regressions between TBRs and LME ranges indicated by PET/CT or MSS (r2 respectively were 0.2436 and 0.3171) were observed.Conclusions: PET/CT showed distinct TBRs for different lesion types with heterogenic calcification. PET/CT and MSS had similar discoverability for LME ranges, which also varied among different lesion types. Higher activity meant wider LME range within certain limit. This pioneering study would be able to provide references for both surgical removal of lesions and sample acquisitions more accurately for basic research targeted to immunology.

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Recent advances in surgical strategies for alveolar echinococcosis of the liver

Cited by 30 publications

References 48 publications

Effectiveness and Safety of Ultrasound-guided Percutaneous Microwave Ablation for Hepatic Alveolar Echinococcosis

Effectiveness and Safety of Ultrasound-guided Percutaneous Microwave Ablation for Hepatic Alveolar Echinococcosis

Case Report: Successful DaVinci-Assisted Major Liver Resection for Alveolar Echinococcosis

Quantitative evaluation of range and metabolic activity of hepatic alveolar echinococcosis lesion microenvironment using PET/CT and multi-site sampling method

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