Reappraisal of the impact of resection margin on outcomes after hepatectomy and perioperative treatment for Alveolar echinococcosis a single center experience

IF 2.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2025-10-01 DOI:10.1016/j.hpb.2025.07.002

Antoine Notte , Alexandre Doussot , Paul Calame , Carine Richou , Frédéric Grenouillet , Damien Montange , Florent Demonmerot , Laurence Millon , Delphine Weil-Verhoeven , Solange Bresson-Hadni , Bruno Heyd , Célia Turco

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引用次数: 0

Abstract

Background

Alveolar echinococcosis (AE) is a rare benign but potentially life-threatening condition. Albeit benign, recurrence after surgical resection remains frequent. Systematic perioperative benzimidazoles (BZM) treatment along with complete and large resection margin have been advocated to prevent recurrence, although data on long-term outcomes are lacking.

Methods

Consecutive patients who underwent hepatectomy for AE between 2005 and 2023 were included. Perioperative management and long-term outcomes were analyzed.

Results

Over the study period, 76 patients underwent hepatectomy for AE, of which 71 (93 %) received preoperative antiparasitic treatment. R0 rate was 58 % and R1 resection rate was 41 %, including 21 planned R1 resections. Severe morbidity occurred in 7 patients (9 %) including one postoperative death. Overall, 70 patients (92 %) received postoperative treatment for a median duration of 24 months (range, 10–108). After a median follow-up of 48 months (range, 10–226), 2 patients developed recurrence. No recurrence was observed in patients who underwent planned R1 resections. Overall survival at 5 and 10 years were 99 % and 86 % respectively.

Conclusion

Hepatectomycombined with perioperative parasitostatic treatment allowed prolonged overall survival similar to the general population. R1 resection does not seem to influence survival.

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重新评估切除边缘对肺泡包虫病肝切除术和围手术期治疗结果的影响：单中心经验。

背景：肺泡包虫病（AE）是一种罕见的良性但可能危及生命的疾病。虽然是良性的，但手术切除后复发仍然很频繁。尽管缺乏长期结果的数据，但围手术期系统的苯并咪唑（BZM）治疗以及完全和大切除边缘被提倡预防复发。方法：纳入2005年至2023年间因AE接受肝切除术的连续患者。分析围手术期处理及远期疗效。结果：在研究期间，76例AE患者行肝切除术，其中71例（93%）术前接受了抗寄生虫治疗。R0率为58%，R1切除率为41%，其中计划R1切除21例。7例（9%）患者出现严重并发症，包括1例术后死亡。总体而言，70名患者（92%）接受了术后治疗，中位持续时间为24个月（范围10-108个月）。中位随访48个月（范围10-226）后，2例患者复发。在计划进行R1切除的患者中未观察到复发。5年和10年的总生存率分别为99%和86%。结论：肝切除术联合围手术期抑菌治疗可延长患者的总生存期，与普通人群相似。R1切除似乎不影响生存。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).