Clinical experiences in the treatment of human multi-organ alveolar echinococcosis by surgery and drugs

Abstract

To explore the approach of operation plus chemotherapy in the treatment and diagnosis of human complicated alveolar echinococcosis (AE) in multi-organs (liver, lung and brain). The clinical data for 17 cases of alveolar echinococcosis were reviewed by a follow-up of 1 - 7 years between 2000 and 2009 at our hospital. Among 17 cases, 8 cases achieved an excellent effect after taking liposomal albendazole, 3 cases received radical hepatectomy and 1 case pneumonectomy with a better effect, 1 case of palliative liver transplantation had lung metastasis and stayed on a long-term therapy of liposomal albendazole. Another case of liver transplantation received a long-term postoperative chemotherapy. And the metastases of lung and brain were found. Three operative cases suffered serious complications in liver and brain and received a long-term chemotherapy. One of them died of serious brain complications after a 6-month follow-up. And one advanced AE patient died at home due to a refusal of any further treatment. Since more than two organs are involved by AE lesion of alveolar echinococcosis, it was rather difficult to diagnose and cure AE radically by complicated surgery. Thus the life quality and long-term survival of patients were seriously endangered. Based on surgical approaches for serious complications and a comprehensive medical therapy, the multi-organ AE patients may have a prolonged survival and an improved clinical outcome.