Abstract
ObjectiveTo retrospectively analyze the effects of radical lesion resection and quasi radical lesion resection on the quality of life of patients with advanced hepatic alveolar echinococcosis.MethodsThrough the existing HIS system of Qinghai Provincial People's Hospital, 104 patients with hepatic alveolar echinococcosis who underwent surgical treatment in our hospital from January 2012 to December 2017 and completed the quality of life questionnaire were selected as the research objects. The above cases were divided into radical group (n = 51) and quasi-radical group (n = 53) according to different surgical methods (degree of radical cure). The quality of life of patients with hydatidosis was measured by interview or telephone follow-up. The preoperative indexes, intraoperative conditions and postoperative recovery indicators of the two groups were observed, such as Child-Puhg grade, PNM classification, scope of hepatectomy, intraoperative bleeding, Clavien grade, incidence of complications, 5-year recurrence rate and total score of quality of life and so on.ResultsThere was no significant difference between the two groups in general data such as age, gender, hydatid size, Child-Puhg grade and preoperative liver function (P > 0.05). However, there was a statistically significant difference in PNM classification between the two groups (P < 0.05). There were significant differences in intraoperative bleeding, postoperative liver function recovery, Clavien grade of complication severity and 5-year recurrence rate between the two groups (P < 0.05). There was no significant difference in postoperative quality of life between the two groups (P > 0.05).ConclusionFor patients with advanced hepatic alveolar echinococcosis whose objective cannot be achieved by conventional hepatectomy, quasi-radical resection of the lesion can not only reduce the risk and difficulty of surgery, but also the quality of life of the patients may be as good as that of radical resection.
Highlights
Hepatic alveolar echinococcosis (HAE) is a common parasitic disease caused by multilocular Echinococcus infection [1,2,3], it is a benign parasitic disease, its biological behavior is malignant, so it is called “Hydatid Cancer.” Hepatic alveolar echinococcosis shows a similar pattern to malignancies in terms of radiologic and clinical features
Radical lesion resection: The range of liver resection should be more than 1.0 cm above the edge of hydatid lesion, and the surgical margin should reach R0 resection
Indications: According to the WHO Guidelines for Diagnosis and Treatment of Echinococcosis [17], patients who are diagnosed with hepatic alveolar echinococcosis and whose lesions are larger than 5.0 cm in diameter and can tolerate surgery should undergo radical resection
Summary
Hepatic alveolar echinococcosis (HAE) is a common parasitic disease caused by multilocular Echinococcus infection [1,2,3], it is a benign parasitic disease, its biological behavior is malignant, so it is called “Hydatid Cancer.” Hepatic alveolar echinococcosis shows a similar pattern to malignancies in terms of radiologic and clinical features. Hepatic alveolar echinococcosis shows a similar pattern to malignancies in terms of radiologic and clinical features. Quasi-radical lesion resection is an operation in which the lesion resection range reaches more than 95% and the residual hydatid lesion is inactivated after electrocoagulation This procedure is an alternative operation for patients with endstage hepatic alveolar echinococcosis who cannot undergo radical lesion resection and whose family members refuse to undergo in vitro hepatectomy and autologous liver transplantation. Guo Min [16] from Xinjiang Medical University developed the first evaluation index system of QoL of patients with hydatid surgery in China. This scale was in line with the humanistic beliefs, geographical environment and social factors of the Qinghai-Tibet Plateau, and had high credibility for hydatid patients in Xinning region. The relationship between surgical methods and QoL was discussed as the entry point, and the efficacy of various surgical methods was evaluated
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