More Than 25 Years of Surgical Treatment of Hydatid Cysts in a Nonendemic Area Using the “Frozen Seal” Method

Abstract

Background Hydatid disease of the liver remains endemic in the world and is an imported disease in The Netherlands. The aim of this study was to evaluate the treatment and outcome of surgically treated patients for hydatid disease in a single center in The Netherlands. Methods This retrospective study included 112 consecutive patients surgically treated for hydatid disease between 1981 and 2007. The primary outcome was relapse of the disease. Secondary outcomes were infections, complications, reoperations, length of hospital stay, and mortality.Results In all cases, echinococcosis was diagnosed by computed tomography or ultrasonography (US). Serology (enzyme-linked immunosorbent assay, immunofluorescence) confirmed the diagnosis in 92.9%. Most of the cysts were seen only in the liver (73.5%). All cysts were operated on with the frozen seal technique. Relapse of disease was seen in 9 (8.0%) cases. Five (4.5%) required surgical treatment at a later stage. Twenty (17.9%) complications were recorded. Four (3.6%) needed radiological drainage and three (2.7%) a reoperation. Follow-up was performed with US and/or serology at a mean of 24 months (range 0.5-300 months). All but one complication were seen in the liver-operated group, this proved not to be of statistical significance (P = 0.477). Patients with complications stayed significantly longer in hospital than did the patients without complications (P \ 0.001). No mortality was observed in this study. Conclusions The present study suggests that the frozen seal method of surgery for hydatid disease is safe and effective. Future studies are needed to prove its position in the treatment of hydatid disease as new developments show promising results.

Study of operated primary and secondary [recurrence] hydatidosis in hospitals of Kermanshah, west of Islamic Republic of Iran

“…In addition, a study in 2010 observed the recurrence of hydatid disease to be 8% during a median follow-up period of 33 months. Other studies indicated a reported incidence between 1.1%-25%, which may be caused by spilling of the cyst's contents during a previous operation [4]. In Iraq, in which 14.5% of patients had cystic lesions in the liver or other abdominal organs, no recurrences of hydatidosis were observed, except in 1 patient who was referred to a surgery department as a case of pleural effusion drainage despite albendazole therapy [26].…”

“…Other surgeons recommended albendazole for 3 21-day courses with 10-day rest periods between courses and only 1 recurrence was reported from month 1-72 [26]. Some suggested that the frozen-seal technique is safe and effective for the surgical treatment of hydatid disease in non-endemic areas and results showed the recurrence rates and mortality rates were lower [4]. In our study, surgical methods and the use of chemotherapeutic agents such as albendazole were employed, even though the secondary or recurrence rates were higher than in other studies (6.2%).…”

“…Hydatid disease is endemic in sheep-raising areas of Africa, the Mediterranean region of Europe, the Middle East, Greece, Asia, South America, Australia and New Zealand [4,5]. The parasite has a very wide geographical distribution [6] and there is evidence for the emergence or re-emergence of human cystic echinococcosis in parts of China, Central Asia, Eastern Europe and Israel.…”

Surgical management of symptomatic hydatid liver disease: experience from a Western centre

“…[3][4][5][6] Over the years, a few contributions from Western centres have appeared, originating mostly in Europe. 7,9,10 In contrast, the North American experience with hydatid disease remains extremely limited owing to the rarity of this pathology and is restricted to rare series and occasional case reports. 8,11 To our knowledge, the present series represents the largest combined surgical experience with hydatid disease of the liver in North America.…”

“…[3][4][5][6] In contrast, liver surgeons working in Western centres -particularly North American hospitals -can be expected to treat only a handful of such patients over the course of their careers. [7][8][9][10][11] In this context, it becomes particularly important to define surgical treatment strategies that are specific to the expertise of Western liver surgeons, which is lacking in the literature. We sought to review a single North American tertiary care centre's experience with patients who underwent liver surgery for hydatid cysts of the liver.…”