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Retrospective Study of Cystic Echinococcosis in a Recent Cohort of a Referral Center for Liver Surgery

Authors
  • Escolà-Vergé, Laura1
  • Salvador, Fernando1
  • Sánchez-Montalvá, Adrián1
  • Escudero-Fernández, José Miguel2
  • Sulleiro, Elena3
  • Rando, Ariadna3
  • Bilbao, Itxarone4
  • Lázaro, José Luis4
  • Serres, Xavier2
  • Salvador, Josep2
  • Molina, Israel1
  • 1 Hospital Universitari Vall d’Hebron, PROSICS Barcelona, Department of Infectious Diseases, P° Vall d’Hebron 119-129, Barcelona, 08035, Spain , Barcelona (Spain)
  • 2 Hospital Universitari Vall d’Hebron, Department of Radiology, Barcelona, Spain , Barcelona (Spain)
  • 3 Hospital Universitari Vall d’Hebron, PROSICS Barcelona, Microbiology Department, Barcelona, Spain , Barcelona (Spain)
  • 4 Hospital Universitari Vall d’Hebron, Department of Hepatopancreatobiliary Surgery and Transplants, Barcelona, Spain , Barcelona (Spain)
Type
Published Article
Journal
Journal of Gastrointestinal Surgery
Publisher
Springer-Verlag
Publication Date
Sep 21, 2018
Volume
23
Issue
6
Pages
1148–1156
Identifiers
DOI: 10.1007/s11605-018-3971-y
Source
Springer Nature
Keywords
License
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Abstract

BackgroundCystic echinococcosis (CE) is a zoonosis endemic in Spain caused by the larval stage of the cestode Echinococcus granulosus and is one of the 18 neglected tropical diseases recognized by the WHO. The aim of this study was to describe the epidemiological and clinical data of CE in a surgical referral hospital.MethodsA retrospective descriptive study of all adults’ patients diagnosed with CE and followed at Vall d’Hebron University Hospital in Barcelona, Spain, between 2000 and 2015.ResultsWe found 151 cases, 78 (51.7%) women, and median age at diagnosis was 68 (range, 15–92) years. Diagnosis was a radiological finding in 97 (64.2%) and the most frequent location was the liver [135 (89.4%) patients]. Nearly 80% of the cysts were calcified and serology was positive in 48 (51.6%). The WHO-IWGE classification was only available in 70 of the 104 (67.3%) cases of liver cysts that had an ultrasound. First therapeutic plan was “watch and wait” followed by surgery. International recommendations were not always followed, particularly in CE4 and CE5 stages, and 20% needed a change of treatment because of progression or recurrence. Patients treated surgically were younger, more symptomatic, and had larger and less calcified cysts in multiple sites. Serology was not useful for CE diagnosis and neither serology nor calcification of the cyst helped to predict viability.ConclusionsThe formation of multidisciplinary teams in reference hospitals could help to improve CE diagnosis, its management, and follow-up, since international recommendations are not usually followed.

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