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

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.