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Abstract：
BACKGROUND: Radical or conservative surgical treatment for hepatic Cystic Echinococcosis (hepatic CE) is controversial. We aimed to measure the association between radical surgery (RS) versus conservative surgery (CS) and short-term outcomes in our cohort.
METHODS: Medical records of hepatic CE patients\' demographic, clinical, radiological, operative and postoperative details who underwent surgical treatment between January 3, 2017 and January 3, 2018 at the Department of General Surgery, Nyingchi People\'s Hospital, Nyingchi, China, were retrieved and analyzed. The primary outcome was overall morbidity. The secondary outcomes included: (i) bile leakage; (ii) complications of lung, pleura, heart, liver, pancreas and biliary tract; (iii) incision infection and residual cavity abscess formation; (iv) anaphylactic reaction and shock; (v) tear of surrounding tissues; (vi) hospital and post-operative length of stay (LOS); (vii) length of surgery; (viii) blood loss during surgery. Multivariable logistic/linear regression models with various adjustment strategies for confounders were performed to evaluate the association.
RESULTS: A total of 128 hepatic CE patients were included with 82 (64.1%) and 46 (35.9%) receiving CS and RS, respectively. After fully adjusted, RS was associated with 60% lower risk of overall complication (aOR 0.4; 95%CI, 0.2-0.9) and 0.6-h shorter surgical time (aβ 0.4; 95%CI,-0.0-0.8) comparing to CS. However, RS was associated with more blood loss during surgery (aβ 179.3; 95%CI, 54.2-304.5).
CONCLUSIONS: To conclude, RS was associated with a 60% reduction in developing overall complication in the short term, but may result in more blood loss during surgery than CS.
METHODS: Medical records of hepatic CE patients\' demographic, clinical, radiological, operative and postoperative details who underwent surgical treatment between January 3, 2017 and January 3, 2018 at the Department of General Surgery, Nyingchi People\'s Hospital, Nyingchi, China, were retrieved and analyzed. The primary outcome was overall morbidity. The secondary outcomes included: (i) bile leakage; (ii) complications of lung, pleura, heart, liver, pancreas and biliary tract; (iii) incision infection and residual cavity abscess formation; (iv) anaphylactic reaction and shock; (v) tear of surrounding tissues; (vi) hospital and post-operative length of stay (LOS); (vii) length of surgery; (viii) blood loss during surgery. Multivariable logistic/linear regression models with various adjustment strategies for confounders were performed to evaluate the association.
RESULTS: A total of 128 hepatic CE patients were included with 82 (64.1%) and 46 (35.9%) receiving CS and RS, respectively. After fully adjusted, RS was associated with 60% lower risk of overall complication (aOR 0.4; 95%CI, 0.2-0.9) and 0.6-h shorter surgical time (aβ 0.4; 95%CI,-0.0-0.8) comparing to CS. However, RS was associated with more blood loss during surgery (aβ 179.3; 95%CI, 54.2-304.5).
CONCLUSIONS: To conclude, RS was associated with a 60% reduction in developing overall complication in the short term, but may result in more blood loss during surgery than CS.
摘要：
背景：肝囊性棘球蚴病（肝CE）的根治性或保守性手术治疗存在争议。我们的目的是在我们的队列中测量根治性手术（RS）与保守性手术（CS）与短期结局之间的关联。
方法：肝CE患者的医疗记录临床,放射学,2017年1月3日至2018年1月3日在普外科接受手术治疗的手术和术后细节，林芝人民医院,林芝,中国,进行了检索和分析。主要结果是总体发病率。次要结果包括：（i）胆漏；（ii）肺部并发症，胸膜,心,肝脏,胰腺和胆道;(iii)切口感染和残余腔脓肿形成;(iv)过敏反应和休克;(v)周围组织撕裂;(vi)住院和术后住院时间(LOS);(vii)手术时间;(viii)手术期间失血。使用具有各种混杂因素调整策略的多变量逻辑/线性回归模型来评估相关性。
结果：共128例肝性CE患者，其中82例（64.1%）和46例（35.9%）接受CS和RS，分别。完全调整后,与CS相比，RS与总并发症风险降低60％（aOR0.4;95CI，0.2-0.9）和手术时间缩短0.6小时（aβ0.4;95CI，-0.0-0.8）相关。然而,RS与手术中更多的失血有关（aβ179.3；95CI，54.2-304.5）。
结论：总而言之，RS与短期内发生整体并发症减少60%相关，但在手术过程中可能导致比CS更多的失血。
方法：肝CE患者的医疗记录临床,放射学,2017年1月3日至2018年1月3日在普外科接受手术治疗的手术和术后细节，林芝人民医院,林芝,中国,进行了检索和分析。主要结果是总体发病率。次要结果包括：（i）胆漏；（ii）肺部并发症，胸膜,心,肝脏,胰腺和胆道;(iii)切口感染和残余腔脓肿形成;(iv)过敏反应和休克;(v)周围组织撕裂;(vi)住院和术后住院时间(LOS);(vii)手术时间;(viii)手术期间失血。使用具有各种混杂因素调整策略的多变量逻辑/线性回归模型来评估相关性。
结果：共128例肝性CE患者，其中82例（64.1%）和46例（35.9%）接受CS和RS，分别。完全调整后,与CS相比，RS与总并发症风险降低60％（aOR0.4;95CI，0.2-0.9）和手术时间缩短0.6小时（aβ0.4;95CI，-0.0-0.8）相关。然而,RS与手术中更多的失血有关（aβ179.3；95CI，54.2-304.5）。
结论：总而言之，RS与短期内发生整体并发症减少60%相关，但在手术过程中可能导致比CS更多的失血。
