Postoperative Recurrence of Hydatid Cyst According to World Health Organization (WHO) Classification

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Hydatid cyst is one of the most common diseases of humans and animals, which its most common involved site is liver. Despite various treatments, hydatid cyst recurrence is still a serious problem in areas with high prevalence. Therefore, in this study, we aimed to investigate the recurrence rate of hydatid cyst, and also the association of recurrence with the characteristics and manifestations of sonography according to the classification of hydatid cyst by World Health Organization (WHO).Methods: In this cross-sectional study, all patients with hydatid cyst, who underwent surgery during 2011-2014 were evaluated for demographic characteristics, cyst features, and types of surgical methods. After surgery, all the patients were followed up for 3 years, and increase of size in repeated sonographies was considered as recurrence.Findings: Based on WHO classification, the most common types of cysts included 23 cases (35.4%) of cystic echinococcosis type 1 (CE1), 12 cases (18.5%) of CE3b, 11 cases (16.9%) of CE3a, 7 cases (10.8%) of CE2, 3 cases (4.6%) of CE4, and 2 cases (3.1%) of CE5. Three cases (4.6%) of the patients had hydatid cyst recurrence. There was no significant association between demographic characteristics, cyst features, cyst classification according to WHO, and surgical methods with recurrence rate (P > 0.05).Conclusion: Hydatid cysts types of CE1, CE3b and CE3a are the most common types based on the WHO classification, and there is no association between their frequencies and the recurrence rate of hydatid cyst. Therefore, the use of this method of hydatid cyst classification is not recommended in order to determine the probability of recurrence of patients. However, more extensive studies in this field are recommended to determine the efficacy of this classification method to determine the risk of recurrence of hydatid cyst.

Keywords


  1. Geramizadeh B. Isolated Peritoneal, Mesenteric, and Omental Hydatid Cyst: A Clinicopathologic Narrative Review. Iran J Med Sci 2017; 42(6): 517-23.
  2. Rahman ML, Badruzzaman M, Mokhlesuzzaman A, Kabir MM, Chowdhury MMG, Hossain MA. Hydatid cyst of lung. KYAMC Journal 2014; 4(2): 427-30.
  3. Iqbal N, Hussain M, Idress R, Irfan M. Disseminated hydatid cyst of liver and lung. BMJ Case Rep 2017; 2017: bcr-2017-222808.
  4. Grubor NM, Jovanova-Nesic KD, Shoenfeld Y. Liver cystic echinococcosis and human host immune and autoimmune follow-up: A review. World J Hepatol 2017; 9(30): 1176-89.
  5. Hiremath B, Subramaniam N, Boggavarapu M. Primary pancreatic hydatid cyst: an unexpected differential diagnosis. BMJ Case Reports 2015; 2015.
  6. Zhang Z, Fan J, Dang Y, Xu R, Shen C. Primary intramedullary hydatid cyst: a case report and literature review. Eur Spine J 2017; 26(Suppl 1): 107-10.
  7. Unal E, Keles M, Yazgan S, Karcaaltincaba M. A rare retrovesical hydatid cyst and value of transrectal ultrasonography in diagnosis: A case report and review of the literature. Med Ultrason 2017; 19(1): 111-3.
  8. Malik A, Chandra R, Prasad R, Khanna G, Thukral BB. Imaging appearances of atypical hydatid cysts. Indian J Radiol Imaging 2016; 26(1): 33-9.
  9. Giorgio A, Di Sarno A, de Stefano G, Liorre G, Farella N, Scognamiglio U, et al. Sonography and clinical outcome of viable hydatid liver cysts treated with double percutaneous aspiration and ethanol injection as first-line therapy: Efficacy and long-term follow-up. AJR Am J Roentgenol 2009; 193(3): W186-W192.
  10. Kahriman G, Ozcan N, Dogan S, Karaborklu O. Percutaneous treatment of liver hydatid cysts in 190 patients: A retrospective study. Acta Radiol 2017; 58(6): 676-84.
  11. Kabaalioglu A, Ceken K, Alimoglu E, Apaydin A. Percutaneous imaging-guided treatment of hydatid liver cysts: Do long-term results make it a first choice? Eur J Radiol 2006; 59(1): 65-73.
  12. Sokouti M, Sadeghi R, Pashazadeh S, Abadi SEH, Sokouti M, Rezaei-Hachesu P, et al. A systematic review and meta-analysis on the treatment of liver hydatid cyst: Comparing laparoscopic and open surgeries. Arab J Gastroenterol 2017; 18(3): 127-35.
  13. Kohansal MH, Nourian A, Rahimi MT, Daryani A, Spotin A, Ahmadpour E. Natural products applied against hydatid cyst protoscolices: A review of past to present. Acta Trop 2017; 176: 385-94.
  14. Ramia JM, Ramiro C, Arteaga V. Radical surgery for hepatic hydatid cyst recurrence with vascular involvement. J Visc Surg 2013; 150(3): 223-4.
  15. Jerraya H, Khalfallah M, Osman SB, Nouira R, Dziri C. Predictive factors of recurrence after surgical treatment for liver hydatid cyst. Surg Endosc 2015; 29(1): 86-93.
  16. Velasco-Tirado V, Romero-Alegria A, Belhassen-Garcia M, Alonso-Sardon M, Esteban-Velasco C, Lopez-Bernus A, et al. Recurrence of cystic echinococcosis in an endemic area: a retrospective study. BMC Infect Dis 2017; 17(1): 455.
  17. Kapan M, Kapan S, Goksoy E, Perek S, Kol E. Postoperative recurrence in hepatic hydatid disease. J Gastrointest Surg 2006; 10(5): 734-9.