The Growth Pattern And Influencing Factors For The Recurrenced Hepatic Hydatid Disease

Objective Through a retrospective study on recurrent hepatic hydatid disease, investigate the relevant factors that influence the recurrence rate of the hepatic hydatid disease; Through cross-section sampling study,investigate the recurrent cyst's growth pattern and possible factors; Through re-operation and long-term follow-up study, evaluate two surgical procedures'efficacy on recurrent hepatic hydatid disease and provide reference for clinical prevention and control.Methods The 277 cases(148men,129women), who underwent surgeries from December 1995 to December 2008 in our hospital, for hydatid cyst of the liver, were retrospectively reviewed, the age range was from 5 to 83 years (mean=31.2±12.1years).Among the total, 103 cases(57men,46women) were recurrent hepatic hydatid disease, the age range was from 17 to 79 years (mean=35.4±9.3years). The recurrence rates were assessed as well as the following seven potential factors: age, gender, type (whether the initial recurrence or multiple recurrence), drug treatment, whether the incision outside the capsule, previous postoperative complications eight factors of as risk factors through Logistic regression models to analyze its impact on the relapse rate. Through the application of cross-section sampling study, investigate the recurrent cyst's growth pattern and drawthe growth curve. Analyze the following factors'impact on the recurrent cyst's growth rate: age, gender, drug treatment, cyst with biliary fistula, cyst number, with other organ hydatid, liver foundamental disease and outside calcificated capsule.From time-consuming operation, bleeding volume, the average postoperative hospital stay, postoperative complications residual cavity Cert (bile leakage, infection, effusion), mortality and recurrence rate in situ.et al. evaluate two surgical procedures(traditional procedure and Subadventitial Total Exocystectomy) in the treatment of recurrent hepatic hydatid disease.Results①Single-factor analysis showed that age, previous post-operative complications and liver foundamental disease had nothing to do with liver hydatid relapse rates, no statistic significance(p=0.878, p=0.053,p=0.794); And drug treatment, outside the capsule open, with other organs'echinococcosis et al. impact the relapse rate (p=0.047,p=0.039,p=0.000,p=0.032),Logistic Multivariate analysis show that outside the capsule open was the only risk factor(OR=6.979,95%CI 3.742～15.357).②Recurrent liver hydatid cysts was linear growth in the earlier 46.5months,0.2cm/month, then the growth rate gradually slowed down, its average diameter of the largest cross-section maintained a long-term stable plateau.③Single-factor analysis showed that:age, drug treatment,the number of cysts, with biliary fistula, with other organs'echinococcosis and recurrence frequency impact the recurrent liver hydatid cysts'growth rate(p=0.046,p=0.019,p=0.043,p=0.037,p=0.035,p=0.045,);but gender, cyst location, calcificated outer capsule and liver foundamental diseases had nothing to do with the recurrent liver hydatid cysts'growth rate, no statistical significanc(ep=0.794,p=0.053,p=0.816,p=0.842). Logistic Multivariate analysis show that drug treatment,with biliary fistula and combined echinococcosis can independently impact the recurrent liver hydatid growth rate(OR=0. 630,0. 457,0. 516,0. 806。).④Among 103 recurrent cases, 37(35.9%) cases re-undergo the traditional procedure (cystectomy), residual cavity complications cases 9(24.3%), finally completed follow-up cases35(94.6%),recurrence cases6(17.1%), 66(64.1%) cases re-undergo the new procedure (Subadventitial Total Exocystectomy , external capsule will be completely removed), no residual cavity complications, finally completed follow-up cases61(92.4%),recurrence cases1(1.6%),Conclusion Drug treatment, outside the capsule open, with other organs'echinococcosis can. impact the relapse rate, outside the capsule open can independently mpact the relapse rate. Recurrent liver hydatid cysts show a linear growth in the earlier stage,and then the growth rate gradually slowed down, its average diameter of the largest cross-section maintained a long-term stable plateau. Age, drug treatment, the number of cysts, with biliary fistula, with other organs'echinococcosis and recurrence frequency impact the recurrent liver hydatid cysts'growth rate, among the total, drug treatment, with biliary fistula and combined echinococcosis can independently impact the recurrent liver hydatid growth rate. Compared with traditional surgical procedure, Subadventitial Total Exocystectomy has a lower complications and recurrence rate and should be preferred.