Endocystectomy as a conservative surgical treatment for hepatic cystic echinococcosis: A systematic review with single-arm meta-analysis
In patients with hepatic cystic echinococcosis (CE), treatment effectiveness, outcomes, complications, and recurrence rate are controversial. Endocystectomy is a conservative surgical approach that adequately removes cyst contents without loss of parenchyma. This conservative procedure has been modi...
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| creator | Al-Saeedi, Mohammad Ramouz, Ali Khajeh, Elias El Rafidi, Ahmad Ghamarnejad, Omid Shafiei, Saeed Ali-Hasan-Al-Saegh, Sadeq Probst, Pascal Stojkovic, Marija Weber, Tim Frederik Hoffmann, Katrin Mehrabi, Arianeb |
| description | In patients with hepatic cystic echinococcosis (CE), treatment effectiveness, outcomes, complications, and recurrence rate are controversial. Endocystectomy is a conservative surgical approach that adequately removes cyst contents without loss of parenchyma. This conservative procedure has been modified in several ways to prevent complications and to improve surgical outcomes. This systematic review aimed to evaluate the intraoperative and postoperative complications of endocysectomy for hepatic CE as well as the hepatic CE recurrence rate following endocystectomy.
A systematic search was made for all studies reporting endocystectomy to manage hepatic CE in PubMed, Web of Science, and Cochrane CENTRAL databases. Study quality was assessed using the methodological index for non-randomized studies (MINORS) criteria and the Cochrane revised tool to assess risk of bias in randomized trials (RoB2). The random-effects model was used for meta-analysis and the arscine-transformed proportions were used to determine complication-, mortality-, and recurrence rates. This study is registered with PROSPERO (number CRD42020181732).
Of 3,930 retrieved articles, 54 studies reporting on 4,058 patients were included. Among studies reporting preoperative anthelmintic treatment (31 studies), albendazole was administered in all of them. Complications were reported in 19.4% (95% CI: 15.9-23.2; I2 = 84%; p-value |
| doi_str_mv | 10.1371/journal.pntd.0009365 |
| format | Article |
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A systematic search was made for all studies reporting endocystectomy to manage hepatic CE in PubMed, Web of Science, and Cochrane CENTRAL databases. Study quality was assessed using the methodological index for non-randomized studies (MINORS) criteria and the Cochrane revised tool to assess risk of bias in randomized trials (RoB2). The random-effects model was used for meta-analysis and the arscine-transformed proportions were used to determine complication-, mortality-, and recurrence rates. This study is registered with PROSPERO (number CRD42020181732).
Of 3,930 retrieved articles, 54 studies reporting on 4,058 patients were included. Among studies reporting preoperative anthelmintic treatment (31 studies), albendazole was administered in all of them. Complications were reported in 19.4% (95% CI: 15.9-23.2; I2 = 84%; p-value <0.001) of the patients; biliary leakage (10.1%; 95% CI: 7.5-13.1; I2 = 81%; p-value <0.001) and wound infection (6.6%; 95% CI: 4.6-9; I2 = 27%; p-value = 0.17) were the most common complications. The post-endocystectomy mortality rate was 1.2% (95% CI: 0.8-1.8; I2 = 21%; p-value = 0.15) and the recurrence rate was 4.8% (95% CI: 3.1-6.8; I2 = 87%; p-value <0.001). Thirty-nine studies (88.7%) had a mean follow-up of more than one year after endocystectomy, and only 14 studies (31.8%) had a follow-up of more than five years.
Endocystectomy is a conservative and feasible surgical approach. Despite previous disencouraging experiences, our results suggest that endocystectomy is associated with low mortality and recurrence.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0009365</identifier><identifier>PMID: 33979343</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Bias ; Biology and Life Sciences ; Care and treatment ; Clinical trials ; Complications ; Confidence intervals ; Cystectomy ; Cysts ; Echinococcosis ; Endoscopy ; Intervention ; Laboratories ; Liver diseases ; Medicine and Health Sciences ; Meta-analysis ; Methods ; Mortality ; Patient outcomes ; Physical Sciences ; Research and Analysis Methods ; Surgery ; Sutures ; Systematic review ; Tropical diseases</subject><ispartof>PLoS neglected tropical diseases, 2021-05, Vol.15 (5), p.e0009365</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Al-Saeedi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Al-Saeedi et al 2021 Al-Saeedi et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c521t-9682940b5696059ebccf3fb77d232913ea2958e66ca4db28b117b587999813e13</citedby><cites>FETCH-LOGICAL-c521t-9682940b5696059ebccf3fb77d232913ea2958e66ca4db28b117b587999813e13</cites><orcidid>0000-0001-8599-0522 ; 0000-0001-7424-1323 ; 0000-0002-0895-4015 ; 0000-0001-6163-1525 ; 0000-0001-5911-123X ; 0000-0001-7431-4836</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8143402/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8143402/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23847,27903,27904,53768,53770,79345,79346</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33979343$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Torgerson, Paul R.</contributor><creatorcontrib>Al-Saeedi, Mohammad</creatorcontrib><creatorcontrib>Ramouz, Ali</creatorcontrib><creatorcontrib>Khajeh, Elias</creatorcontrib><creatorcontrib>El Rafidi, Ahmad</creatorcontrib><creatorcontrib>Ghamarnejad, Omid</creatorcontrib><creatorcontrib>Shafiei, Saeed</creatorcontrib><creatorcontrib>Ali-Hasan-Al-Saegh, Sadeq</creatorcontrib><creatorcontrib>Probst, Pascal</creatorcontrib><creatorcontrib>Stojkovic, Marija</creatorcontrib><creatorcontrib>Weber, Tim Frederik</creatorcontrib><creatorcontrib>Hoffmann, Katrin</creatorcontrib><creatorcontrib>Mehrabi, Arianeb</creatorcontrib><title>Endocystectomy as a conservative surgical treatment for hepatic cystic echinococcosis: A systematic review with single-arm meta-analysis</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>In patients with hepatic cystic echinococcosis (CE), treatment effectiveness, outcomes, complications, and recurrence rate are controversial. Endocystectomy is a conservative surgical approach that adequately removes cyst contents without loss of parenchyma. This conservative procedure has been modified in several ways to prevent complications and to improve surgical outcomes. This systematic review aimed to evaluate the intraoperative and postoperative complications of endocysectomy for hepatic CE as well as the hepatic CE recurrence rate following endocystectomy.
A systematic search was made for all studies reporting endocystectomy to manage hepatic CE in PubMed, Web of Science, and Cochrane CENTRAL databases. Study quality was assessed using the methodological index for non-randomized studies (MINORS) criteria and the Cochrane revised tool to assess risk of bias in randomized trials (RoB2). The random-effects model was used for meta-analysis and the arscine-transformed proportions were used to determine complication-, mortality-, and recurrence rates. This study is registered with PROSPERO (number CRD42020181732).
Of 3,930 retrieved articles, 54 studies reporting on 4,058 patients were included. Among studies reporting preoperative anthelmintic treatment (31 studies), albendazole was administered in all of them. Complications were reported in 19.4% (95% CI: 15.9-23.2; I2 = 84%; p-value <0.001) of the patients; biliary leakage (10.1%; 95% CI: 7.5-13.1; I2 = 81%; p-value <0.001) and wound infection (6.6%; 95% CI: 4.6-9; I2 = 27%; p-value = 0.17) were the most common complications. The post-endocystectomy mortality rate was 1.2% (95% CI: 0.8-1.8; I2 = 21%; p-value = 0.15) and the recurrence rate was 4.8% (95% CI: 3.1-6.8; I2 = 87%; p-value <0.001). Thirty-nine studies (88.7%) had a mean follow-up of more than one year after endocystectomy, and only 14 studies (31.8%) had a follow-up of more than five years.
Endocystectomy is a conservative and feasible surgical approach. Despite previous disencouraging experiences, our results suggest that endocystectomy is associated with low mortality and recurrence.</description><subject>Bias</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Clinical trials</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Cystectomy</subject><subject>Cysts</subject><subject>Echinococcosis</subject><subject>Endoscopy</subject><subject>Intervention</subject><subject>Laboratories</subject><subject>Liver diseases</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Methods</subject><subject>Mortality</subject><subject>Patient outcomes</subject><subject>Physical Sciences</subject><subject>Research and Analysis Methods</subject><subject>Surgery</subject><subject>Sutures</subject><subject>Systematic review</subject><subject>Tropical 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as a conservative surgical treatment for hepatic cystic echinococcosis: A systematic review with single-arm meta-analysis</title><author>Al-Saeedi, Mohammad ; Ramouz, Ali ; Khajeh, Elias ; El Rafidi, Ahmad ; Ghamarnejad, Omid ; Shafiei, Saeed ; Ali-Hasan-Al-Saegh, Sadeq ; Probst, Pascal ; Stojkovic, Marija ; Weber, Tim Frederik ; Hoffmann, Katrin ; Mehrabi, Arianeb</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c521t-9682940b5696059ebccf3fb77d232913ea2958e66ca4db28b117b587999813e13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Bias</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Clinical trials</topic><topic>Complications</topic><topic>Confidence intervals</topic><topic>Cystectomy</topic><topic>Cysts</topic><topic>Echinococcosis</topic><topic>Endoscopy</topic><topic>Intervention</topic><topic>Laboratories</topic><topic>Liver diseases</topic><topic>Medicine and Health Sciences</topic><topic>Meta-analysis</topic><topic>Methods</topic><topic>Mortality</topic><topic>Patient outcomes</topic><topic>Physical Sciences</topic><topic>Research and Analysis Methods</topic><topic>Surgery</topic><topic>Sutures</topic><topic>Systematic review</topic><topic>Tropical diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Al-Saeedi, Mohammad</creatorcontrib><creatorcontrib>Ramouz, Ali</creatorcontrib><creatorcontrib>Khajeh, Elias</creatorcontrib><creatorcontrib>El Rafidi, Ahmad</creatorcontrib><creatorcontrib>Ghamarnejad, Omid</creatorcontrib><creatorcontrib>Shafiei, Saeed</creatorcontrib><creatorcontrib>Ali-Hasan-Al-Saegh, Sadeq</creatorcontrib><creatorcontrib>Probst, Pascal</creatorcontrib><creatorcontrib>Stojkovic, Marija</creatorcontrib><creatorcontrib>Weber, Tim Frederik</creatorcontrib><creatorcontrib>Hoffmann, Katrin</creatorcontrib><creatorcontrib>Mehrabi, 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Ahmad</au><au>Ghamarnejad, Omid</au><au>Shafiei, Saeed</au><au>Ali-Hasan-Al-Saegh, Sadeq</au><au>Probst, Pascal</au><au>Stojkovic, Marija</au><au>Weber, Tim Frederik</au><au>Hoffmann, Katrin</au><au>Mehrabi, Arianeb</au><au>Torgerson, Paul R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endocystectomy as a conservative surgical treatment for hepatic cystic echinococcosis: A systematic review with single-arm meta-analysis</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2021-05-12</date><risdate>2021</risdate><volume>15</volume><issue>5</issue><spage>e0009365</spage><pages>e0009365-</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>In patients with hepatic cystic echinococcosis (CE), treatment effectiveness, outcomes, complications, and recurrence rate are controversial. Endocystectomy is a conservative surgical approach that adequately removes cyst contents without loss of parenchyma. This conservative procedure has been modified in several ways to prevent complications and to improve surgical outcomes. This systematic review aimed to evaluate the intraoperative and postoperative complications of endocysectomy for hepatic CE as well as the hepatic CE recurrence rate following endocystectomy.
A systematic search was made for all studies reporting endocystectomy to manage hepatic CE in PubMed, Web of Science, and Cochrane CENTRAL databases. Study quality was assessed using the methodological index for non-randomized studies (MINORS) criteria and the Cochrane revised tool to assess risk of bias in randomized trials (RoB2). The random-effects model was used for meta-analysis and the arscine-transformed proportions were used to determine complication-, mortality-, and recurrence rates. This study is registered with PROSPERO (number CRD42020181732).
Of 3,930 retrieved articles, 54 studies reporting on 4,058 patients were included. Among studies reporting preoperative anthelmintic treatment (31 studies), albendazole was administered in all of them. Complications were reported in 19.4% (95% CI: 15.9-23.2; I2 = 84%; p-value <0.001) of the patients; biliary leakage (10.1%; 95% CI: 7.5-13.1; I2 = 81%; p-value <0.001) and wound infection (6.6%; 95% CI: 4.6-9; I2 = 27%; p-value = 0.17) were the most common complications. The post-endocystectomy mortality rate was 1.2% (95% CI: 0.8-1.8; I2 = 21%; p-value = 0.15) and the recurrence rate was 4.8% (95% CI: 3.1-6.8; I2 = 87%; p-value <0.001). Thirty-nine studies (88.7%) had a mean follow-up of more than one year after endocystectomy, and only 14 studies (31.8%) had a follow-up of more than five years.
Endocystectomy is a conservative and feasible surgical approach. Despite previous disencouraging experiences, our results suggest that endocystectomy is associated with low mortality and recurrence.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33979343</pmid><doi>10.1371/journal.pntd.0009365</doi><orcidid>https://orcid.org/0000-0001-8599-0522</orcidid><orcidid>https://orcid.org/0000-0001-7424-1323</orcidid><orcidid>https://orcid.org/0000-0002-0895-4015</orcidid><orcidid>https://orcid.org/0000-0001-6163-1525</orcidid><orcidid>https://orcid.org/0000-0001-5911-123X</orcidid><orcidid>https://orcid.org/0000-0001-7431-4836</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1935-2735 |
| ispartof | PLoS neglected tropical diseases, 2021-05, Vol.15 (5), p.e0009365 |
| issn | 1935-2735 1935-2727 1935-2735 |
| language | eng |
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| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access; Public Library of Science (PLoS) |
| subjects | Bias Biology and Life Sciences Care and treatment Clinical trials Complications Confidence intervals Cystectomy Cysts Echinococcosis Endoscopy Intervention Laboratories Liver diseases Medicine and Health Sciences Meta-analysis Methods Mortality Patient outcomes Physical Sciences Research and Analysis Methods Surgery Sutures Systematic review Tropical diseases |
| title | Endocystectomy as a conservative surgical treatment for hepatic cystic echinococcosis: A systematic review with single-arm meta-analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-28T08%3A07%3A06IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Endocystectomy%20as%20a%20conservative%20surgical%20treatment%20for%20hepatic%20cystic%20echinococcosis:%20A%20systematic%20review%20with%20single-arm%20meta-analysis&rft.jtitle=PLoS%20neglected%20tropical%20diseases&rft.au=Al-Saeedi,%20Mohammad&rft.date=2021-05-12&rft.volume=15&rft.issue=5&rft.spage=e0009365&rft.pages=e0009365-&rft.issn=1935-2735&rft.eissn=1935-2735&rft_id=info:doi/10.1371/journal.pntd.0009365&rft_dat=%3Cgale_plos_%3EA663949287%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2541858066&rft_id=info:pmid/33979343&rft_galeid=A663949287&rft_doaj_id=oai_doaj_org_article_a3d32e1d710149c09c87a92b300755cb&rfr_iscdi=true |