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Percutaneous Versus Surgical Interventions for Hepatic Cystic Echinococcosis: A Systematic Review and Meta-Analysis
G L E Mönnink1, C Stijnis2, O M van Delden3
1Department of Infectious Diseases, Division of Internal Medicine, Center of Tropical Medicine and Travel Medicine, Amsterdam Public Health, Amsterdam Infection & Immunity, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
Purpose:
This systematic review and meta-analysis summarises the current literature on invasive treatment options of cystic hepatic echinococcosis (CE), comparing percutaneous radiological interventions to surgery, still the cornerstone of treatment in many countries.
Methods:
A literature search was conducted in Medline and EMBASE databases (PROSPERO registration number: CRD42019126150). The primary outcome was recurrence of cysts after treatment. Secondary outcomes were complications, duration of hospitalisation, mortality and treatment conversion.
Results:
The number of eligible prospective studies, in particular RCTs, was limited. In the four included studies, only conventional surgery is compared directly to percutaneous techniques. From the available data, in terms of recurrence, percutaneous treatment of hydatid cysts is non-inferior to open surgery. With regard to complications and length of hospital stay, outcomes favour percutaneous therapy.
Conclusion:
Although evidence from prospective research is small, percutaneous treatment in CE is an effective, safe and less invasive alternative to surgery.
