Clinical Analysis Of Multi-disciplinary Treatment Apply In Late Stage Hepatic Alveolar Echinococcosis

Objective:to analyze the applications and advantages of Muitidisciplinary team(MDT) for late stage hepatic alveolar echinococcosis.Methods:A retrospective study was conducted on application of Multidisciplinary team mode to individualize diagnosis and treatment of 137 patients with late stage hepatic alveolar echinococcosis with invaded major blood vessels and bile duct as well as(or) lung and brain metastasis in our hospital from January 2005 to December 2013.The patients were divided into two groups:MDT consultation group (MDT group,n=49) and Professional discussion group(non-MDT group,n=88).MDT group was further divided into two groups:group A is the surgical treatment group(n=26),and group B is the Non-surgical treatment group (n=26),in the B group 13 patients underwent late radical surgery.Non-MDT group was further divided into two groups:group a is the surgical treatment group(n=61),group b is the Non-surgical treatment group (n=27),in b group 5 patients underwent late radical surgery.The hospital confirmed the diagnosis time,perioperative hospital stay,operation time,blood loss,postoperative drainage time,postoperative hospital stay,early postoperative complications(pleural and peritoneal effusions,bile leakage,anastomotic leakage),late postoperative complications(jaundice, anastomotic stenosis, recurrence), rates of radical surgery were compared between group A and group a.Rates of late radical resection were compared between B group with group b.All data were analyzed by using the Mann-Whitney rank sum test or Chi-square test.Results:group A had significantly shorter perioperative hospital stay, postoperative hospital stay, total length of hospital stay than group a (P<0.05), the incidence of late postoperative complications(jaundice, anastomotic stenosis, recurrence) less than group a (P<0.05),had higher Radical surgery rate than group a (P<0.05). The hospital confirmed the diagnosis time,operation time,blood loss,postoperative drainage time early postoperative complications(pleural and peritoneal effusions,bile leakage,anastomotic leakage) there were no significant difference(P<0.05) between group A and group a.Group B after chemotherapy alone or drainage+ chemotherapy, late implement radical resection rate was significantly higher than group b (P<0.05).Conclusions:Multidisciplinary team mode individualized treatment comprehensively by combining the advantages of drug,intervention,surgery and systemic nutritional support,draw up the best individualized treatment plan,can improve the rates of radical surgery in late stage hepatic alveolar echinococcosis,reduce postoperative complications and improve the quality of life,even create opportunities of radical resection in those patients that had lost chances for surgery.