The Influence Of Different Surgical Margins On Postoperative Recurrence Of The Hepatic Alveolar Echinococcosis

Objective: investigate the effect of different surgical margins on the recurrence of hepatic alveolar echinococcosis after hepatectomy.Methods:A retrospective analysis was performed on patients who diagnosed as hepatic alveolar echinococcosis and underwent partial hepatectomy in our hospital from August 1,2010 to December 31,2015,46 of them belong to the R0 group,and the 47 belong to R1 group,the 45 belong to R2 group.Pathologically we get the conclusion after observing andmeasuring the The pathological sections of 16 HAE specimens under microscope.Results:The mean diameter of the lesion,the invasion of the second hepatic hilum and the invasion of the vena cava were significantly different between the three groups(P<0.005).In the three groups,the recurrence rate and the density of the R2 group were significantly higher than those of the R0 group and the R1 group(P<0.005).In group R0,5 patients were lost after operation,and 3 patients had recurrent lesions after operation.In group R1,12 patients were lost after operation,and 5 patients had recurrent lesions after operation.7 of the 30 patients after Ex-vivo liver resection died within one month after the operation,and 1 died 6 months after the operation?In group R3,8 patients were lost after operation,and 15 patients had recurrent lesions after operation.1 died 6 months after the operation ?The average follow-up time of the three groups was different,the R0 and R1 group were longer than the R2 group.The mortality of the three groups was significantly different,the group R1 was significantly higher than the other two groups.The mortality of the three groups was same after removing the 30 patients after Ex-vivo liver resection.There was no statistically significant difference in the loss rate,discontinuous medication rate,the average time of recurrence,and the surgery unrelated mortality in the three groups.There was significant difference in the recurrence rate between the three groups.The recurrence rate of group R2 was significantly higher than that in group R0 and group R1(P<0.005).Pathological hints:The presence of inflammatory zone around lesions composed of inflammatory cells,contain no Hydatid protoscolex.The width of inflammatory zone is between 0.60-1.60 mm,average value is 1.12 mm.The outer margin of the hydatid cyst is irregular,outward,and burr like,which is continuous with the echinococcosis lesion.It is usually between 0.5-3.0mm.conclusions:1)conclusions:the size of the HAE lesion,whether the lesion invaded the postcava and the second porta hepatis were the decisive factors for the selection of the surgical procedure.2)the recurrence rate of R0 and R1 after hepatectomy is the same.both can achieve a radical cure.The recurrence rate of group R2 was higher than that of the other two groups.