Radical surgical treatment of recurrent hepatic hydatidosis

BACKGROUND/AIMS: The treatment of relapsing hydatidosis must aim at the reduction of both morbidity and mortality rates and the risk of new recurrences. METHODOLOGY: Thirty-three patients with recurrence of hepatic ecchinococcosis were observed between January 1975 and May 2001. All selected patients received a first conservative surgical treatment, and recurrences developed in a period ranging from 1 to 46 years from the therapy. All patients with secondary hydatidosis were then submitted to radical surgical treatment. Ultrasound examinations, the first after 3 months from surgery, were performed to evaluate disease recurrence. Intraoperative morbidity and mortality were also evaluated. RESULTS: No intraoperative mortality was encountered. Intraoperative and postoperative morbidity were 6% and 12% respectively. During follow-up, (mean duration 53 months) no recurrences were recorded. CONCLUSIONS: Radical surgical approach is the best treatment of recurrent hydatid cysts as it represents a valid compromise between the need of a surgical radicality and a low intraoperative and postoperative morbidity.