Percutaneous aspiration-injection-reaspiration drainage plus albendazole or mebendazole for hepatic cystic echinococcosis: a meta-analysis.
Using meta-analysis methodology, we compared the clinical outcomes for 769 patients with hepatic cystic echinococcosis treated with percutaneous aspiration-injection-reaspiration (PAIR) plus albendazole or mebendazole (group 1) with 952 era-matched historical control subjects undergoing surgical intervention (group 2). The rate of clinical and parasitologic cure (P<.0001) was greater in patients receiving PAIR plus chemotherapy. Disease recurrence (P<.0001), major complications (anaphylaxis, biliary fistula, cyst infection, liver/intra-abdominal abscess, and sepsis; P<.0001), minor complications (P<.0001), and death (P<.0824) occurred more frequently among surgical control subjects. Fever (P<.002) and minor allergic reactions subjects (P<.0001) were more common among PAIR-treated subjects. The mean durations of hospital stay were 2.4 days for group 1 and 15.0 days for group 2 (P<.001). Compared with surgery, PAIR plus chemotherapy is associated with greater clinical and parasitologic efficacy; lower rates of morbidity, mortality, and disease recurrence; and shorter hospital stays.
Smego
Raymond A
RA
Department of Medicine, Aga Khan University, Karachi, Pakistan. rsmego@medicine.nodak.edu
Bhatti
Sabha
S
Khaliq
Amir A
AA
Beg
M Asim
MA
D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D004322:Drainage; D004444:Echinococcosis, Hepatic / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D004446:Echinococcus / Q000187:drug effects; D006801:Humans; D007267:Injections; D007902:Length of Stay; D008463:Mebendazole / Q000627:therapeutic use*; D012008:Recurrence; D016896:Treatment Outcome
D000871:Anthelmintics; D008463:Mebendazole; D015766:Albendazole