title: Ambispective comparative study of two surgical strategies for liver hydatidosis.
abstract: OBJECTIVE
  To investigate the morbidity, mortality, recurrence and technical aspects of two distinct surgical strategies that were implemented in successive periods.
  
  
  METHODS
  Ninty-two patients with 113 cysts underwent surgical procedures. The study was divided into 2 periods. Data from first period (P1) were compiled retrospectively. The surgical strategy was conservative surgery. The second period (P2) included a prospective study conducted according to a protocol following the criterion that radical procedures should be performed whenever it is technically feasible.
  
  
  RESULTS
  Patients of both periods showed no statistically significant differences in age, gender, cyst location or mortality. Among the P2 group, patients exhibited more preoperative jaundice, and cyst size was smaller (P < 0.05). Changes in surgical strategy increased the rate of radical surgery, decreases morbidity and in-hospital stay (P < 0.001). A negative result in P2 was the death of two old patients (4.8%) who had undergone conservative treatments. The rate of radical surgery in P2 was around 75%.
  
  
  CONCLUSIONS
  Radical surgery should be the technique of choice whenever it is feasible, because it diminishes morbidity and in-hospital stay. Conservative surgery must be employed only in selected cases.
authors.affiliation: Department of Surgery, Hepato-Bilio-Pancreatic Surgery Unit, Guadalajara University Hospital, Guadalajara 19002, Spain. jose_ramia@hotmail.com
authors.forename: Jose M
authors.initials: JM
authors.lastname: Ramia
authors.forename: Francisco
authors.initials: F
authors.lastname: Ruiz-Gomez
authors.forename: Roberto
authors.initials: R
authors.lastname: De la Plaza
authors.forename: Pilar
authors.initials: P
authors.lastname: Veguillas
authors.forename: Jose
authors.initials: J
authors.lastname: Quiñones
authors.forename: Jorge
authors.initials: J
authors.lastname: García-Parreño
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004444:Echinococcosis, Hepatic / Q000517:prevention & control / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult