Published online Jun 27, 2025. doi: 10.4240/wjgs.v17.i6.105007
Revised: March 19, 2025
Accepted: March 20, 2025
Published online: June 27, 2025
Processing time: 138 Days and 3.3 Hours
Alveolar and cystic echinococcoses are lethal zoonotic diseases caused by Echinococcus multilocularis and Echinococcus granulosus infections, leading to alveolar echinococcosis (AE) or cystic echinococcosis (CE), respectively. No study has hitherto reported effective treatment approaches for AE or CE with concurrent hepatorenal involvement.
To investigate the feasibility and efficacy of simultaneous combined surgery (SCS) as a comprehensive treatment approach for patients with hepatorenal echinococcosis.
Clinical datasets of hepatorenal AE (n = 10) and CE (n = 11) patients were retrospectively collected and systematically analyzed. The SCS approach was introduced, and surgical outcomes, complications, and prognoses were documented in detail.
The SCS approach incorporated hybridized techniques, including partial hepatectomy, partial or total nephrectomy, ex vivo liver resection and autotransplantation, and total or subtotal cystectomy with endocystectomy. Radical SCS was achieved in 100% of AE patients and 63.6% of CE patients. All surgeries were completed without intraoperative complications. The short-term complication rate was 28.6% (Clavien-Dindo classification: AE-1 IIIb, 3 IIIa; CE-2 II), while the long-term complication rate was 4.8% (Clavien-Dindo classification: AE-1 IIIb). Patients were followed up for a median of 37 months (AE: 6-81 months; CE: 34-123 months), with no reported deaths or disease relapses.
CS appears to be a feasible and effective treatment method for patients with hepatorenal involvement of AE or CE. It fulfills the management criteria for advanced AE or CE cases, aiming to maximize patient benefits.
Core Tip: This study introduces simultaneous combined surgery (SCS) as a novel and effective approach for treating hepatorenal involvement in alveolar echinococcosis (AE) and cystic echinococcosis (CE). SCS integrates advanced surgical techniques, including ex vivo liver resection and autotransplantation, partial or total nephrectomy, and cystectomy, to achieve radical resection in complex cases. Our study demonstrates that SCS is feasible, safe, and cost-effective, providing a comprehensive solution for advanced AE and CE patients. By addressing extensive lesion invasion and minimizing the risk of disease relapse, this approach maximizes patient outcomes and fulfills the management criteria for these challenging conditions.