Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2025; 17(6): 105007
Published online Jun 27, 2025. doi: 10.4240/wjgs.v17.i6.105007
Simultaneous combined surgery for hepatic-renal double organ alveolar or cystic echinococcosis: A retrospective study
Alimu Tulahong, Da-Long Zhu, Chang Liu, Tie-Min Jiang, Rui-Qing Zhang, Talaiti Tuergan, Tuerganaili Aji, Ying-Mei Shao
Alimu Tulahong, Da-Long Zhu, Chang Liu, Tie-Min Jiang, Rui-Qing Zhang, Talaiti Tuergan, Tuerganaili Aji, Ying-Mei Shao, Department of Hepatobiliary and Echinococcosis Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
Co-first authors: Alimu Tulahong and Da-Long Zhu.
Co-corresponding authors: Tuerganaili Aji and Ying-Mei Shao.
Author contributions: Tulahong A, Zhu DL, Shao YM, and Aji T conceived and designed the study; Tulahong A obtained partial funding for the research; Jiang TM, Zhang RQ, Tuergan T, and Liu C were responsible for data acquisition, preliminary analysis, and interpretation, participating in the discussion and revision of the manuscript to ensure the accuracy and reliability of the data interpretation. Tulahong A and Zhu DL organized the collected data, performed re-analysis, created figures, conducted literature searches, and completed the draft manuscript, making critical contributions that qualify them as co-first authors. Aji T and Shao YM supervised the research process, provided methodological guidance, and played key roles in ensuring the integrity and ethical considerations of the research. They were also responsible for applying for and obtaining funding for this research project. As the main implementers of the surgical plan, they made significant contributions to the design and execution of complex cases, co-revised the manuscript, and participated in discussions and interpretations of the research results. Given their contributions and responsibilities for this research, they are listed as co-corresponding authors. Shao YM managed the submission of the manuscript and coordinated subsequent revisions. All authors have read and approved the final manuscript.
Supported by the National Natural Science Foundation of China, No. 82360111; Xinjiang Science and Technology Department-Leading Talents in Technological Innovation - High-Level Leading Talents, No. 2022TSYCLJ0034; State Key Laboratory for The Cause and Control of High Incidence in Central Asia Jointly Constructed by The Ministry and The Province, No. SKL-HIDCA-2023-2 and No. SKL-HIDCA-2024-22; and Xinjiang Uygur Autonomous Region Graduate Innovation Program, No. XJ2024G153.
Institutional review board statement: The study was reviewed and approved by The First Affiliated Hospital of Xinjiang Medical University Institutional Review Board, No. K202202-04.
Informed consent statement: Informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data from this study are included in the article and its supplementary materials, available for readers to review and use.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying-Mei Shao, MD, PhD, Chief Physician, Professor, Department of Hepatobiliary and Echinococcosis Surgery, The First Affiliated Hospital of Xinjiang Medical University, No. 393 Xinyi Road, Urumqi 830054, Xinjiang Uygur Autonomous Region, China. syingmei1@163.com
Received: January 12, 2025
Revised: March 19, 2025
Accepted: March 20, 2025
Published online: June 27, 2025
Processing time: 138 Days and 3.3 Hours
Abstract
BACKGROUND

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.

AIM

To investigate the feasibility and efficacy of simultaneous combined surgery (SCS) as a comprehensive treatment approach for patients with hepatorenal echinococcosis.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

Keywords: Simultaneous combined surgery; Liver; Kidney; Alveolar echinococcosis; Cystic echinococcosis

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.