Secondary Cystic Echinococcosis in South of Iran: A Retrospective Study

Document Type : Research/Original Article

Authors

1 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran

2 Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

3 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,

4 Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

5 Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

6 Department of Medical Biotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background: Cystic echinococcosis (CE) is a parasitic and zoonotic infection, recognized globally as a
neglected disease, with significant morbidity and mortality rates, especially in low-advantaged countries. We
aimed to evaluate the recurrence rate after hydatid disease surgery in Fars Province, Iran.
Methods: A retrospective design was used to examine the data collected from Nemazee and Shahid Faghihi
Hospitals, Shiraz, southern Iran, over eight years, from 2011 to 2019. The research was conducted in 2023.
The study extracted the following data from hospital records: demographic characteristics, paraclinical
findings (such as sonography and CT scan), organ involvement, cyst number and size, surgical procedure, cyst
complications, intraoperative or postoperative complications, and recurrence rate.
Results: The study included 303 patients, of whom recurrence occurred in 36 (11.9%). Intra or postoperative
complications were associated with recurrence (P=0.001). In the recurrent cases, the most common intraoperative
complication was anaphylactic shock (P=0.001), and the most common postoperative complications
were unresolved pneumothorax and empyema (P=0.001). There was a significant association between
recurrence and complicated cysts (P=0.001). There was no significant difference between the organ involved
and the complicated cyst in the recurrence (P=0.50). There was no association between increasing the cyst’s
size and the chance of the recurrence rate. There was a significant relationship between recurrence and the
number of cysts in the affected organ (P=0.001). There was a significant association between using no scolicidal
agents and recurrence (P=0.001), and no antiparasitic drugs were used in only one (2.7%) patient (P=0.3240).
There was no significant association between recurrence and duration of admission (P=0.193).
Conclusion: Intra or postoperative complications (anaphylactic shock, unresolved pneumothorax, and
empyema), complicated cysts, the number of cysts in the affected organ, and injecting of no scolicidal agents
were significantly associated with recurrence. Recurrence may have many reasons, such as insufficient drainage
(incomplete peri-cystectomy and minute spillage of cyst contents), missing hidden cysts (numbered cysts),
rupture or spillage of the cysts, and inadequate medical treatment.

Keywords

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Iranian Journal of Colorectal Research
Volume 12, Issue 2
June 2024
Pages 33-39

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