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Basic Operative Tactics for Pulmonary Echinococcosis in the Era of Endostaplers and Energy Devices. Medicina (B Aires) 2023; 59:medicina59030543. [PMID: 36984545 PMCID: PMC10056258 DOI: 10.3390/medicina59030543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 03/14/2023] Open
Abstract
Human echinococcosis is a zoonotic infection caused by the larvae of the tapeworm species Echinococcus. The liver is the most common location for a primary echinococcosis. However, the parasite may bypass or spread from the liver to the lungs, causing primary or secondary pulmonary echinococcosis, respectively. Pulmonary echinococcosis is a clinically challenging condition in which anthelminthic regiments are important, but surgery has the central role in removing the cysts and preventing recurrences. Surgical treatment may involve cystotomy, enucleation, capitonnage, or atypical resections, which occasionally are in combination with hepatic procedures. The utilization of modern devices is greatly underdescribed in surgery for thoracic infections, even though these facilitate much of the work. Therefore, this article aims to describe pulmonary echinococcosis and the role of modern surgical devices in the treatment process. Furthermore, we report surgical treatment of three different cases of pulmonary echinococcosis. Surgeries of uncomplicated and ruptured hepatic or pulmonary cysts are described. Simple small pulmonary echinococcal lesions can be excised by endostaplers both for diagnostic and curative reasons. Larger cysts can be removed by energy devices unless large bronchial air leaks occur. Complicated cysts require treatment by more extensive techniques. Inexperienced surgeons should not abstain but should carefully decide preoperatively how to proceed.
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Li Y, Yu Y, Liu Q, Qi H, Li S, Xin J, Xing Y. A CT-based radiomics nomogram for the differentiation of pulmonary cystic echinococcosis from pulmonary abscess. Parasitol Res 2022; 121:3393-3401. [PMID: 36181541 PMCID: PMC9525946 DOI: 10.1007/s00436-022-07663-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 09/06/2022] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to establish a clinical prediction model for the differential diagnosis of pulmonary cystic echinococcosis (CE) and pulmonary abscess according to computed tomography (CT)-based radiomics signatures and clinical indicators. This is a retrospective single-centre study. A total of 117 patients, including 53 with pulmonary CE and 64 with pulmonary abscess, were included in our study and were randomly divided into a training set (n = 95) and validation set (n = 22). Radiomics features were extracted from CT images, a radiomics signature was constructed, and clinical indicators were evaluated to establish a clinical prediction model. Finally, a model combining imaging radiomics features and clinical indicators was constructed. The performance of the nomogram, radiomics signature and clinical prediction model was evaluated and validated with the training and test datasets, and then the three models were compared. The radiomics signature of this study was established by 25 features, and the radiomics nomogram was constructed by using clinical factors and the radiomics signature. Finally, the areas under the receiver operating characteristic curve (AUCs) for the training set and test set were 0.970 and 0.983, respectively. Decision curve analysis showed that the radiologic nomogram was better than the clinical prediction model and individual radiologic characteristic model in differentiating pulmonary CE from pulmonary abscess. The radiological nomogram and models based on clinical factors and individual radiomics features can distinguish pulmonary CE from pulmonary abscess and will be of great help to clinical diagnoses in the future.
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Affiliation(s)
- Yan Li
- School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yaohui Yu
- Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, No 137, LiYuShan South Road, Urumqi, 830011, Xinjiang, China
| | - Qian Liu
- Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, No 137, LiYuShan South Road, Urumqi, 830011, Xinjiang, China
| | - Haicheng Qi
- Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, No 137, LiYuShan South Road, Urumqi, 830011, Xinjiang, China
| | - Shan Li
- Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, No 137, LiYuShan South Road, Urumqi, 830011, Xinjiang, China
| | - Juan Xin
- Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, No 137, LiYuShan South Road, Urumqi, 830011, Xinjiang, China
| | - Yan Xing
- Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, No 137, LiYuShan South Road, Urumqi, 830011, Xinjiang, China.
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Medical Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
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Calame P, Weck M, Busse-Cote A, Brumpt E, Richou C, Turco C, Doussot A, Bresson-Hadni S, Delabrousse E. Role of the radiologist in the diagnosis and management of the two forms of hepatic echinococcosis. Insights Imaging 2022; 13:68. [PMID: 35394226 PMCID: PMC8994011 DOI: 10.1186/s13244-022-01190-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
Echinococcosis is a parasitic disease caused by two zoonotic tapeworms (cestodes) of the Echinocococcus genus. It can be classified as either alveolar or cystic echinococcosis. Although the two forms differ significantly in terms of imaging findings, they share similarities in terms of management and treatment. In parallel to medical treatment with albendazole (ABZ), and surgery, historically used in these diseases, various imaging-guided interventional procedures have recently emerged (drainage, stenting, or Puncture, aspiration, injection, and reaspiration (PAIR)). These options open up a new range of therapeutic options. As in oncology, multidisciplinary consultation meetings now play a major role in adapted management and patient care in hepatic echinococcosis. Consequently, diagnostic imaging and interventional expertise have brought radiologists to the fore as important members of these multidisciplinary team. The radiologist will need to evaluate parasite activity in both forms of the disease, to guide the choice of the appropriate therapy from among medical treatment, interventional radiology procedures and/or surgical treatment. Knowledge of the specific complications of the two forms of echinococcosis will also help radiologists to discuss the appropriate treatment and management. The aim of this review is to describe the core knowledge that what a radiologist should possess to actively participate in multidisciplinary meetings about hepatic echinococcosis. We discuss the role of imaging, from diagnosis to treatment, in alveolar (AE) and cystic echinococcosis (CE), respectively.
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Affiliation(s)
- Paul Calame
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France. .,EA 4662 Nanomedicine Lab, Imagery and Therapeutics, University of Bourgogne Franche-Comté, Besançon, France.
| | - Mathieu Weck
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Andreas Busse-Cote
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Eleonore Brumpt
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Carine Richou
- Department of Hepatology, University of Bourgogne Franche-Comté, University Hospital Besançon, 25030, Besançon, France
| | - Celia Turco
- Department of Digestive Surgery, University of Bourgogne Franche-Comté, University Hospital Besançon, 25030, Besançon, France
| | - Alexandre Doussot
- Department of Digestive Surgery, University of Bourgogne Franche-Comté, University Hospital Besançon, 25030, Besançon, France
| | - Solange Bresson-Hadni
- Laboratoire de Parasitologie-Mycologie, University Hospital Besançon, 25030, Besançon, France.,Centre National de Référence Echinococcoses, University Hospital Besançon, 25030, Besançon, France
| | - Eric Delabrousse
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France.,EA 4662 Nanomedicine Lab, Imagery and Therapeutics, University of Bourgogne Franche-Comté, Besançon, France
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