Percutaneous Aspiration-Injection-Reaspiration Drainage Plus Albendazole or Mebendazole for Hepatic Cystic Echinococcosis: A Meta-analysis

• Published in: Clinical infectious diseases Vol. 37; no. 8; pp. 1073 - 1083
• Main Authors: Smego, Raymond A., Bhatti, Sabha, Khaliq, Amir A., Beg, M. Asim
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.10.2003; University of Chicago Press
• Subjects: Albendazole - therapeutic use; Anaphylaxis; Animals; Anthelmintics - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiparasitic agents; Biliary fistula; Biological and medical sciences; Cysts; Diseases caused by cestodes; Drainage; Echinococcoses; Echinococcosis; Echinococcosis, Hepatic - complications; Echinococcosis, Hepatic - drug therapy; Echinococcosis, Hepatic - surgery; Echinococcus - drug effects; Ethanol; Fever; Health outcomes; Helminthic diseases; Humans; Hydatids; Infections; Infectious diseases; Injections; Length of Stay; Liver; Major Articles; Mebendazole - therapeutic use; Medical sciences; Parasitic diseases; Pharmacology. Drug treatments; Recurrence; Treatment Outcome; Relapse; Prognosis; Methodology; Liver; Check; Hepatic disease; Hydatid cyst; Percutaneous route; Prevention; Mebendazole; Abdominal abscess; Surgery; Echinococciasis; Human; Immunopathology; Drug combination; Aspiration; Cure; Rate; Parasitosis; Helminthiasis; Cestode disease; Infection; Drainage; Chemotherapy; Albendazole; Treatment; Benzimidazole derivatives; Abdominal disease; Digestive diseases; Parasiticide; Liver abscess; Comparative study
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/378275

Using meta-analysis methodology, we compared the clinical outcomes for 769 patients with hepatic cystic echinococcosis treated with percutaneous aspiration-injection-reaspiration (PAIR) plus albendazole or mebendazole (group 1) with 952 era-matched historical control subjects undergoing surgical intervention (group 2). The rate of clinical and parasitologic cure (P < .0001) was greater in patients receiving PAIR plus chemotherapy. Disease recurrence (P < .0001), major complications (anaphylaxis, biliary fistula, cyst infection, liver/intra-abdominal abscess, and sepsis; P < .0001), minor complications (P < .0001), and death (P < .0824) occurred more frequently among surgical control subjects. Fever (P < .002) and minor allergic reactions subjects (P < .0001) were more common among PAIR-treated subjects. The mean durations of hospital stay were 2.4 days for group 1 and 15.0 days for group 2 (P < .001). Compared with surgery, PAIR plus chemotherapy is associated with greater clinical and parasitologic efficacy; lower rates of morbidity, mortality, and disease recurrence; and shorter hospital stays.