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

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 int...

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Bibliographic Details
Published in:Clinical infectious diseases 2003-10, Vol.37 (8), p.1073-1083
Main Authors: Smego, Raymond A., Bhatti, Sabha, Khaliq, Amir A., Beg, M. Asim
Format: Article
Language:English
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
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Summary: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.
ISSN:1058-4838
1537-6591
DOI:10.1086/378275