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Is RTA a new potential option for the treatment of hydatid cysts?
Date:7/24/2009

Current treatment of cystic echinococcosis is surgery or percutaneous aspiration, injection and reaspiration (PAIR) using hypertonic saline or ethanol. It is aimed at causing permanent damage to the endocyst - the thin, delicate, and translucid inner membrane that produces the cystic fluid and generates new larval elements able to expand the infestation. Surgery and PAIR on liver and lung can result in biliary or bronchial fistulae, prompted by endocyst detachment; chemical cholangitis or pneumonia, due to passing of hypertonic saline or ethanol into the biliary or bronchial tree; and infection or abscess on the residual cyst cavity.

A research article to be published on July 14, 2009 in the World Journal of Gastroenterology addresses a new, possible therapeutic approach to treating hydatid cysts as an alternative to surgery and PAIR.

Dr. Lamonaca and his group from the Mediterranean Institute for Transplantation and Advanced Therapies (ISMETT) in Palermo, Italy, experimented with the use of radiofrequency thermal ablation (RTA) to treat hydatid cysts. No controlled study of this kind has been reported in the literature. RTA is a technique that converts electric power passing through a needle placed in an organ tissue into released heat, which then causes tissue necrosis. This technique is currently used for treatment of neoplasms, primarily hepatocellular carcinoma.

The authors wanted to verify whether radiofrequency is able to warm and irreversibly damage hydatid cysts, causing cyst wall necrosis through a heat-related mechanism, and, secondly, whether the heat-related coagulative necrosis of the cyst wall allows the parasitic endocyst to remain attached to the pericystium, unlike surgery or PAIR, which invariably causes endocyst detachment.

RTA was performed on 17 cysts (9 hepatic and 8 pulmonary), and was followed by pathology examination. Necrosis of the endocyst with a 100% success rate was seen in both hepatic
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Contact: Lai-Fu Li
wjg@wjgnet.com
86-105-908-0039
World Journal of Gastroenterology
Source:Eurekalert

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