Open AccessAn integrated surgical training program for hepatic cystic echinococcosis in Xinjiang of China
Author(s) -
Hongwei Zhang,
Jian Yang,
Li Jiang,
Jing Yang,
Yunbao Yu,
Guisheng Liu,
Yongguo Zhang,
Long Zhang,
Wei Guo,
Abuduwayiti,
Hong Sun,
Shuxiang Guo,
Xueling Chen,
Xiangwei Wu,
Shijie Zhang,
Xinyu Peng
Publication year - 2020
Publication title -
plos neglected tropical diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.99
H-Index - 135
eISSN - 1935-2735
pISSN - 1935-2727
DOI - 10.1371/journal.pntd.0008023
Subject(s) - medicine , cystic echinococcosis , modalities , perioperative , echinococcosis , china , health care , surgery , social science , sociology , political science , law , economics , economic growth
Background Human cystic echinococcosis (CE) is one of the commonest zoonoses, and it is endemic in many parts of the world including China. Complications and recurrences after the surgical treatment of hepatic CE (HCE) incur a large personal, healthcare, and societal burden. There has been some progress in HCE prevention, diagnosis, and treatment, but there is no “one size fits all” approach, and surgery still remains the cornerstone of treatment for some cyst stages and locations or in areas with little knowledge or access to other treatment modalities. In 2009 we designed and implemented a program to improve surgical outcomes from HCE in Xinjiang province, China. Methodology/Principal findings A multimodal HCE training program was implemented in eleven primary hospitals in Xinjiang province, China, which provided education and training on HCE clinical knowledge and practice, the application of diagnostic and treatment options, and optimal surgery. The management of HCE cases was analyzed before and after program implementation. Contrast enhanced CT use, application of scoloicidal agents, removal of necrotic cyst wall remnants, appropriate perioperative drug use, and the use of optimal surgical approach increased after program implementation. Further, postoperative recurrences and residual cavity complications creased from 7.4% to 1.3% and 15.2% to 9.0% after program implementation, respectively. Conclusions/Significance Tis integrated surgical training program is useful for improving outcomes of patients with HCE and can be used in institutions in other endemic areas.