{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T08:14:51Z","timestamp":1789892091973,"version":"4.0.1"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,11,7]],"date-time":"2016-11-07T00:00:00Z","timestamp":1478476800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,11,7]],"date-time":"2016-11-07T00:00:00Z","timestamp":1478476800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In humans, alveolar echinococcosis (AE) is a serious helminthic disease. Additionally to a long\u2010term medical treatment, in all suitable cases a complete surgical resection with a 20\u2010mm safe distance (minimal distance of larval tissue to resection margin) is recommended. We analyzed the influence of the safe distance and the effect of the postoperative anthelmintic prophylaxis on the long\u2010term outcome of patients who underwent surgery with curative intent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Ninety\u2010two operated patients were evaluated regarding the safe distance, the duration of medical therapy with benzimidazole derivates, and the further course of AE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median follow\u2010up after surgical procedure was 8.3 years. Twelve patients had a safe distance of 20\u00a0mm or more, 16 patients between 10 and 19\u00a0mm, 21 patients between 1 and 10\u00a0mm, and 10 patients 1\u00a0mm. In a further 33 patients, the affected liver was resected without any safe distance. Recurrence of AE was seen in 15 patients between 4\u00a0months and 24 years after initial operation. Safe distances of patients with recurrent disease were: 13 \u00d7 no safe distance, one patient with 1\u2010mm and one patient with 13\u2010mm safe distance. In all patients except one with recurrent AE, postoperative therapy with benzimidazole derivates was stopped.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A safe distance of at least 1\u00a0mm in combination with medical anthelmintic treatment continuing for two years might offer a good chance of being disease\u2010free long term, but the exact period of medical treatment needed is not defined. The therapy regime should be determined through an interdisciplinary approach in specialized centers.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-016-3813-6","type":"journal-article","created":{"date-parts":[[2016,11,7]],"date-time":"2016-11-07T19:54:31Z","timestamp":1478548471000},"page":"1012-1018","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Impact of Safe Distance on Long\u2010Term Outcome After Surgical Therapy of Alveolar Echinococcosis"],"prefix":"10.1002","volume":"41","author":[{"given":"Andreas","family":"Hillenbrand","sequence":"first","affiliation":[{"name":"Department of General and Visceral Surgery University Hospital Ulm Albert Einstein Allee 23 89081 Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beate","family":"Gruener","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University Hospital Ulm Ulm 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