Editing Echinococcosis (section)

===Cystic===
[[File:Vuitton et al - International consensus on terminology - parasite200043-fig3.png|thumb|left|International consensus on nomenclature framework for cystic echinococcosis surgery]]

For simple cases of cystic echinococcosis, the most common form of treatment is open surgical removal of the cysts combined with chemotherapy using [[albendazole]] and/or [[mebendazole]] before and after surgery. However, if there are cysts in multiple organs or tissues, or the cysts are in risky locations, surgery becomes impractical. For inoperable cases such as these, chemotherapy and/or [[PAIR (puncture-aspiration-injection-reaspiration)]] become alternative options of treatment.<ref name=Eckert04 /> In the case of alternative treatment using just chemotherapy, albendazole is preferred twice a day for 1–5 months.<ref name=DPDxTapeworm>{{cite web |title=The Medical Letter (Drugs for Parasitic Infections) |date=20 July 2009 |publisher=DPDx, CDC |url=http://www.dpd.cdc.gov/dpdx/hTML/PDF_Files/MedLetter/TapewormInfection.pdf |url-status=live |archive-url=https://web.archive.org/web/20100304174546/http://www.dpd.cdc.gov/dpdx/HTML/PDF_Files/MedLetter/TapewormInfection.pdf |archive-date=4 March 2010  }}</ref> An alternative to albendazole is mebendazole for at least 3 to 6 months. The other alternative to surgery is PAIR with chemotherapy. PAIR is a minimally invasive procedure that involves three steps: puncture and needle aspiration of the cyst, injection of a [[scolicidal]] solution for 20–30 min, and cyst-re-aspiration and final irrigation. People who undergo PAIR typically take albendazole or mebendazole from 7 days before the procedure until 28 days after the procedure.{{cn|date=May 2021}}

While open surgery still remains as the standard for cystic echinococcosis treatment, there have been a number of studies that suggest that PAIR with chemotherapy is more effective than surgery in terms of disease recurrence, and morbidity and mortality.<ref>{{cite journal |vauthors=Park KH, Jung SI, Jang HC, Shin JH |title=First successful puncture, aspiration, injection, and re-aspiration of hydatid cyst in the liver presenting with anaphylactic shock in Korea |journal=Yonsei Med. J. |volume=50 |issue=5 |pages=717–20 |date=October 2009 |pmid=19881979 |pmc=2768250 |doi=10.3349/ymj.2009.50.5.717 }}</ref> In addition to the three above mentioned treatments, there is currently research and studies looking at new treatment involving percutaneous thermal ablation (PTA) of the germinal layer in the cyst by means of a radiofrequency ablation device. This form of treatment is still relatively new and requires much more testing before being widely used.<ref name=Eckert04 /> An alternative to open surgery is laparoscopic surgery, which provides excellent cure rates with minimal morbidity and mortality.<ref>{{cite journal |author=Jani K |title=Spillage-free laparoscopic management of hepatic hydatid disease using the hydatid trocar canula |journal=J Minim Access Surg |volume=10 |issue=3 |pages=113–8 |date=July 2014 |pmid=25013326 |pmc=4083542 |doi=10.4103/0972-9941.134873 }}</ref>