# Total Cystectomy in the Management of Primary Retroperitoneal Echinococcal Cysts: Current Evidence and Future Directions

## TL;DR

This paper reviews the use of total cystectomy for treating rare retroperitoneal echinococcal cysts, highlighting its benefits and challenges while suggesting areas for future research.

## Contribution

The paper provides a systematic review of total cystectomy for PRECs, identifying gaps in evidence and suggesting future research directions.

## Key findings

- Total cystectomy showed low recurrence rates and minimal complications in managing PRECs.
- Technical challenges and proximity to vital structures were noted as limitations.
- Future research should explore minimally invasive techniques and adjuvant therapies.

## Abstract

Echinococcal cysts (ECs) are a significant public health concern globally, particularly in endemic regions. Among these, primary retroperitoneal echinococcal cysts (PRECs) present unique challenges due to their location and complex presentations. Total cystectomy, involving complete removal of the EC and surrounding tissue, is a surgical option for managing PRECs. However, evidence regarding its efficacy and safety is limited. We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to evaluate the role of total cystectomy in managing PRECs. A comprehensive search of databases yielded four relevant studies. These studies reported favorable outcomes following total cystectomy, including low recurrence rates and minimal postoperative complications. However, challenges such as technical complexity and proximity to vital structures were noted. Future research should focus on evaluating minimally invasive approaches, exploring adjuvant therapies, identifying predictors of recurrence, and assessing cost-effectiveness. This systematic review underscores the need for further investigation to optimize the management of PRECs and improve patient outcomes.