To analyze the difficulties, risks and prognosis of splenectomy, subtotal cystectomy and classic endocystectomy for the treatment of secondary splenic cystic hydatidosis.

The clinical data of seventy-one patients with secondary splenic cystic hydatidosis who underwent surgical treatment in the First Affiliated Hospital of Xinjiang Medical University from January 2007 to January 2017 were retrospectively analyzed. Among them, 26 patients received splenectomy (group A), 26 patients received subtotal cystectomy (group B), and 19 patients received clssic endocystectomy (group C). The intraoperative condition, postoperative recovery, postoperative residual complications and recurrence were observed and compared.

Group A had the greatest intraoperative blood loss, longest postoperative anal exhaust time, catheter time, hospital stay, and highest hospital costs. However, intraoperative blood loss, postoperative catheter time, length of stay were shorter, and hospitalization cost were the lowest in group B (all P<0.05). After 2.5-12.5 years of follow-up, the incidence of postoperative complications in both group A and B was 3.85% (1/26), with no recurrence. The incidence of postoperative complications in group C was 21.05% (4/19), and the recurrence rate was 15.79% (3/19). The incidence of postoperative complications in the three groups was not statistically significant (χ²=4.62, P=0.090), but the recurrence rate in group C was significantly higher than that in the other two groups (χ²=8.28, P=0.016).

On the premise of strictly grasping the indications of operation, it is safe and the first choice to treat the secondary echinococcosis of spleen with subtotal resection of external capsule. The patients recover quickly after operation with low complication rates and hospitalization costs.