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Bhende VV, Rathod JB, Sharma AS, Thacker JP, Krishnakumar M, Mankad SP, Mehta DV, Kamat HV, Khara BN, Mehta SH, Prajapati D, Kumar A, Chaudhary M, Kotadiya KV, Gohil AB, Vani PP, Panchal SR, Mehta NJ, Patel DA, Gadoya VA, Ghoti HD. Conservative Surgical Management of a Pulmonary Hydatid Cyst in an Adolescent Having Extra-pulmonary Lesions by a Multi-disciplinary Approach. Cureus 2024; 16:e58600. [PMID: 38651089 PMCID: PMC11034718 DOI: 10.7759/cureus.58600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 04/25/2024] Open
Abstract
Echinococcus granulosus causes hydatid cysts, a significant zoonotic and pulmonary parasitic disease that can mimic various pathologies and is often harder to manage than the disease itself. A hydatid cyst is considered a significant health problem in India, Iran, China, and Mediterranean countries, which lack satisfactory environmental health, preventive medicine, and veterinarian services. Echinococcosis continues to be a major community health burden in several countries, and in some terrains, it constitutes an emerging and re-emerging disease. Cystic echinococcosis is the most common human disease of this genus, and it accounts for a significant number of cases worldwide. Herein, a case involving an 11-year-old presenting with fever, dry cough, and right hypochondrial pain is presented, where imaging revealed a hydatid cyst in the lung. Surgical removal of the cyst was achieved through right posterolateral thoracotomy under one-lung ventilation and anesthesia using intubation with a double-lumen endotracheal tube (DLET or DLT), highlighting surgery as the primary treatment despite the lack of consensus on surgical methods. This case underscores the effectiveness of individualized, parenchyma-preserving surgery for even large, uncomplicated cysts, indicating a positive prognosis.
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Affiliation(s)
- Vishal V Bhende
- Pediatric Cardiac Surgery, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Jignesh B Rathod
- Surgery, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Ashwin S Sharma
- Internal Medicine, Gujarat Cancer Society Medical College, Hospital, and Research Centre, Ahmedabad, IND
| | - Jigar P Thacker
- Pediatrics, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | | | | | - Deepakkumar V Mehta
- Radiodiagnosis and Imaging, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Hemlata V Kamat
- Anesthesiology, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Birva N Khara
- Anesthesiology, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Sanket H Mehta
- Anesthesiology, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Dhavalkumar Prajapati
- Pulmonary Medicine, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Amit Kumar
- Pediatric Intensive Care Unit (PICU), Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Mansi Chaudhary
- Anesthesiology, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Kuldeep V Kotadiya
- Surgery, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Aradhanaba B Gohil
- Pediatrics, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Prachi P Vani
- Pediatrics, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Sweta R Panchal
- Pediatrics, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Nili J Mehta
- Pediatrics, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Divyanshi A Patel
- Pediatrics, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Vidit A Gadoya
- Surgery, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Himanshu D Ghoti
- Surgery, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
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Aydın Y, Özgökçe M, Bilal Ulas A, Durmaz F, Kaşali K, Eren S, Aksungur N, Eroğlu A. Doubling time in pulmonary and hepatic hydatid cysts. TURK GOGUS KALP DAMAR CERRAHISI DERGISI 2024; 32:185-194. [PMID: 38933308 PMCID: PMC11197416 DOI: 10.5606/tgkdc.dergisi.2024.25844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 12/28/2023] [Indexed: 06/28/2024]
Abstract
Background This study aims to investigate whether the concept of doubling time in hydatid cysts differs according to different parameters such as age, sex, and whether the cyst is located in the lung or liver. Background: This study aims to investigate whether the concept of doubling time in hydatid cysts differs according to different parameters such as age, sex, and whether the cyst is located in the lung or liver. Methods Between January 2012 and August 2023, a total of 138 hydatid cysts were retrospectively analyzed. There were 55 pulmonary (32 males, 23 females; mean age: 25.6±23.8 years; range, 2 to 77 years) and 83 hepatic hydatid cyst patients (32 males, 51 females; mean age: 31.1±22.8 years; range, 3 to 75 years). Results The mean doubling times for pulmonary and hepatic hydatid cysts were 73.4±41.8 and 172.6±108.8 days, respectively (p<0.001). When children (≤18 years old) and adult cases were compared for pulmonary hydatid cysts, the mean doubling times were 61.1±17.6 and 87.1±55.3 days, respectively (p=0.119), and for hepatic hydatid cysts, 110.6±48.4 and 215.6±118.3 days, respectively (p<0.001). While comparing male and female cases, the mean doubling time for pulmonary hydatid cysts was 77.6±32.2 and 67.6±52.6 days, respectively (p=0.018), while for hepatic hydatid cysts, it was 192.0±111.7 and 160.4±106.2 days, respectively (p=0.250). Conclusion The doubling time seems to be approximately 10 weeks in the lung and approximately 25 weeks in the liver. Hydatid cysts grow faster in children than adults in both the lungs and liver.
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Affiliation(s)
- Yener Aydın
- Department of Thoracic Surgery, Atatürk University Faculty of Medicine, Erzurum, Türkiye
| | - Mesut Özgökçe
- Department of Radiology, Van Yüzüncü Yıl University Faculty of Medicine, Van, Türkiye
| | - Ali Bilal Ulas
- Department of Thoracic Surgery, Atatürk University Faculty of Medicine, Erzurum, Türkiye
| | - Fatma Durmaz
- Department of Radiology, Van Yüzüncü Yıl University Faculty of Medicine, Van, Türkiye
| | - Kamber Kaşali
- Department of Biostatistics, Atatürk University Faculty of Medicine, Erzurum, Türkiye
| | - Suat Eren
- Department of Radiology, Atatürk University Faculty of Medicine, Erzurum, Türkiye
| | - Nurhak Aksungur
- Department of General Surgery, Atatürk University Faculty of Medicine, Erzurum, Türkiye
| | - Atilla Eroğlu
- Department of Thoracic Surgery, Atatürk University Faculty of Medicine, Erzurum, Türkiye
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Vantankhah A, Taqanaki PB, Rahmanian M, Ameri L, Atqiaee K, Mashhadi MP. A life-threatening encounter: an uncommon case of ruptured hydatid cyst presenting as anaphylactic shock and respiratory distress in a 12-year-old boy. Ann Med Surg (Lond) 2023; 85:5742-5747. [PMID: 37915699 PMCID: PMC10617809 DOI: 10.1097/ms9.0000000000001330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/10/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction and importance Although rare, the spontaneous rupture of a lung hydatid cyst or its perforation into the pleural cavity can give rise to an abrupt onset of symptoms, including cough, fever, hemoptysis (coughing up blood), and hypersensitivity reactions, and can ultimately lead to respiratory failure. Case presentation A 12-year-old boy was brought to the emergency room with a loss of consciousness. Symptoms included tachypnea, fever, low blood pressure, and overall respiratory distress. After resuscitation, a chest X-ray revealed a distinct, well-defined round opacity located in the lower region of the right lung, leading to mediastinal displacement. After confirmation of the disease, the child was hospitalized in the ICU care and consequently underwent surgery. Treatment was successful and there was no recurrence on the follow-up. Clinical discussion Studies have demonstrated that the right lower lobe of the lung is the most frequently affected area of the lung by hydatid cysts. Symptomatic and complicated hydatid cysts are a rare concept in children, and only a small percentage, are diagnosed in patients younger than 16 years. Surgery remains the preferred treatment for the majority of patients with pulmonary hydatid disease. It is important to note that combined surgery and chemotherapy represents the current gold standard in managing pulmonary hydatid cyst. Conclusion Although anaphylactic shock caused by a ruptured lung hydatid cyst is rare, it should be taken into consideration by physicians as a differential diagnosis in patients who also have respiratory symptoms, particularly in endemic areas.
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Affiliation(s)
| | | | - Mohsen Rahmanian
- School of Medicine, North Khorasan University of Medical Sciences, Bojnurd
| | | | - Khashayar Atqiaee
- Department of Pediatric Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
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Shahriarirad R, Erfani A, Ebrahimi K, Rastegarian M, Eskandarisani M, Ziaian B, Sarkari B. Hospital-based retrospective analysis of 224 surgical cases of lung hydatid cyst from southern Iran. J Cardiothorac Surg 2023; 18:204. [PMID: 37400848 DOI: 10.1186/s13019-023-02327-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 06/29/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND The lungs are considered the second-most frequent location for hydatid cyst in human. The current retrospective hospital-based study aimed to assess the epidemiological data, clinical presentation, and treatment outcomes of lung hydatid cyst in patients who underwent surgery for this disease in Fars province, southern Iran. METHODS In this retrospective study, hospital records of 224 pulmonary hydatid cyst patients were assessed in two main university-affiliated hospitals in Fars Province, southern Iran. Clinical features of patients, epidemiological data, cyst features, surgical interventions, and treatment outcomes were reviewed and analyzed. RESULTS A total of 224 hydatid cyst cases of the lung were reviewed. Male patients accounted for the majority of cases (60.4%). The average age of the patients was 31.13 (± 19.6), ranging from 2 to 94 years old. Of the 224 patients, 145 (75.9%) cases had only one single cyst and mostly 110 (53.9%) located in the right lung. Also, 6 (2.9%) cases had cysts in both lungs. The lower lobe of the lungs was the most common location of the hydatid cyst. The average size of lung hydatid cyst was 7.37 cm (SD = 3.86; rang: 2-24) while for the cyst areas was 42.87cm2 (SD = 52.76; range: 2-488). Regarding the surgical method, 86 (38.6%) cases were operated by lung resection surgery while 137 (61.4%) cases had lung preserving one. The chief complaints of the patients were cough (55.4%) and dyspnea (32.6%). Relapse was documented in 25 (11.16%) of cases. CONCLUSIONS Lung hydatid cyst is a common infection in southern Iran. Lung preserving surgery is the method of choice for the management of hydatid cyst. Relapse, which was not uncommon in our study, is a challenging feature of hydatid cyst management.
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Affiliation(s)
- Reza Shahriarirad
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirhossein Erfani
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamyar Ebrahimi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Bizhan Ziaian
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bahador Sarkari
- Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Science, Shiraz, Iran.
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Abstract
Echinococcosis is a worldwide public health problem causing considerable paediatric morbidity and mortality in endemic areas. The presentation of cystic echinococcosis (CE) varies by age. Unlike adults, where hepatic involvement is common, pulmonary CE is the dominant site in the paediatric population. Pulmonary cysts are typically first seen on chest X-ray, either as an incidental finding or following respiratory symptoms after cyst rupture or secondary infection of the cyst. In children, pulmonary cysts have a broad differential diagnosis, and a definitive diagnosis relies on the combination of imaging, serology, and histology. In countries with high infectious burdens from diseases such as acquired immunodeficiency syndrome (AIDS) and tuberculosis (TB), the diagnosis is additionally challenging, as atypical infections are more common than in developed countries. Pulmonary CE is treated with a combination of surgery and chemotherapy.
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Kocaman OH, Günendi T, Dere O, Dörterler ME, Boleken ME. Pulmonary Hydatid Cyst in Children: A Single-Institution Experience. Cureus 2022; 14:e26670. [PMID: 35949804 PMCID: PMC9357973 DOI: 10.7759/cureus.26670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 11/29/2022] Open
Abstract
Objective: Hydatid cysts can occur in any place such as the liver, lung, spleen, kidney, brain, and soft tissue. Pulmonary hydatid cysts are more prone to rupture than liver hydatid cysts. In this study, we aimed to present the demographic characteristics, clinical symptoms, radiological findings, surgical findings, type of surgery performed, and postoperative complications of patients with pulmonary hydatid cysts. Materials and method: The files of 94 patients who were operated on for pulmonary hydatid cysts in our clinic between January 2011 and October 2021 were retrospectively analyzed. The patients were divided into two groups: ruptured pulmonary hydatid cysts and non-ruptured pulmonary hydatid cysts. Results: A total of 120 pulmonary hydatid cysts were detected in 94 patients who were operated on for pulmonary hydatid cysts. Cyst rupture was detected in 63 (52.5%) patients. Rupture was found significantly higher in cysts with a diameter of <10 cm (p=0.005). Complaints of fever and hemoptysis were found significantly higher in the ruptured group. Pneumothorax was detected in six patients after the operation with an average of two months, one of which was the patient who underwent video-assisted thoracoscopy (VATS). Conclusion: Pulmonary hydatid cyst should be kept in mind in children presenting with lower respiratory tract symptoms in regions where echinococcosis is endemic. Parenchyma-sparing methods should be the first choice in the management of pulmonary hydatid cysts. Patients who develop early postoperative complications should also be followed closely for late impediments.
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Ahmed SK, Essa RA, Bapir DH. Uniportal Video-assisted Thoracoscopic Surgery (u-VATS) for Management of pulmonary hydatid cyst: A systematic review. Ann Med Surg (Lond) 2022; 75:103474. [PMID: 35386784 PMCID: PMC8978088 DOI: 10.1016/j.amsu.2022.103474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 01/08/2023] Open
Abstract
Background and objectives Hydatid disease of the lung, caused by Echinococcus granulosus, is an unusual parasitic disease. The aim of the current review for managing pulmonary hydatid cysts by uniportal video-assisted thoracoscopic surgery (u-VATS), and their complications, the size of hydatid cyst, length of hospital stay, surgery time, the rate of conversion from u-VATS to thoracotomy or mini-thoracotomy, follow-up, and outcomes. Methods We conduct the platform searches on the PubMed and Google Scholar electronic databases from inception to January 20, 2022, among patients diagnosed with pulmonary hydatid cyst (PHC) who underwent the u-VATS approach. Results This systematic review comprised five studies reporting 85 cases of PHC underwent (u-VATS) approach. Most patients were adults. The most common location of pulmonary hydatid cyst was the right lower lobe followed by the left lower lobe. The average size of PHC was 8.41 cm in all studies. The length of hospital stay was 3.85 days. The duration of operation time based on the means of the included studies was 86.19 min for each patient. Furthermore, the overall complication occurred in 9.35% of patients (n = 11) from 85 cases. The most complication was emphysema and prolonged air leak. The recurrence of pulmonary hydatid cyst did not occur in all studies. Conclusion The feasibility of the video-assisted thoracoscopic surgery (VATS) approach has been proven globally in terms of reducing the overall complication, shorter chest tube duration, shorter surgery time, reduce postoperative pain, shorter chest tube duration, lower chest tube drainage, and less required to pain killers postoperatively.
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Affiliation(s)
- Sirwan Khalid Ahmed
- Department of Emergency, Rania Teaching Hospital, Rania, Sulaimani, Kurdistan-region, Iraq
- Department of Cardiothoracic and Vascular Surgery, Rania Medical City Hospital, Rania, Sulaimani, Kurdistan-Region, Iraq
- Department of Emergency, Rania Pediatric & Maternity Teaching Hospital, Rania, Sulaimani, Kurdistan-region, Iraq
- Department of Biotechnology, Institute of Science and Modern Technology, Rojava University, Qamishlo, Syria
| | - Rawand Abdulrahman Essa
- Department of Emergency, Rania Teaching Hospital, Rania, Sulaimani, Kurdistan-region, Iraq
- Department of Cardiothoracic and Vascular Surgery, Rania Medical City Hospital, Rania, Sulaimani, Kurdistan-Region, Iraq
- Department of Emergency, Rania Pediatric & Maternity Teaching Hospital, Rania, Sulaimani, Kurdistan-region, Iraq
| | - Dunya Hars Bapir
- Department of Biotechnology, Institute of Science and Modern Technology, Rojava University, Qamishlo, Syria
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Khalfallah I, Hajjej S, Ferchichi M, Boussetta A, Affes M, Louhaichi S, Hamdi B, Ammar J, Hamzaoui A. Giant pulmonary hydatid cyst in children. Monaldi Arch Chest Dis 2021; 92. [PMID: 34523320 DOI: 10.4081/monaldi.2021.1770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/13/2021] [Indexed: 11/23/2022] Open
Abstract
Hydatid disease is still endemic in Tunisia. It is mostly seen in young people less than 40 years and children are affected in one third of cases. The lungs are the predominant location in children. Our study aims to define the particularities of children PHC's (pulmonary hydatic cyst) management, the characteristics of giant cyst and to study predictive factors of complications. We included retrospectively 105 children with PHC followed between 1999 and 2019. Patients were aged less than 16 years with surgically confirmed diagnosis of PHC. Two groups of cysts were defined: giant cysts which were 10 cm across or more, and no giant cysts.The sex-ratio was 1,38 with a mean age of 10.5±3 years. The symptomatology was dominated by cough (59%), thoracic pain (51%) and hemoptysis (46%). Giant cysts were observed in 24 (22.9%) patients. Dyspnea (29% vs 5% p<0.001) and thoracic pain (88% vs .41% p<0.001) were significantly more frequently reported in giant cysts. Eighty-six patients had a single cyst (83%) and 19 had multiple cysts (17%). Giant cysts accounted for 22,9% (24 cases). Thoracic ultrasonography was diagnostic in 77.4%. The thoracic CT scan was performed in 27 children with inaccessible cysts in thoracic ultrasonography or in diagnostic doubt.Patients were all treated surgically. Surgical procedures consisted of cystectomy (59%), pericystectomy (18%) and pulmonary resection when parenchyma was destroyed (23%). Parenchymal resection was more often performed in complicated cysts (27% vs 20% p>0.05) and in giant cysts (41% vs 18% p<0.05). A two-stage thoracotomy was performed in the 4 patients with bilateral cysts. Thirteen patients presented immediate post-operative complications which occurred more frequently in complicated and giant cysts. Hospital stay was longer in complicated cysts (16±9 days vs 7±3 days; p<0.001) and in giant cysts (14±9 days vs 11±8 days; p>0.05). In endemic regions, the diagnosis of PHC in children should be based on the combination of thoracic radiography and ultrasonography which are effective, not costly, safe and accessible. Complicated and giant PHC cause lung damage leading to extensive parenchymal resection. They are more associated with post-operative complications prolonging hospital stay and increasing expenses.
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Affiliation(s)
- Ikbel Khalfallah
- Pulmonology B Department, Abderrahmen Mami Hospital, Ariana; Faculty of Medicine, El Manar University, Tunis.
| | - Sabri Hajjej
- Pulmonology B Department, Abderrahmen Mami Hospital, Ariana; Faculty of Medicine, El Manar University, Tunis.
| | - Meriem Ferchichi
- Pulmonology B Department, Abderrahmen Mami Hospital, Ariana; Faculty of Medicine, El Manar University, Tunis.
| | - Abir Boussetta
- Faculty of Medicine, El Manar University, Tunis; Pediatric Department, Charles Nicolle Hospital, Tunis .
| | - Meriam Affes
- Faculty of Medicine, El Manar University, Tunis; Radiology Department, Abderrahmen Mami hospital, Ariana.
| | - Sabrine Louhaichi
- Pulmonology B Department, Abderrahmen Mami Hospital, Ariana; Faculty of Medicine, El Manar University, Tunis.
| | - Besma Hamdi
- Pulmonology B Department, Abderrahmen Mami Hospital, Ariana; Faculty of Medicine, El Manar University, Tunis.
| | - Jamel Ammar
- Pulmonology B Department, Abderrahmen Mami Hospital, Ariana; Faculty of Medicine, El Manar University, Tunis.
| | - Agnès Hamzaoui
- Pulmonology B Department, Abderrahmen Mami Hospital, Ariana; Faculty of Medicine, El Manar University, Tunis.
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Aydin Y, Ulas AB, Ince I, Kuran E, Keskin H, Kirimli SN, Kasali K, Ogul H, Eroglu A. Modified capitonnage technique for giant pulmonary hydatid cyst surgery. Interact Cardiovasc Thorac Surg 2021; 33:721-726. [PMID: 34041544 DOI: 10.1093/icvts/ivab152] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study investigated the effectiveness of the modified technique (Aydin Technique), which was applied for capitonnage in the surgical treatment of giant pulmonary hydatid cysts. METHODS Twenty-two cases were operated on for giant hydatid cysts with a total of 23 modified techniques for capitonnage (bilateral giant hydatid cyst in 1 case) in our clinic between January 2018 and December 2020. The demographic data were recorded. RESULTS Thirteen out of 22 (59.1%) of cases were male and 9 (40.9%) were female. The mean age was 22.0 ± 15.8 and 14 cases (63.6%) were children. Hydatid cysts were intact in 13 (56.5%) cases and ruptured in 10 (43.5%) cases. Hydatid cyst diameters were on average 123 ± 21 mm. A modified method was performed for capitonnage in all cases while decortication was performed in 2 (8.7%) cases due to pleural thickening. Radiological atelectasis was observed in 6 cases (27.3%) postoperatively. The patients with atelectasis recovered without any clinical problem and no intervention was needed. In 1 case, an infection developed at the incision site. Postoperative prolonged air leak, empyema and mortality were not observed in any of the cases. The postoperative mean length of hospital stay was 7.18 ± 2.15 days. The mean follow-up period was 19.5 ± 11.5 months. No recurrence was encountered in the follow-up of the patients. CONCLUSIONS The results of this study may suggest to perform this new-described modified Aydin technique to avoid major capitonnage complications of the giant pulmonary hydatid cyst surgery.
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Affiliation(s)
- Yener Aydin
- Department of Thoracic Surgery, Ataturk University, School of Medicine, Erzurum, Turkey.,Anesthesiology, Clinical Research Office, Ataturk University, School of Medicine, Erzurum, Turkey
| | - Ali Bilal Ulas
- Department of Thoracic Surgery, Ataturk University, School of Medicine, Erzurum, Turkey
| | - Ilker Ince
- Anesthesiology, Clinical Research Office, Ataturk University, School of Medicine, Erzurum, Turkey.,Department of Anesthesiology and Reanimation, Ataturk University, School of Medicine, Erzurum, Turkey
| | - Emre Kuran
- Department of Thoracic Surgery, Ataturk University, School of Medicine, Erzurum, Turkey
| | - Hilmi Keskin
- Department of Thoracic Surgery, Ataturk University, School of Medicine, Erzurum, Turkey
| | - Sevde Nur Kirimli
- Department of Thoracic Surgery, Ataturk University, School of Medicine, Erzurum, Turkey
| | - Kamber Kasali
- Anesthesiology, Clinical Research Office, Ataturk University, School of Medicine, Erzurum, Turkey.,Department of Biostatistics, Ataturk University, School of Medicine, Erzurum, Turkey
| | - Hayri Ogul
- Anesthesiology, Clinical Research Office, Ataturk University, School of Medicine, Erzurum, Turkey.,Department of Radiology, Ataturk University, School of Medicine, Erzurum, Turkey
| | - Atilla Eroglu
- Department of Thoracic Surgery, Ataturk University, School of Medicine, Erzurum, Turkey
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Abdennadher M, Hadj Dahmane M, Zribi H, Zairi S, Bouassida I, Sahnoun I, Neji H, Mlika M, Ouerghi S, Marghli A. Management of giant hydatid cysts: a tertiary centre experience. THE CARDIOTHORACIC SURGEON 2021. [DOI: 10.1186/s43057-021-00048-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Hydatid cyst (HC), the most parasitic disease of the lung, is still an important health problem in Tunisia. In this study, we reviewed our experience in a surgical management of 33 patients with giant pulmonary hydatid cyst (GPHC) (diameter ≥ 10 cm).
Main body
Between 1998 and 2019, a total of 33 patients with GPHC were operated in the Thoracic Surgery Department in Abderrahmane Mami Hospital. Seventeen were males (51.51) and 16 were females (48.48%). The median age was 33.9 years (range 7–83 years). The diameters of the cyst ranged between 10 and 20 cm (mean 13.15 cm). The most common symptoms were chest pain (63.63%) and cough (33.33%). Imaging showed a single GPHC in all cases. GPHC was intact in 75.75% cases and complicated in 24.25% cases. Posterolateral thoracotomy was performed in 27 cases (81.81%). For the residual cavity, parenchyma-saving procedures were performed in 54.54% and anatomical resection was performed in 45.46%. Morbidity was low, and no mortality was seen.
Conclusion
GPHC are considered more difficult to treat surgically than small cysts; parenchyma preserving should and could be the surgical method of choice with a good prognosis. The decision of anatomical pulmonary resection is taken in per-operative when conservative surgery is not possible.
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11
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Aqqad A, Hamdi B, Louhaichi S, Khalfallah I, Attia M, Zairi S, Ammar J, Hamzaoui A. Giant pulmonary hydatid cyst in children. Arch Pediatr 2021; 28:273-277. [PMID: 33773892 DOI: 10.1016/j.arcped.2021.02.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/07/2020] [Accepted: 02/13/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Lungs are the second most common site for hydatid disease after the liver. Giant hydatid cyst (GHC) of the lung is a special clinical entity in children and is related to higher lung tissue elasticity. AIM To compare clinical and imaging features, types of surgical interventions, and postoperative complications in pulmonary GHC and non-giant pulmonary hydatid cysts (NGHC) in children. METHODS A retrospective study was undertaken. The data analyzed were taken from medical records of children with pulmonary hydatid cyst (PHC) hospitalized in a pulmonary department in Tunisia between January 2004 and February 2019. Cysts were divided according to their size into GHC ( ≥10cm) and NGHC (<10cm). RESULTS In the study period, 108 PHC were recorded in 84 children. GHC accounted for 21 (19.4%) and NGHC for 87 (80.6%). The median of age of the children was 11 years (IQR 1-9, IQR 3-14) and the mean age was 11.6 years (10.5 in GHC vs. 11.4 years in NGHC). Hemoptysis was found in 25% of the GHC group vs. 48.4% of the NGHC group (P=0.27). Cysts were multiple in 23.8% of cases and predominated in the right in 64.3% of cases and in the inferior lobes in 71.4% of the cases. GHCs were less frequently complicated (60% vs. 78.1% in NGHC, P≤0.11), although not significantly. Parenchymal resection was realized in 50% of GHC vs. 18.8% of NGHC (P=0.006). No significant difference was found in postoperative complications between the two groups and there was no recurrence in either group. CONCLUSION GHC is a special clinical entity in children. It requires major surgery with parenchymal resection, and therefore early diagnostic and therapeutic management is warranted.
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Affiliation(s)
- Alaa Aqqad
- Department B, Abderrahmen Mami Hospital, 2080 Ariana, Tunisia.
| | - Besma Hamdi
- Department B, Abderrahmen Mami Hospital, 2080 Ariana, Tunisia
| | | | | | - Monia Attia
- Radiology Department, Abderrahmen Mami Hospital, 2080 Ariana, Tunisia
| | - Sarra Zairi
- Thoracic Surgery Department, Abderrahmen Mami Hospital, 2080 Ariana, Tunisia
| | - Jamel Ammar
- Department B, Abderrahmen Mami Hospital, 2080 Ariana, Tunisia
| | - Agnès Hamzaoui
- Department B, Abderrahmen Mami Hospital, 2080 Ariana, Tunisia
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12
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ÖZTÜRK G. The two huge pulmonary hytadic cyst in the one lobe of lung: A case report. TURKISH JOURNAL OF INTERNAL MEDICINE 2021. [DOI: 10.46310/tjim.876357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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13
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Lawandi A, Yansouni CP, Libman M, Rubin E, Emil S, Bernard C, Ndao M, Barkati S. A 9-Year-Old Female With a Cough and Cavitary Lung Lesion. Clin Infect Dis 2020; 69:705-708. [PMID: 31986208 DOI: 10.1093/cid/ciy769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Cedric P Yansouni
- Division of Infectious Diseases, Department of Medical Microbiology.,J.D. MacLean Centre for Tropical Diseases
| | - Michael Libman
- Division of Infectious Diseases, Department of Medical Microbiology.,J.D. MacLean Centre for Tropical Diseases
| | - Earl Rubin
- Division of Infectious Diseases, Department of Medical Microbiology, The Montreal Children's Hospital
| | - Sherif Emil
- Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital
| | - Chantal Bernard
- Department of Pathology, Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Momar Ndao
- J.D. MacLean Centre for Tropical Diseases.,National Reference Centre for Parasitology, Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Sapha Barkati
- Division of Infectious Diseases, Department of Medical Microbiology.,J.D. MacLean Centre for Tropical Diseases
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14
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ULUŞAN A, HENGİRMEN MA, ŞANLI M, IŞIK AF. 16 Yaş Altı Çocuklarda Akciğer Hidatik Kist Cerrahisi: Vaka Serisi. DICLE MEDICAL JOURNAL 2020. [DOI: 10.5798/dicletip.706104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Successful Management of a Huge Pulmonary Hydatid Cyst with Lung-Preserving Surgery. Case Rep Surg 2020; 2020:9526406. [PMID: 32257501 PMCID: PMC7103054 DOI: 10.1155/2020/9526406] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/29/2020] [Accepted: 03/09/2020] [Indexed: 02/07/2023] Open
Abstract
The lung is the second most commonly involved organ in humans by hydatid disease. Management of large pulmonary hydatid cysts is a great challenge for thoracic surgeons. Lung resections should be considered the last choice for huge pulmonary hydatid cysts when the lung expansion is not optimal after cyst removal. Here, we present a case of huge lung hydatid cyst involving the entire right lower lobe which was successfully managed by lung-preserving surgery in which the postoperative course showed gradual resolution of the involved lobe during a one-year follow-up.
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16
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Abu Akar F, Gonzalez-Rivas D, Shaqqura B, Salman W, Ismail M, Safadi T, Adwan R, Al-Hassan H, Rumman N, Hijjeh N. Uniportal video assisted thoracoscopy versus open surgery for pulmonary hydatid disease-a single center experience. J Thorac Dis 2020; 12:794-802. [PMID: 32274146 PMCID: PMC7139009 DOI: 10.21037/jtd.2019.12.73] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Although rare in the Western world, the incidence of hydatid disease is still prevalent and strikingly endemic among the Palestinians. Until 2017, surgical treatment of lung pathologies was performed through the traditional incision (open thoracotomy). Uniportal video-assisted thoracoscopic surgery (VATS) approach has recently been applied in the cases of the pulmonary hydatid cysts with very satisfactory results. Methods Between January 2010 and January 2019, 39 patients with pulmonary HC disease have been surgically treated. The cases divided into two cohorts: operations performed by thoracotomy classified as group A, (n=16). Operations performed by uniportal VATS classified as group B, (n=23). Prospectively collected data was analysed retrospectively, and the results compared between both groups. Results No significant statistical differences were noticed in terms of demographics and comorbidity. Laboratory tests were similar except haemoglobin level, which was higher in group A (P=0.001). Despite that, blood transfusion was higher in group A (P=0.016). Moreover, operation time was longer in group A (P=0.000). Chest drainage remained longer in group A (P=0.077). The level of postoperative pain was significantly higher in group A certainly in POD 1 (P=0.000). Patients in group B discharged earlier from the hospital (P=0.011) and experienced lower complications (P=0.060). No significant difference in length of ICU stay. Neither recurrence nor 30-day mortality recorded in either group. Conclusions Uniportal VATS can be safely applied for pulmonary hydatidosis. It also seems to have a preference in several aspects compared to open Thoracotomy approach.
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Affiliation(s)
- Firas Abu Akar
- Department of Cardiothoracic Surgery, Makassed Charitable Society Hospital, East Jerusalem, Palestine
| | - Diego Gonzalez-Rivas
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.,Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain
| | - Bisanne Shaqqura
- Department of Cardiothoracic Surgery, Makassed Charitable Society Hospital, East Jerusalem, Palestine
| | - Waseem Salman
- Department of Cardiothoracic Surgery, Makassed Charitable Society Hospital, East Jerusalem, Palestine
| | - Mahmoud Ismail
- Department of Thoracic Surgery, Klinikum Ernst von Bergmann Academic Hospital of the Charité - Universitätsmedizin Humboldt University Berlin, Berlin, Germany
| | - Tammah Safadi
- Department of Cardiothoracic Surgery, Makassed Charitable Society Hospital, East Jerusalem, Palestine
| | - Rabee Adwan
- Infectious Diseases Unit, Makassed Charitable Society Hospital, East Jerusalem, Palestine
| | - Haitham Al-Hassan
- Division of Surgery, Makassed Charitable Society Hospital, East Jerusalem, Palestine
| | - Nisreen Rumman
- Department of Pediatrics, Makassed Charitable Society Hospital, East Jerusalem, Palestine
| | - Nizar Hijjeh
- Department of Cardiothoracic Surgery, Makassed Charitable Society Hospital, East Jerusalem, Palestine
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17
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Oncel M, Yildiran H, Sunam GS. Trust the Capitonnage in the Giant Cyst: Case Report. Surg J (N Y) 2018; 4:e212-e214. [PMID: 30377655 PMCID: PMC6205863 DOI: 10.1055/s-0038-1675370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 09/10/2018] [Indexed: 11/17/2022] Open
Abstract
Cyst hydatid in the lung is still a health problem for many countries. It develops in the lung and can grow into the lung parenchyma. When it is diagnosed as a giant cyst, surgery should be performed. In the surgery, capitonnage is necessary to protect the lung parenchyma.
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Affiliation(s)
- Murat Oncel
- Department of Thoracic Surgery, Selcuk University Medical Faculty, Selcuk University, Konya, Turkey
| | - Huseyin Yildiran
- Department of Thoracic Surgery, Kars Harakani State Hospital, Kars, Turkey
| | - Guven Sadi Sunam
- Department of Thoracic Surgery, Selcuk University Medical Faculty, Selcuk University, Konya, Turkey
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18
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Thapa B, Sapkota R, Kim M, Barnett SA, Sayami P. Surgery for parasitic lung infestations: roles in diagnosis and treatment. J Thorac Dis 2018; 10:S3446-S3457. [PMID: 30505532 DOI: 10.21037/jtd.2018.08.32] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Pulmonary parasitic infestations are a worldwide problem associated with significant morbidity and socioeconomic impact. They are known to have varied clinical presentations and radiological appearances. Prevention of parasite transmission and medical treatment of cases form the two pillars of control of these diseases. The role of surgery is limited to the diagnosis and definitive treatment of the minority of pulmonary parasitic afflictions, most notably hydatidosis. Despite surgery being established as the treatment of choice in pulmonary hydatid cysts (PHCs) for over half a century, variations and unresolved controversies persist regarding the best surgical technique. Complications brought on by cyst rupture, multiplicity and multi-organ involvement add complexity to treatment decisions. The development of video-assisted thoracoscopic surgery (VATS) brings the promise of reduced peri-operative morbidity but is yet to be universally accepted as a safe technique. In this review, we endeavor to discuss the common pulmonary infestations focusing on the current trends and controversies surrounding surgery for PHC.
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Affiliation(s)
- Bibhusal Thapa
- Olivia Newton-John Cancer Research Institute, Victoria, Australia.,Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu, Nepal
| | - Ranjan Sapkota
- Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu, Nepal
| | - Michelle Kim
- Department of Cardiothoracic Surgery, Barwon Health, Geelong, Australia
| | | | - Prakash Sayami
- Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu, Nepal
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19
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Onal O, Demir OF. Is Anatomic Lung Resection Necessary in Surgical Treatment of Giant Lung Hydatid Cysts in Childhood? Ann Thorac Cardiovasc Surg 2017; 23:286-290. [PMID: 28883209 DOI: 10.5761/atcs.oa.17-00023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE The aim of this study is to evaluate the results of parenchymal saving methods for giant lung hydatid cysts and to discuss the necessity of anatomic lung resection in childhood. METHODS The patients under the age of 16 years who were operated between January 2000 and January 2017 due to pulmonary hydatid cyst were evaluated retrospectively (n = 200). In all, 32 patients who had giant hydatid cyst were included in this study. Parenchymal saving methods (cystotomy-capitonnage) were preferred and decortication was also performed for pleural thickening if needed. No lung resections were applied. RESULTS Male patients were 53.1%. The mean age was 11.3 ± 3.2 years. The total number of giant cysts was 32. The average size of the cysts was 11 cm. Thirty seven point five percent of the cysts were perforated. Postoperative complication rate was 31.3%. No recurrence and mortality were seen during follow-up period. CONCLUSION Considering the high recovery capacity of lung tissue, a chance should be given to recover the existing infection, atelectasis, and parenchymal damage. Especially in areas where hydatid disease is endemic, children may be infected with the parasite again. For these reasons, we do not recommend resection with any indications.
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Affiliation(s)
- Omer Onal
- Faculty of Medicine, Department of Thoracic Surgery, University of Erciyes, Kayseri, Turkey
| | - Omer Faruk Demir
- Faculty of Medicine, Department of Thoracic Surgery, University of Erciyes, Kayseri, Turkey
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20
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Conservative Surgical Management for Pulmonary Hydatid Cyst: Analysis and Outcome of 148 Cases. Can Respir J 2016; 2016:8473070. [PMID: 27642249 PMCID: PMC5013219 DOI: 10.1155/2016/8473070] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 07/10/2016] [Accepted: 07/25/2016] [Indexed: 11/18/2022] Open
Abstract
Background. Hydatid cyst (HC) disease is endemic in many developing countries, like Yemen, Egypt, and Saudi Arabia, especially in the rural regions. The disease has a variable clinical courses and even might be asymptomatic for many years. Objectives. In giant and large pulmonary hydatid cysts, pulmonary resection is the usual method of surgical treatment. In this study, we aimed to evaluate the lung conservative surgery in treatment of cases with giant and large hydatid lung cysts, as an effective method of management. Patients and Methods. Between January 2009 and August 2014, a total of 148 patients with pulmonary hydatid cysts were operated and their data was reviewed retrospectively and analyzed. Out of these cases, 52 (35.14%) cysts with more than 10 cm in diameter and 36 (24.32%) cysts with 5–9 cm were regarded as giant and large hydatid lung cysts, respectively. The small cysts less than 5 cm were presented in 8 (5.4%) cases only; other cases had ruptured cysts. Preservation of the lung tissues during surgery by cystotomy and Capitonnage was our conservative surgical methods of choice. Results. Eight patients developed bronchopleural fistula (BPF); of them, 4 BPFs have healed with chest tube and physiotherapy, but in the other 4 patients reoperation was done for the closure of persistent BPF. No mortality was observed in the present study. Conclusion. We conclude that conservative surgical procedure can achieve complete removal of the pulmonary hydatid cyst. Enucleation of the intact huge cysts is safe. Careful and secured closure of the bronchial communication should be done by purse string or figure-of-8 sutures, with or without Teflon pledgets. These simple procedures are safe, reliable, and successful.
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21
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Eren MN, Balci AE, Eren S. Non-Capitonnage Method for Surgical Treatment of Lung Hydatid Cysts. Asian Cardiovasc Thorac Ann 2016; 13:20-3. [PMID: 15793045 DOI: 10.1177/021849230501300105] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Capitonnage is usually advocated for obliteration of the residual cavity after removal of a hydatid cyst. To assess a non-capitonnage method, results in 33 patients were compared with those of 80 patients who had capitonnage. The non-capitonnage patients had a shorter mean hospital stay and earlier radiologic improvement but higher morbidity than the capitonnage patients. Extended air leak caused significant morbidity in each group. Bronchoscopic intervention was needed for atelectasis in 1 patient. There was no mortality in either group. In the follow-up period, no late complication or recurrence was observed in non-capitonnage patients. Among the capitonnage patients, 2 had bronchiectasis, and suture material expectoration occurred in one. The non-capitonnage method may be a good alternative to the capitonnage procedure for lung hydatid cyst. Better management of bronchial openings should improve the results of the non-capitonnage method.
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Affiliation(s)
- M Nesimi Eren
- Department of Thoracic Surgery, Dicle and Firat University School of Medicine, Elaziğ 23100, Turkey
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22
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Vennarecci G, Manfredelli S, Guglielmo N, Laurenzi A, Goletti D, Ettorre GM. Major liver resection for recurrent hydatid cyst of the liver after suboptimal treatment. Updates Surg 2016; 68:179-84. [PMID: 27126358 DOI: 10.1007/s13304-016-0368-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 04/16/2016] [Indexed: 12/24/2022]
Abstract
Recurrent hydatid disease (HD) of the liver after a previous suboptimal invasive treatment is a clinical situation not well codified in terms of management and surgical treatment. Between June 2001 and July 2015, 1525 liver resection were performed at our unit, of whom 217 were with a laparoscopic and 20 with a robotic approach. The most common indications were hepatocellular carcinoma grown on a cirrhotic liver and colorectal metastasis. During the same period, we performed liver surgery for HD in 34 patients (21 females, 13 males). This retrospective study focused on the management and surgical treatment of three unusual cases of recurrent hydatid cyst. All patients had a course of perioperative albendazole. Thirty-four patients had a surgical treatment [open surgery in 30 (88 %) and laparoscopic in four (12 %)]. Surgical procedures were classified as radical resections in 33 patients [total cystopericystectomy (10), left lateral hepatectomy (5), left hepatectomy (2), right hepatectomy (7), segmentectomy/bisegmentectomy (9)]. One patient underwent subtotal pericystectomy as the cyst was close to a major vascular pedicle in a cirrhotic liver. Post operative complications of grade I-II occurred in 11 (32 %) patients, of grade III-IV in one (3 %). Three patients had HD recurrence after a previous suboptimal invasive treatment [PAIR (2), unroofing (1)] and all had to undergo a major liver resection for the complete removal of parasites. The HD first relapse rate for the whole surgical series was 3 %. The second relapse rate was 33 %. The overall survival rate was 100 %. Operations for recurrent HD of the liver represent a surgical challenge due to volume of the cyst, presence of adhesions related to previous invasive treatments and proximity to major vascular structures of the liver. In such instances, pericystectomy can be difficultly achieved making necessary a formal major liver resection.
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Affiliation(s)
- Giovanni Vennarecci
- Division of Surgical Oncology and Liver Transplantation, San Camillo Hospital, POIT San Camillo-INMI Lazzaro Spallanzani, Cir.ne Gianicolense N° 187, 00100, Rome, Italy.
| | - Simone Manfredelli
- Division of Surgical Oncology and Liver Transplantation, San Camillo Hospital, POIT San Camillo-INMI Lazzaro Spallanzani, Cir.ne Gianicolense N° 187, 00100, Rome, Italy
| | - Nicola Guglielmo
- Division of Surgical Oncology and Liver Transplantation, San Camillo Hospital, POIT San Camillo-INMI Lazzaro Spallanzani, Cir.ne Gianicolense N° 187, 00100, Rome, Italy
| | - Andrea Laurenzi
- Division of Surgical Oncology and Liver Transplantation, San Camillo Hospital, POIT San Camillo-INMI Lazzaro Spallanzani, Cir.ne Gianicolense N° 187, 00100, Rome, Italy
| | - Delia Goletti
- Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - Giuseppe Maria Ettorre
- Division of Surgical Oncology and Liver Transplantation, San Camillo Hospital, POIT San Camillo-INMI Lazzaro Spallanzani, Cir.ne Gianicolense N° 187, 00100, Rome, Italy
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Abstract
Cystic echinococcosis (CE) is a zoonotic parasitic disease caused by the larval stages of the cestode Echinococcus granulosus. Worldwide, pulmonary hydatid cyst is a significant problem medically, socially, and economically. Surgery is the definitive therapy of pulmonary hydatidosis. Benzimidazoles may be considered in patients with a surgical contraindication. This review will focus on pathogenesis, lifecycle, clinical features, and management of pulmonary hydatid disease.
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Affiliation(s)
- Malay Sarkar
- Department of Pulmonary Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - Rajnish Pathania
- Department of Cardiac and Thoracic Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - Anupam Jhobta
- Department of Radiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - Babu Ram Thakur
- Department of Cardiac and Thoracic Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - Rajesh Chopra
- Department of Cardiac and Thoracic Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
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Uygun SS, Arıbaş OK, Pekcan S. 8-year old patient with giant hydatid cyst consulted with chest wall asymmetry. Pediatr Int 2015; 57:1164-6. [PMID: 26711916 DOI: 10.1111/ped.12811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 01/04/2015] [Accepted: 01/15/2015] [Indexed: 11/27/2022]
Abstract
Cystic echinococcosis, a zoonotic disease, is common in Turkey and is caused by the Echinococcus granulosus tapeworm. We describe the case of an 8-year-old girl who was admitted to hospital with chest wall asymmetry after a fall from height, without any other symptoms. Cystic lesion was identified on radiology, and serology supported the diagnosis of hydatid cyst. The patient underwent thorax surgery. Postoperatively, she was treated with benzimidazoles for 2 months. Rarely, hydatid cysts can reach a size sufficiently large to cause chest deformity.
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Affiliation(s)
- Saime Sündüs Uygun
- Department of Neonatology, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Olgun Kadir Arıbaş
- Departments of Thoracic Surgery, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Sevgi Pekcan
- Department of Pediatric Pulmonology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
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25
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Aydogdu B, Sander S, Demirali O, Guvenc U, Besik C, Kuzdan C, Goya C, Tireli G. Treatment of spontaneous rupture of lung hydatid cysts into a bronchus in children. J Pediatr Surg 2015; 50:1481-3. [PMID: 25783398 DOI: 10.1016/j.jpedsurg.2015.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 12/18/2014] [Accepted: 01/15/2015] [Indexed: 11/25/2022]
Abstract
PURPOSE While several publications have reported the treatment of ruptured lung hydatid cysts (HC) in adults, there is limited information on the treatment of children. This study summarizes the treatment approach and outcomes of 11 children with spontaneous rupture of lung HCs into a bronchus. METHODS The complete medical records of 11 patients with spontaneous lung HC bronchus rupture between March 1993 and April 2012 were examined retrospectively. Gender, age at the time of diagnosis, patient symptoms, lung localization, dimensions of the cyst, medical treatment duration, and associated morbidities were evaluated. Routine chest x-rays, ultrasonography, computed tomography and serological tests were used. RESULT The study included 11 patients [4 males, 7 females; average age 7.45 (range 5-11) years] presenting to the Emergency Department. The symptoms at the time of presentation were coughing in 81.8% (n=9), hemoptysis in 54.5% (n=6), and chest pain in 54.5% (n=6). The average cyst diameter was 8.71(35-15) cm. The rupture involved the left lung in 7 (63.6%) patients and the right in 4 (36.4%). Serological tests were positive in seven patients and all patients had eosinophilia. The treatment of one patient was discontinued, while all of the other patients were treated medically. Pneumonia developed in four patients and lung abscesses in two. Both patients who developed lung abscesses had cysts with diameters greater than 10 cm. The average follow-up period was 48.4 (range 15-85) months; no mortality occurred. CONCLUSION In our experience, medical treatment is adequate for patients with lung HCs progressing to spontaneous bronchus rupture. There was a high rate of abscess development within the thoracic cavity in patients with cysts over 10 cm in diameter; these patients can be treated effectively with a medical approach.
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Affiliation(s)
- Bahattin Aydogdu
- Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280 Diyarbakir, Turkey.
| | - Serdar Sander
- Department of Pediatric Surgery, İstanbul Kanuni Sultan Suleyman Education And Research Hospital, 34303, İstanbul, Turkey
| | - Oyhan Demirali
- Department of Pediatric Surgery, İstanbul Kanuni Sultan Suleyman Education And Research Hospital, 34303, İstanbul, Turkey
| | - Unal Guvenc
- Department of Pediatric Surgery, İstanbul Kanuni Sultan Suleyman Education And Research Hospital, 34303, İstanbul, Turkey
| | - Cemile Besik
- Department of Pediatric Surgery, İstanbul Kanuni Sultan Suleyman Education And Research Hospital, 34303, İstanbul, Turkey
| | - Canan Kuzdan
- Department of Pediatric Infectious Diseases, İstanbul Kanuni Sultan Suleyman Education and Research Hospital, 34303 İstanbul, Turkey
| | - Cemil Goya
- Department of radiology, Medical Faculty of Dicle University, 21280 Diyarbakir, Turkey
| | - Gulay Tireli
- Department of Pediatric Surgery, İstanbul Kanuni Sultan Suleyman Education And Research Hospital, 34303, İstanbul, Turkey
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26
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Özdemir A, Bozdemir ŞE, Akbiyik D, Daar G, Korkut S, Korkmaz L, Baştuğ O. Anaphylaxis due to ruptured pulmonary hydatid cyst in a 13-year-old boy. Asia Pac Allergy 2015; 5:128-31. [PMID: 25938078 PMCID: PMC4415179 DOI: 10.5415/apallergy.2015.5.2.128] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 02/26/2015] [Indexed: 11/04/2022] Open
Abstract
Hydatid cyst, a common disease in the world, is usually transmitted to humans through dog feces. Hydatid cyst is caused by Echinococcus granulosus. Diagnostic interventions for hydatid cyst include physical examination and chest x-ray tomography. Although the treatment options of hydatid cyst vary according to the clinical findings of the patients, the primary treatment may be considered as surgery. We herein reported the case of a child hospitalized due to pneumonia who developed anaphylaxis as a result of the rupture of a pulmonary hydatid cyst.
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Affiliation(s)
- Ahmet Özdemir
- Department of Pediatrics, Erciyes University Medical Faculty, 38039 Kayseri, Turkey
| | - Şefika Elmas Bozdemir
- Department of Pediatrics, Kayseri Teaching and Research Hospital, 38170 Kayseri, Turkey
| | - Demet Akbiyik
- Department of Pediatrics, Kayseri Teaching and Research Hospital, 38170 Kayseri, Turkey
| | - Ghania Daar
- Department of Pediatrics, Yozgat Bozok University Faculty of Medicine, 66200 Yozgat, Turkey
| | - Sabriye Korkut
- Department of Pediatrics, Erciyes University Medical Faculty, 38039 Kayseri, Turkey
| | - Levent Korkmaz
- Department of Pediatrics, Erciyes University Medical Faculty, 38039 Kayseri, Turkey
| | - Osman Baştuğ
- Department of Pediatrics, Erciyes University Medical Faculty, 38039 Kayseri, Turkey
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Bouchikh M, Achir A, Maidi M, Ouchen F, Fenane H, Benosman A. [Intrapleural rupture of pulmonary hydatid cysts]. REVUE DE PNEUMOLOGIE CLINIQUE 2014; 70:203-207. [PMID: 24646780 DOI: 10.1016/j.pneumo.2013.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 11/17/2013] [Accepted: 12/14/2013] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Intrapleural rupture of pulmonary hydatid cyst (PHC) is a rare but dangerous complication. The purpose of this study was to report the characteristics of this form of thoracic hydatidosis and analyze the favoring factors. MATERIALS AND METHODS Between 1996 and 2011, 75 patients were operated in our department for PHC ruptured in the pleura (PHCP). The characteristics of this group were compared with those of a control group of 300 patients randomly selected from patients operated during the same period for PHC. RESULTS PHCP patients were younger than controls (23 years old vs. 27,56) (P=0.03) with male predominance (70% vs. 46%) (P=0.01). The PHCP were often located in the lower lobes (64% vs. 48%) (P=0.03). Anatomic resections were more used in control group (P=0.03) whereas decortication and pleurectomy were more frequently in PHCP (P=0.001). CONCLUSION Young age, male sex, and basal locations of PHC promote their rupture in the pleura. Surgical treatment of these cysts requires less anatomic resections but more decortication and pleurectomy.
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Affiliation(s)
- M Bouchikh
- Service de chirurgie thoracique, CHU Ibn Sina, BP 353 Rabat Principale, 10001 Rabat, Maroc; Unité de pédagogie et recherche en chirurgie thoracique, faculté de médecine et pharmacie, Rabat, Maroc.
| | - A Achir
- Service de chirurgie thoracique, CHU Ibn Sina, BP 353 Rabat Principale, 10001 Rabat, Maroc; Unité de pédagogie et recherche en chirurgie thoracique, faculté de médecine et pharmacie, Rabat, Maroc
| | - M Maidi
- Service de chirurgie thoracique, CHU Ibn Sina, BP 353 Rabat Principale, 10001 Rabat, Maroc
| | - F Ouchen
- Service de chirurgie thoracique, CHU Ibn Sina, BP 353 Rabat Principale, 10001 Rabat, Maroc
| | - H Fenane
- Service de chirurgie thoracique, CHU Ibn Sina, BP 353 Rabat Principale, 10001 Rabat, Maroc
| | - A Benosman
- Service de chirurgie thoracique, CHU Ibn Sina, BP 353 Rabat Principale, 10001 Rabat, Maroc; Unité de pédagogie et recherche en chirurgie thoracique, faculté de médecine et pharmacie, Rabat, Maroc
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Halezeroglu S. Resection of intrathoracic and subdiaphragmatic hydatid cysts. Multimed Man Cardiothorac Surg 2014; 2005:mmcts.2004.000307. [PMID: 24414326 DOI: 10.1510/mmcts.2004.000307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The goal of surgical therapy in pulmonary hydatid disease is to remove the cyst while preserving as much lung tissue as possible. The surgical method may be different in the intact (simple) and ruptured (complicated) cysts. The operation has two steps: a) removal of the germinative layer, b) management of the residual pulmonary cavity. Simple cysts are generally removed after needle aspiration or enucleation without needle aspiration. Enucleation cannot be performed in ruptured cysts. The lung cavity that remains after removal of the cyst may be left as it is or obliterated by sutures from within the cavity in regard to the size and location of the cyst. However, the bronchial openings in the cavity must be closed by sutures in all cases. Rarely, hydatid cysts can occur in other thoracic structures such as pulmonary artery, chest wall or diaphragm. Those cysts located on the liver dome are operated by transthoracic-transdiaphragmatic approach. The surgical methods performed for the resection of hydatid cysts located in the chest or in the subdiaphragmatic area are presented with an overview of the literature.
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Affiliation(s)
- Semih Halezeroglu
- Sureyyapasa Thoracic and Cardiovascular Diseases Teaching and Investigation Hospital, Maltepe, 81530 Istanbul, Turkey
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Kuzucu A, Ulutas H, Reha Celik M, Yekeler E. Hydatid cysts of the lung: lesion size in relation to clinical presentation and therapeutic approach. Surg Today 2013; 44:131-6. [DOI: 10.1007/s00595-012-0484-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 11/04/2012] [Indexed: 10/27/2022]
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Ganguly S, Samanta M, Chatterjee S. Bilateral giant-sized symmetrical pulmonary hydatid cysts in an 8-year-old girl. Paediatr Int Child Health 2012; 32:180-2. [PMID: 22824671 DOI: 10.1179/2046905511y.0000000010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
An 8-year-old girl presented with a low-grade fever and cough for 4 weeks and minimal physical findings. Chest radiograph demonstrated two giant hydatid cysts occupying two-thirds of each lung and another two cysts in the liver were detected by ultrasonography. The cysts were resected from both lungs and the liver under albendazole cover. She made a complete recovery.
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Abstract
Hydatid disease is caused by the parasite Echinococcus granulosus. The liver and the lungs are common sites. When a cystic lesion is seen on CT scan, diagnosis is made based on the patient having lived in an endemic area. Serologic tests are used for differential diagnosis. Medical treatment is centered on albendazole. Surgery is recommended either by open or endoscopic technique depending on the characteristics of the cysts and the patient. Complications of surgery are rare except for prolonged air leaks. Mortality occurs when the cyst is located in the central nervous system or occludes major vessels.
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Affiliation(s)
- Semih Halezeroglu
- Thoracic Surgery Department, Faculty of Medicine, Acibadem University, Acibadem Maslak Hospital, Buyukdere Cad, 34457 Istanbul, Turkey.
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Yaldiz S, Gursoy S, Ucvet A, Yaldiz D, Kaya S. Capitonnage Results in Low Postoperative Morbidity in the Surgical Treatment of Pulmonary Echinococcosis. Ann Thorac Surg 2012; 93:962-6. [DOI: 10.1016/j.athoracsur.2011.11.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2011] [Revised: 11/04/2011] [Accepted: 11/07/2011] [Indexed: 11/25/2022]
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Durgun Yetim T, Basoglu A, Taslak Sengul A, Yetim I, Serdar Bekdemir O, Hokelek M. Comparison of the protoscolocidal effectiveness of hypertonic saline, povidone-iodine and albendazole solutions in an experimental lung hydatid cyst model. J Int Med Res 2012; 39:1230-8. [PMID: 21986125 DOI: 10.1177/147323001103900411] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Secondary hydatidosis is an important problem encountered during the surgical treatment of hydatid cysts. This study describes an experimental model of secondary hydatidosis by cyst inoculation, used to explore whether simultaneous inoculation of protoscolocidal agents could prevent secondary hydatidosis. Fertile cyst fluid was injected into the pleural space of rabbits alone (group 1, n = 8), and in combination with 2% albendazole solution (group 2, n = 8), 20% hypertonic saline (group 3, n = 8) or 10% povidone-iodine (group 4, n = 8). Computed tomography imaging of the thorax, indirect haemagglutination (IHA) titres and eosinophil counts were used to determine cyst development. After 16 months, three control rabbits had pneumothorax, seven had cysts and four had parenchymal nodules. Histopathological investigation of nodules revealed 87.5% cyst formation. Pleural thickening was observed in rabbits from all groups. Cyst formation rates, IHA titres and eosinophilia counts were higher in group 1 than in groups 2-4. This study demonstrated the experimental formation of secondary hydatidosis and found that topical protoscolocidal agents were beneficial in preventing cyst recurrence.
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Affiliation(s)
- T Durgun Yetim
- Department of Thoracic Surgery, Mustafa Kemal University School of Medicine, Antioch, Turkey.
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Nabi MS, Waseem T, Tarif N, Chima KK. Pulmonary Hydatid Disease: Capitonnage is mandatory following Cystotomy. Int J Surg 2010; 8:S1743-9191(10)00086-5. [PMID: 20685407 DOI: 10.1016/j.ijsu.2010.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Revised: 05/15/2010] [Accepted: 05/28/2010] [Indexed: 11/18/2022]
Abstract
Pulmonary hydatid disease still remains an important healthcare problem. Conservative operative interventions including cystotomy or cystotomy with capitonnage are the two commonly used techniques. There is still significant controversy, however, over selection of these two procedures. In this retrospective analysis of 66 patients with hydatid disease, we employed three types of interventions, Group A, (n=5) cystotomy alone with closure of bronchial openings; Group B, (n=54) cystotomy with capitonnage and Group C, (n=7) lobectomy over a period of seven years in our patients and compared their postoperative outcome in terms of morbidity and mortality. Our data show that cystotomy with capitonnage is associated with low rates of postoperative prolonged air leak, bronchopleural fistula formation, empyema formation [mean complication rate 0.12% (Mean 0.08; 0.151- 95% CI)] as compared to cystotomy alone with closure of bronchial openings [mean complication rate 44% (Mean 2.20; 3.18- 95% CI)]. The lobectomy group was excluded from the comparison, as this approach is quite different from the cystostomy based enucleation techniques. We conclude that capitonnage with cystotomy may be a preferred procedure due to its lower rate of complications.
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Affiliation(s)
- Muhammad Shoaib Nabi
- Department of Pulmonology & Thoracic Surgery, Services Institute of Medical Sciences, Lahore, Pakistan
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Nabi MS, Waseem T. Pulmonary hydatid disease: What is the optimal surgical strategy? Int J Surg 2010; 8:612-6. [DOI: 10.1016/j.ijsu.2010.08.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Revised: 08/14/2010] [Accepted: 08/16/2010] [Indexed: 10/19/2022]
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Surgical treatment of intrathoracic hydatid disease: a 5-year experience in an endemic region. Surg Today 2009; 40:31-7. [PMID: 20037837 DOI: 10.1007/s00595-009-4063-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Accepted: 04/27/2009] [Indexed: 01/21/2023]
Abstract
PURPOSE To present our recent surgical experience in treating patients with intrathoracic hydatidosis. METHODS This study reviewed the files of patients with pulmonary/intrathoracic extrapulmonary hydatid cysts treated surgically between 2003 and 2009. Demographic, laboratory and radiological data, clinical manifestations, site of the cyst, surgical approaches, and final outcome were noted and analyzed. RESULTS Forty patients underwent 42 operations (21 females, 19 males, mean age 36 years). Thirty-six patients (90%) had pulmonary (56.7% were intact/uncomplicated), three (7.5%) had intrathoracic extrapulmonary, and one (2.5%) had both pulmonary/intrathoracic extrapulmonary hydatid cysts. The right lung was involved in 64.9%. Larger pulmonary cysts ruptured more commonly (P = 0.007). Most patients (95%) were symptomatic, mostly dyspneic (72.5%). The mean forced expiratory volume in 1 s value was significantly reduced in cases with a large (P < 0.0001), or ruptured cyst (P = 0.05). The erythrocyte sedimentation rate was elevated in case of rupture (P = 0.05). A thoracotomy was performed for all patients. A cystotomy and capitonnage was performed more commonly than cystotomy without capitonnage for the pulmonary, and total excision was performed for the intrathoracic extrapulmonary hydatid cysts. The mortality was 0% and the morbidity was 17.5%. All patients received antihelminthic therapy postoperatively. There was no recurrence. CONCLUSION Surgery is considered to be the optimal treatment for intrathoracic hydatid disease. In addition, recurrence is very low when all such patients receive postoperative antihelminthic therapy.
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Kocer B, Gulbahar G, Han S, Durukan E, Dural K, Sakinci U. An analysis of clinical features of pulmonary giant hydatid cyst in adult population. Am J Surg 2009; 197:177-81. [DOI: 10.1016/j.amjsurg.2007.12.053] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2007] [Revised: 12/05/2007] [Accepted: 12/07/2007] [Indexed: 10/21/2022]
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Arroud M, Afifi MA, El Ghazi K, Nejjari C, Bouabdallah Y. Lung hydatic cysts in children: comparison study between giant and non-giant cysts. Pediatr Surg Int 2009; 25:37-40. [PMID: 18828025 DOI: 10.1007/s00383-008-2256-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2008] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study is to review our experience in pediatric giant pulmonary hydatid cysts focusing on clinical symptoms, location of the cyst, type of the intervention, postoperative complications and long-term results. METHODS Between June 2002 and May 2007, 118 children were operated on for hydatid lung cysts. Two groups were defined: Group 1, 32 children with giant hydatid cysts and Group 2, 86 children with non-giant cysts. The statistical significance between the groups was estimated using paired samples t test. RESULTS The mean age was 11.8 years in G1 and 9.7 years in G2. All of the patients were symptomatic in G1 but only 18% in G2 (P=0.003). The right lower lobe was most frequently involved in both G1 and G2. Surgical parenchymal resection was performed in five patients in G1 (16%) and in 2% in G2 (P=0.033). Postoperative complications in G1 were more significant comparatively to G2 (P=0.003). CONCLUSION Giant hydatid lung cysts represent a distinct pathology. They affect essentially adolescents and may reach a large size causing parenchymal destruction. Thus, surgical resections are frequently used and postoperative complications rate is high.
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Affiliation(s)
- Mounir Arroud
- Department of Pediatric Surgery, University Hospital Hassan II, BP. 2830 Fes principal, 30000, Fez, Morocco.
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Arinc S, Kosif A, Ertugrul M, Arpag H, Alpay L, Unal O, Devran O, Atasalihi A. Evaluation of pulmonary hydatid cyst cases. Int J Surg 2008; 7:192-5. [PMID: 19369124 DOI: 10.1016/j.ijsu.2008.11.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2008] [Revised: 11/16/2008] [Accepted: 11/21/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND The incidence of pulmonary hydatid cyst has been high in developing countries such as Turkey. OBJECTIVE The aim of this study was to evaluate the clinical presentation, treatment and outcomes of pulmonary hydatid cyst disease at a tertiary centre. METHODS A total of 138 patients, aged between 9 and 72 years with pulmonary hydatid cyst were diagnosed between 2000 and 2008 in 2nd thoracic surgery clinic at our hospital. Clinical characteristics of patients, epidemiological features, cyst diameters and localizations, laboratory findings, surgical approaches were recorded and analyzed. RESULTS The most frequent symptoms of pulmonary hydatid cyst were chest pain and cough (44.9%, 37.6%). According to cyst size, there was no difference between younger than twenty and older age groups (p>0.05). Twenty-two patients had complicated cyst cases. Most of them were symptomatic (90.9%). Association of complicated cyst with hepato-pulmonary involvement was significantly higher as compared with single hydatid cyst (p=0.01). Cystectomy was performed in 84.05% of patients and post-operative mortality was seen in only one patient due to pulmonary embolism. CONCLUSION Association of lung and liver hydatid cyst increased the risk of occurrence of a complicated pulmonary hydatid cyst. Choice of surgical approach had satisfactory results and post-operative mortality was low.
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Affiliation(s)
- Sibel Arinc
- Süreyyapasa Chest Disease and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey.
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Ghallab NH, Alsabahi AA. Giant viable hydatid cyst of the lung: a case report. J Med Case Rep 2008; 2:359. [PMID: 19032765 PMCID: PMC2613408 DOI: 10.1186/1752-1947-2-359] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Accepted: 11/25/2008] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Hydatid disease is a parasitic infestation caused by Echinococcus granulosus. The resulting large cysts in the lung are a special clinical entity called giant hydatid cysts. CASE PRESENTATION An 18-year-old Yemeni woman presented with a dry cough and mild fever, with no history of chest pain, dyspnoea or weight loss. Chest X-ray revealed a homogenous opacity almost replacing the right lung. The patient underwent surgery which revealed a large, viable hydatid cyst measuring 26 x 18 x 5 cm. CONCLUSION This case report provides evidence that non-complicated hydatid cysts, even if very large, have a good prognosis and can be safely treated by parenchyma-preserving surgery.
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Affiliation(s)
- Nagi Homesh Ghallab
- Surgical Department Sana'a University and El-thawra Teaching Hospital, Sana'a, Yemen.
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Kilic D, Findikcioglu A, Bilen A, Koc Z, Hatipoglu A. MANAGEMENT OF COMPLICATED HYDATID CYST OF THE THORAX. ANZ J Surg 2007; 77:752-7. [PMID: 17685952 DOI: 10.1111/j.1445-2197.2007.04217.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Complicated hydatid cyst of the thorax is important to the clinical approaches and treatment methods in hydatid disease. The aim of this study was to evaluate the problems of complicated pulmonary hydatid cyst, including choice of surgical methods, diagnostic clues and to discuss the inherent risks of medical therapy and the delay of surgical treatment in pulmonary hydatid disease. METHODS Between 2002 and 2006, 40 operations were carried out in 37 patients whose diagnoses were complicated hydatid cyst. The surgical approach was a posterolateral thoracotomy in all patients; a phrenotomy in two patients and a thoracoabdominal approach in one patient and two-stage bilateral thoracotomy in four patients. The preferred surgical treatment procedure was cystotomy and modified capitonnage, which was carried out in 26 patients (70%). Other procedures included a cystotomy in five (14%) and decortication in six (16%) patients. Segmentectomy was carried out in 1 (3%), and wedge resection in four patients (11%). RESULTS In 25 patients (67.5%), there were single hydatid cysts; whereas 12 patients (32.5%) had multiple cysts. Eleven patients had preoperative hydatid cyst history. Iatrogenic rupture of an intact hydatid cyst occurred in three patients. Extrathoracic involvement was apparent in 10 patients (27%). Intrathoracic but extrapulmonary involvement was apparent in six patients (16%). The morbidity ratio was 5%; there was prolonged air leak and atelectasis in one patient each. The mortality ratio was 3% (one patient). The average hospitalization duration for all patients was 5.7 days (range, 3-17 days). The mean follow up was 18.4 months with no recurrence. CONCLUSION Complicated hydatid cyst may have different clinical manifestations and may present radiologically as a primary lung tumour. In patients with suspicious lung masses owing to endemic area, history of a hydatid cyst or contralateral or extrathoracic hydatid cyst involvement at the same time should indicate a complicated pulmonary hydatid cyst. Preoperative anthelmintic therapy must be avoided owing to the risk of perforation. Treatment of a complicated hydatid cyst differs from that of an intact hydatid cyst. Anatomic resection may be necessary owing to destroyed lung tissue secondary to suppuration from a hydatid cyst; however, parenchymal preserving surgery is preferable in an uncomplicated hydatid cyst. A modified capitonnage method is recommended for complicated hydatid cyst treatment as it has a low morbidity rate.
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Affiliation(s)
- Dalokay Kilic
- Department of Thoracic Surgery, Baskent University Faculty of Medicine, Ankara Teaching and Medical Research Center, 16 Sokak number 11, 06490 Bahcelievler/Ankara, Turkey.
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Şehitoğulları A. Our results in surgical treatment of hydatid cyst of the lungs. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2007. [DOI: 10.29333/ejgm/82413] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kosar A, Orki A, Haciibrahimoglu G, Kiral H, Arman B. Effect of capitonnage and cystotomy on outcome of childhood pulmonary hydatid cysts. J Thorac Cardiovasc Surg 2006; 132:560-4. [PMID: 16935111 DOI: 10.1016/j.jtcvs.2006.05.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2006] [Revised: 05/22/2006] [Accepted: 05/23/2006] [Indexed: 11/17/2022]
Abstract
OBJECTIVE In this clinical retrospective study cystotomy and capitonnage were compared in patients with childhood pulmonary hydatid cysts with regard to postoperative period. METHODS Between 1990 and 2004, 60 children with pulmonary hydatid cysts were treated surgically. There were 33 boys and 27 girls aged from 3 to 16 years. Cystotomy and closure of bronchial openings were performed in all patients. The patients were divided into 2 groups. While the residual cyst cavity was closed by means of capitonnage in group A (n = 37), cystotomy was applied in group B (n = 23). RESULTS There was no mortality in either group. Chest tubes were removed after 3.59 +/- 1.04 days in group A and 5.83 +/- 2.84 days in group B. The hospital stay was 4.86 +/- 1.43 days for group A and 7.22 +/- 3.34 days for group B. Prolonged air leak was found in 2 children in group A and 7 children in group B. There was a significant difference between group A and group B with regard to chest tube removal time (P = .001), hospital stay (P = .003), development of prolonged air leak (P = .004), and all complications (P = .031). Follow-up information was available for 49 children, ranging from 13 to 86 months (mean, 56 months). Recurrence was seen in 2 children of group A and 1 child of group B during the follow-up period (P = .698). CONCLUSION Capitonnage for pulmonary hydatid cysts is superior to cystotomy because it reduces morbidity (especially prolonged air leak) and hospital stay.
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Affiliation(s)
- Altug Kosar
- Thoracic Surgery, Sureyyapasa Thoracic and Cardiovascular Surgery Research and Teaching Hospital, Istanbul, Turkey.
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Dincer SI, Demir A, Sayar A, Gunluoglu MZ, Kara HV, Gurses A. Surgical treatment of pulmonary hydatid disease: a comparison of children and adults. J Pediatr Surg 2006; 41:1230-6. [PMID: 16818054 DOI: 10.1016/j.jpedsurg.2006.03.053] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Hydatid cyst still remains an important health problem in our country as in many Mediterranean countries. The disease may affect children, and its treatment may be challenging in this age group. Surgery is the primary way of treatment. In the current study, the features unique to childhood pulmonary hydatid disease are emphasized. METHODS Between 1992 and 2003, 301 patients were operated on because of pulmonary hydatid cyst in our hospital; 44 of them were 14 years or younger. They were categorized as pediatric patients. We retrospectively evaluated the clinical data of the patients. RESULTS The mean age of the patients was 10.6 +/- 3.7 years (5-14 years) in children and 32.2 +/- 14 years (16-75 years) in adults. The rate of intact cyst was 71% in children and 57% in adults (P = .07). The mean diameter of the cyst was 8.5 +/- 3.1 cm (3-15 cm) and 6.6 +/- 3 cm (2-16 cm) in children and adults, respectively (P < .001). The rate of parenchyme-saving procedures was 84.1% in children, whereas 94.9% in adults. Lobectomy was performed in 16% of children, whereas it was performed in 1.5% of adults (P < .001). Morbidity rates were 13.6% in children and 11.6% in adults. No children but 1 adult died. Long-term follow-up revealed the recurrence rates as 4.5% in children and 4.3% in adults. CONCLUSIONS Surgery, the primary method of treatment of hydatid cyst, is safe. Parenchyma-saving procedures such as cystotomy and capitonnage should be performed as much as possible. Nevertheless, hydatid cyst can reach relatively larger dimensions in children than in adults, which causes parenchyme destruction eventually leading to lung resection.
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Affiliation(s)
- S Ibrahim Dincer
- Department of Thoracic Surgery, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey
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Kilic D, Tercan F, Sahin E, Bilen A, Hatipoglu A. Unusual radiologic manifestations of the echinococcus infection in the thorax. J Thorac Imaging 2006; 21:32-6. [PMID: 16538153 DOI: 10.1097/01.rti.0000186994.92705.2d] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Unusual location and presentation of hydatid cyst disease in the thorax requires careful consideration with respect to clinical approach and therapy. In this pictorial essay, we present imaging findings and describe treatment of thoracic hydatid cysts in patients with lung, mediastinal, chest wall, cardiac, endobronchial, pulmonary artery, and diaphragmatic involvement. A review of the literature is also included.
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Affiliation(s)
- Dalokay Kilic
- Department of Thoracic Surgery, Baskent University Faculty of Medicine, Adana Teaching and Medical Research Center, Adana, Turkey.
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Murat K, Canan D, Cagatay T, Altug K, Senol U, Cuneyt A, Bulent A. One-stage operation via median sternotomy and phrenotomy for bilateral lung and liver hydatid disease. Indian J Thorac Cardiovasc Surg 2005. [DOI: 10.1007/s12055-005-0038-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Abstract
BACKGROUND The purpose of the present study was to compare the clinical features and the surgical approaches of the pulmonary hydatid cysts in children and adults. METHODS One hundred and thirty-four patients, operated on for pulmonary hydatid cysts over the last 10 years were retrospectively evaluated in two groups: 39 children who were younger than 18 years old (29%) and 95 adults (71%). The patients in each group were analysed according to their clinical, radiological and surgical findings. RESULTS The frequency of pulmonary hydatid cysts in children was significantly higher in boys (74%) than in girls (26%). However, there was no sex tendency in adults (52% in male vs 48% in women). The sex difference in hydatid cyst frequencies between adults and children was significant (P < 0.05). Among preoperative pleural complications, pneumothorax (15.5%) in children and empyema (11%) in adults were more frequent. The frequency of concomitant hepatic cysts was less in children than in adults (33%vs 79%). Huge pulmonary cysts (=10 cm) were more common in children (31%) than in adults (22%). Cystotomy with capitonnage was the most frequently preferred method in both groups. Postoperative complications developed in six children (16%) and 19 adults (19%), and were more frequent in patients with huge cysts (27%vs 16%). No recurrence was observed in both groups. CONCLUSIONS Isolated pulmonary cysts are more common in children than adults. The cysts also tend to be bigger in children than adults. The frequency of concomitant hepatic cysts is less in children. Because of higher lung expansion ability and improvement capacity in children, resection should be avoided and lung saving surgical procedures should be performed. In spite of differences observed in the clinical features it does not change the treatment of pulmonary hydatid cysts in children.
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Affiliation(s)
- Fikret Kanat
- Department of Chest Diseases, Meram Medical School of Selcuk University, Konya, Turkey
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Rashid S, Fatimi SH. Atypical pulmonary giant hydatid cyst as bilaterally symmetrical solitary cysts. Asian Cardiovasc Thorac Ann 2004; 12:257-9. [PMID: 15353468 DOI: 10.1177/021849230401200317] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A pulmonary giant hydatid cyst, a special clinical entity, is rare. Our case involves a young patient who presented with a bilaterally symmetrical solitary cyst in each lung, a feature consistent with congenital lung cysts. The radiological and immunological findings were equivocal. A diagnosis of giant hydatid cyst was made intraoperatively and both cysts were removed conservatively. A follow-up showed complete recovery.
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Affiliation(s)
- Saadia Rashid
- Department of Surgery, The Aga Khan University, Karachi, Pakistan.
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