Surgical Treatment of Pulmonary Hydatid Cysts, Which Perforated to the Pleura

Abstract

Objective: Hydatid cyst disease, endemic in Eastern region of Turkey, is a significant parasitic public health problem. In this study, pleural complications of hydatid cysts were presented in 76 cases. Materials and Methods:In our study, of the 412 pulmonary hydatid cyst cases operated on between 2003 and 2011, 76 cases had ruptured into the pleura for various reasons, and the different clinicoradiological presentations were evaluated retrospectively. The age distribution of the cases was between 7 and 56 years, and the mean age was 26.20±13.04. Results:The most frequent symptom due to pleural rupture in patients was dyspnea (44 cases, 57.8%). Etiologically, iatrogenic perforation was detected in four cases and thoracic trauma in nine cases (six car accidents and three falls from a height). An anthelmintic drug use history was found in three cases of ruptured pleura. Spontaneous perforation was detected in the other 60 (78.9%) cases. Two cases that were admitted to the emergency unit and were immediately administered a tube thoracostomy developed tension pneumothorax. In addition, 21 cases had hydropneumothorax, 17 had pneumothorax, and 36 had pleurisy. Morbidity was observed in 30 cases (39.4%). Atelectasis was the most frequent cause of morbidity in these patients (10 cases). The mean duration of hospitalization was determined to be 12.26±2.90 days. Conclusion:This disease can progress asymptomatically for a long time and can sometimes lead to life-threatening emergency situations, such as tension pneumothorax. The delayed admission of a patient to a physician causes the disease to become more complicated and to increase the morbidity and mortality rates. Treatment of the disease is in the form of surgery. Possible parenchymal protection should be applied in surgical treatment, and anatomic resection should not be performed unless necessary.Key Words: Empyema, Capitonnage, Pleura, Rupture Özet Amaç: Kist hidatik hastalığı, yöremizin ve ülkemizin endemik olarak görülen önemli bir paraziter-halk sağlığı sorunudur. Kist hidatik hastalığı, asemptomatik olarak seyredebildiği gibi, tansiyon pnömo-toraks gibi hayatiyet arzeden önemli komplikasyonlarla da kendini gösterebilir. Çalışmamızda kist hidatiğin plevral komplikasyonları 76 olgu temelinde sunulmuştur. Gereç ve Yöntem:2003-2011 yılları arasında opere edilen 412 akciğer kist hidatikli olgudan, plevraya çeşitli nedenlerle ve değişik klinikradyolojik presentasyonlarla rüptüre olan 76 olgu retrospektif olarak değerlendirildi. Olguların 42'si erkek, 34'ü kadındı. Olguların yaş dağılımı 7-56 arasında ve ortalama yaş 26.20±13.04 olarak belirlendi. Bulgular:Plevral rüptür nedeniyle olgularda en sık gözlenen semptom dispne oldu (44 olgu, %57.8). Etyolojide 4 olguda iatrojenik perforasyon, 9 olguda toraks travması (6 olgu araç içi trafik kazası, 3 olguda yüksekten düşme) tesbit edildi. Plevraya rüptüre 3 olguda daha önceden antihelmintik ilaç alımı söz konusuydu. Diğer 60 (%78.9) olguda spontan perforasyon tesbit edildi. Acil ünitesine başvuran ve derhal tüp tora...

Is Anatomic Lung Resection Necessary in Surgical Treatment of Giant Lung Hydatid Cysts in Childhood?

“…They suggested that the decision of lobectomy could be made easily by detecting the opening of the lobe bronchus to the cyst cavity with preoperative flexible bronchoscopy. Cangir et al 16) reported bronchial and pleural perforation rates as 21.1% and 3.6%, respectively. In our study, 37.5% (n = 12) of 32 giant cysts were perforated.…”

“…In the literature, the perforation rates were stated as 24.7%-61%. 10,[14][15][16] Perforation of the cyst can cause hemoptysis, pneumothorax, hydro pneumothorax, empyema, pleural thickening, secondary pleural hydatid disease, and destruction of parenchyma. [17][18][19][20][21] Therefore, some publications suggest more radical surgical procedures such as decortication, segmentectomy, or lobectomy in these patients.…”

Pneumonostomy in the Surgical Management of Hydatid Cyst of the Lung

“…The aforementioned are the most morbid complication of surgery for HCL, the incidence of which is reported to be around 6 to 9% in complicated cysts. 11 In the pneumonostomy technique, the ectocyst must be sutured to the parietal pleura; and if it is not possible, it is important to ensure a watertight closure of pericyst around the Malecot to avoid pneumothorax in the period that it takes for adhesions and a tract to form. Air leak around an inadequately anchored Malecot catheter caused a pneumothorax in one of our patients whose cyst could not be anchored to the parietal pleura.…”

Clinical Study of Pulmonary Hydatid Diseases in a Government Tertiary Hospital

“…Other symptoms included cough (42 cases, 55.2%), chest pain (39 cases, 51.3%), fatigue (32 cases, 42.1%), and fever (28 cases, 36.8%). 9 As a result of the pulmonary hydatid cyst perforating the pleura, symptoms such as chest pain, coughing, cyanosis, fever, and shortness of breath develop. As a result of the rupture of the cyst, the cyst contents pour into the pleura, and the ruptured germinative membrane collapses.…”