R Ulkü1, A Onen, S Onat. 1. Department of Thoracic and Cardiovascular Surgery, Dicle University School of Medicine, Diyarbakir, Turkey. Refiku@dicle.edu.tr
Abstract
AIM OF THE STUDY: Hydatid disease is a parasitic infestation which is endemic in many sheep and cattle raising areas and is still an important health problem in the world. The aim of our study was to present our surgical experience and strategy in the management of pulmonary hydatid disease. METHODS: Sixty-six patients with 83 pulmonary hydatid cysts underwent surgical treatment in our institution between January 1990 and March 2003. We used double-lumen endotracheal tubes in children older than 12 years who were operated on for hydatic cyst in the last 8 years. RESULTS: There were 38 boys and 28 girls with a mean age of 9.6 +/- 7 years (range 5-15 years). Of the 83 cysts, 61 were intact and 22 were ruptured cysts. Isolated pulmonary hydatid cyst was seen in 61 patients (92.4 %), while 5 patients (7.6 %) had combined pulmonary and hepatic cysts. Lateral thoracotomy was performed in 54 patients (82 %), thoracophrenotomy in 5, bilateral thoracotomy in 4, and median sternotomy in 3 patients. Cystotomy and capitonnage was performed in 58 cysts, cystotomy alone in 21, and resection techniques were used in 4. There were 8 postoperative complications in 7 patients. The most common complication was atelectasis. CONCLUSIONS: Surgery is the treatment of choice for most patients with pulmonary hydatid cysts. The usage of double-lumen tubes may decrease intra- and postoperative complications. Thoracophrenotomy can be chosen as the surgical procedure in the management of hepatic and pulmonary hydatid cysts.
AIM OF THE STUDY: Hydatid disease is a parasitic infestation which is endemic in many sheep and cattle raising areas and is still an important health problem in the world. The aim of our study was to present our surgical experience and strategy in the management of pulmonary hydatid disease. METHODS: Sixty-six patients with 83 pulmonary hydatid cysts underwent surgical treatment in our institution between January 1990 and March 2003. We used double-lumen endotracheal tubes in children older than 12 years who were operated on for hydatic cyst in the last 8 years. RESULTS: There were 38 boys and 28 girls with a mean age of 9.6 +/- 7 years (range 5-15 years). Of the 83 cysts, 61 were intact and 22 were ruptured cysts. Isolated pulmonary hydatid cyst was seen in 61 patients (92.4 %), while 5 patients (7.6 %) had combined pulmonary and hepatic cysts. Lateral thoracotomy was performed in 54 patients (82 %), thoracophrenotomy in 5, bilateral thoracotomy in 4, and median sternotomy in 3 patients. Cystotomy and capitonnage was performed in 58 cysts, cystotomy alone in 21, and resection techniques were used in 4. There were 8 postoperative complications in 7 patients. The most common complication was atelectasis. CONCLUSIONS: Surgery is the treatment of choice for most patients with pulmonary hydatid cysts. The usage of double-lumen tubes may decrease intra- and postoperative complications. Thoracophrenotomy can be chosen as the surgical procedure in the management of hepatic and pulmonary hydatid cysts.