BACKGROUND: Hydatid disease is a parasitic infection caused by Echinococcus granulosus, characterized by cystic lesions in the liver, lungs, and, rarely, in other parts of the body. The large cysts in the lung are a special clinical entity called giant hydatid cysts. Characteristics on presentation, operative techniques, and postoperative morbidity and mortality rates in 47 patients with 50 giant pulmonary hydatid cysts 10 cm in diameter or larger were reported in this study. METHODS: Cystotomy plus the obliteration of the residual cavity by imbricating sutures from within (capitonnage) was the most frequently used operative technique (n = 31), followed by pericystectomy plus capitonnage (n = 6), closure of bronchial openings plus pericystectomy (n = 6), and lobectomy (n = 3). RESULTS: The mean age of patients with giant hydatid cyst of the lung was lower than the age of those with usual-sized cysts (p = 0.04). Five patients had prolonged air leaks (more than 10 days), three had empyema, and one had pneumonia in the opposite lung after the operation. One patient died of cardiorespiratory collapse during the operation. There was one recurrence during follow-up. CONCLUSIONS: The increase in the diameter of the cyst in younger ages was correlated with higher lung tissue elasticity and the delay in diagnosis because of delayed symptoms in these patients. Although postoperative complications occurred in 19.1% of patients, all were managed by conservative measures, and there were no indications that the affected lung should have been treated with resection instead of a parenchyma-saving operation.
BACKGROUND:Hydatid disease is a parasitic infection caused by Echinococcus granulosus, characterized by cystic lesions in the liver, lungs, and, rarely, in other parts of the body. The large cysts in the lung are a special clinical entity called giant hydatid cysts. Characteristics on presentation, operative techniques, and postoperative morbidity and mortality rates in 47 patients with 50 giant pulmonary hydatid cysts 10 cm in diameter or larger were reported in this study. METHODS: Cystotomy plus the obliteration of the residual cavity by imbricating sutures from within (capitonnage) was the most frequently used operative technique (n = 31), followed by pericystectomy plus capitonnage (n = 6), closure of bronchial openings plus pericystectomy (n = 6), and lobectomy (n = 3). RESULTS: The mean age of patients with giant hydatid cyst of the lung was lower than the age of those with usual-sized cysts (p = 0.04). Five patients had prolonged air leaks (more than 10 days), three had empyema, and one had pneumonia in the opposite lung after the operation. One patient died of cardiorespiratory collapse during the operation. There was one recurrence during follow-up. CONCLUSIONS: The increase in the diameter of the cyst in younger ages was correlated with higher lung tissue elasticity and the delay in diagnosis because of delayed symptoms in these patients. Although postoperative complications occurred in 19.1% of patients, all were managed by conservative measures, and there were no indications that the affected lung should have been treated with resection instead of a parenchyma-saving operation.
Authors: Giovanni Vennarecci; Simone Manfredelli; Nicola Guglielmo; Andrea Laurenzi; Delia Goletti; Giuseppe Maria Ettorre Journal: Updates Surg Date: 2016-04-28