In our experience the exposure provided by the transaxillary approach is safe and superior to that offered by other approaches as it allows a wide range of surgical applications such as first rib resection, cervical rib resection and resection of fibrotic bands.
ATF due to hydatid cyst is uncommon. In rare cases ATF may be present at the abdominal, thoracic or diaphragmatic level. Thoracophrenotomy is the best surgical treatment for all three levels.
Background: Hydatid disease remains a serious health problem in Mediterranean areas. We reviewed the efficacy of a single-stage operation in coexisting cysts of lung and liver in patients.Methods: Forty-one patients operated for the cysts located on the dome of the liver and right lung with onestage surgical approach on between 1990 and 2010. There were 19 males (46%) and 22 females (54%) patients. The age range was 10-82 years, with a median age of 34 years.Results: All patients had simultaneous operations for both organs via right thoracotomy and phrenotomy except one patient. Surgical techniques used in the lung were cystotomy and capitonnage, with wedge resection of the destroyed lung parenchyma in three (7.3%) and additional decortication in three (7.3%). Cystotomy was applied with membrane removal in the liver cysts. Postoperative complications were prolonged biliary drainage, empyema, prolonged air leak, pleural effusion in one case (2.4%) each, respectively. All patients managed successfully and discharged. No hospital mortality occurred.Conclusions: We propose that concomitant right pulmonary and liver dome hydatid cysts can be treated effectively and safely in a one-stage operation through a right posterolateral thoracotomy and phrenotomy.
Trauma as a cause of hydatid cyst rupture leads to various clinical conditions, especially in children. Current literatures regarding the clinical presentation and management of such patients are rare. Case report: A 14-year-old child was admitted with chest pain and dyspnoea due to blunt thoracic trauma after falling off a bicycle. Chest computed tomography showed right hydropneumothorax and cystic cavity. After chest tube insertion, massive air leak was observed from the tube. Cystotomy and capitonnage were performed on the right lower lobe via a posterolateral thoracotomy. He was discharged from the hospital in good condition. Conclusion: Ruptured hydatid cysts into the pleura are difficult to diagnose radiologically. It can be misdiagnosed radiologically as empyema or hydrothorax. In undetermined cases, all the findings may be suggestive but not diagnostic. Operation must be performed early for exploration when the condition is suspected. High complication rate has been found in children who were operated late.
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