Basic Operative Tactics for Pulmonary Echinococcosis in the Era of Endostaplers and Energy Devices

Abstract

Human echinococcosis is a zoonotic infection caused by the larvae of the tapeworm species Echinococcus. The liver is the most common location for a primary echinococcosis. However, the parasite may bypass or spread from the liver to the lungs, causing primary or secondary pulmonary echinococcosis, respectively. Pulmonary echinococcosis is a clinically challenging condition in which anthelminthic regiments are important, but surgery has the central role in removing the cysts and preventing recurrences. Surgical treatment may involve cystotomy, enucleation, capitonnage, or atypical resections, which occasionally are in combination with hepatic procedures. The utilization of modern devices is greatly underdescribed in surgery for thoracic infections, even though these facilitate much of the work. Therefore, this article aims to describe pulmonary echinococcosis and the role of modern surgical devices in the treatment process. Furthermore, we report surgical treatment of three different cases of pulmonary echinococcosis. Surgeries of uncomplicated and ruptured hepatic or pulmonary cysts are described. Simple small pulmonary echinococcal lesions can be excised by endostaplers both for diagnostic and curative reasons. Larger cysts can be removed by energy devices unless large bronchial air leaks occur. Complicated cysts require treatment by more extensive techniques. Inexperienced surgeons should not abstain but should carefully decide preoperatively how to proceed.

Diagnosis and treatment experience of atypical hepatic cystic echinococcosis type 1 at a tertiary center in China

“…Casulli et al [ 16 ] presented a case of cerebral CE in a child, along with a comparative molecular analysis of the isolated cyst specimens from the patient and sheep from local farms. Bakinowska et al [ 17 ] reported the surgical treatment of three different cases of pulmonary echinococcosis. They demonstrated that simple small pulmonary echinococcal lesions could be excised using endostaplers.…”

The treatment of the pulmonary hydatid cyst in the Stavropol region

“…The most common localizations of HC are the liver and lungs, which account for up to 60-80 % of cases [7][8][9]. Despite the development of detailed diagnostic methods and surgical methods for hydatid cysts, early diagnosis remains difficult [10].…”

“…Unfortunately, VATS may not be applicable in certain clinical settings. At first, in the preoperative period, we can note the difficulties in treating the residual cavity [8,15]. Second, if there's a fear of cystic fluid contamination of the chest cavity.…”