Parenchyma-Saving Surgical Treatment of Giant Pulmonary Hydatid Cysts

Dakak, Mehmet; Çaylak, Hasan; Kavakli, Kuthan; Gözübüyük, Alper; Yücel, Orhan; Gürkök, Sedat; Sapmaz, Ersin; Genç, Onur; Çubukçu, Sibel; Tanyüksel, Mehmet

doi:10.1055/s-2008-1039210

Cited by 30 publications

(37 citation statements)

References 7 publications

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“…Some large cysts may also compel a lobectomy when lesser resection may preserve minimal healthy parenchyma. However, reported experiences with these large cysts (>10 cm) suggest that parenchyma preservation may be achieved with acceptable morbidity (85).…”

Section: Technique Of Enucleationmentioning

confidence: 97%

Surgery for parasitic lung infestations: roles in diagnosis and treatment

Thapa

Sapkota²,

Kim

et al. 2018

J. Thorac. Dis

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Pulmonary parasitic infestations are a worldwide problem associated with significant morbidity and socioeconomic impact. They are known to have varied clinical presentations and radiological appearances. Prevention of parasite transmission and medical treatment of cases form the two pillars of control of these diseases. The role of surgery is limited to the diagnosis and definitive treatment of the minority of pulmonary parasitic afflictions, most notably hydatidosis. Despite surgery being established as the treatment of choice in pulmonary hydatid cysts (PHCs) for over half a century, variations and unresolved controversies persist regarding the best surgical technique. Complications brought on by cyst rupture, multiplicity and multi-organ involvement add complexity to treatment decisions. The development of videoassisted thoracoscopic surgery (VATS) brings the promise of reduced peri-operative morbidity but is yet to be universally accepted as a safe technique. In this review, we endeavor to discuss the common pulmonary infestations focusing on the current trends and controversies surrounding surgery for PHC.

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Section: Technique Of Enucleationmentioning

confidence: 97%

Surgery for parasitic lung infestations: roles in diagnosis and treatment

Thapa

Sapkota²,

Kim

et al. 2018

J. Thorac. Dis

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“…Despite the lack of consensus, the currently most accepted surgical treatment for lung CE is complete excision using parenchyma-preserving methods, such as cystostomy, intact cyst enucleation or removal after needle aspiration preserving as much lung parenchyma as possible [18,19]. Resection techniques such as pneumonectomy, segmentectomy should be reserved to cysts involving whole hemithorax or the whole segment respectively; and lobectomy should be performed only in large abscessed cysts.…”

Section: Treatmentmentioning

confidence: 99%

Pulmonary cystic echinococcosis

Santivañez¹,

Garcı́a²

2010

Current Opinion in Pulmonary Medicine

100

130

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Pulmonary cystic echinococosis, a zoonosis caused by the larvae of the dog tapeworm Echinococcus granulosus, is considered as a major public health problem in those countries where dogs are used to care for large herds because of the incapacitating effects produced in affected population. The ratio lung:liver involvement is higher in children than in adults. A higher proportion of lung cases are discovered incidentally on a routine x-ray evaluation; the majority of infected people remain asymptomatic until the cyst enlarges sufficiently to cause symptoms. The majority of symptoms are caused by mass effect from the cyst volume; the presence of complications caused by cysts broke changes the clinical presentation; the principal complication is cyst rupture, producing cough, chest pain, hemoptysis, or vomica. Diagnosis is obtained by imaging evaluation (Chest X-ray or CT scan), supported by serology in the majority of cases. Surgery is the main therapeutic approach, having as principal objective, the removal of the parasite, preventing intraoperative dissemination; the use of pre surgical chemotherapy reduces the chances of seeding and recurrence; treatment using benzimidazoles is the preferred treatment when surgery is not available, or complete removal is not feasible

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“…[9] Furthermore, Aletras and Symbas [2] recommended a lobectomy for cysts that occupy more than 50% of the lobe. No resection was needed with our technique, and we believe that our method is more convenient than the lung-sparing surgery described by Dakak et al [10,11] In non-complicated smaller cysts, medical treatment is used for patients who cannot tolerate surgical operations or for those who reject surgical treatment. [12] Our postoperative complications included prolonged air leak in four patients (30%), pleural effusion in one patient (7.6%), atelectasis in four others (30.7%), wound infection in one (7.6%), and pneumonia in four others.…”

Section: Discussionmentioning

confidence: 87%

Parenchyma-preserving and minimally invasive thoracotomy technique in giant pulmonary hydatid cysts

Öncel¹

2015

Turk Gogus Kalp Dama

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Bu retrospektif çalışmada dev pulmoner kist hidatiklerde parankim koruyucu ve minimal invaziv ameliyat deneyimlerimiz sunuldu. Ça lış ma pla nı: Dev kist hidatikli 19 hasta (13 erkek, 6 kadın; ort. yaş 22 yıl) ameliyat edildi. Dev kistin en dış katmanı olan adventisya normal parankime kadar eksize edildi ve önceden tespit edilen bronşiyal kaçaklar kapatıldı. Serbest hale gelen kistin adventisyası karşılıklı olarak parankim içerisine dikildi. Bul gu lar: Kist hidatikler 13 hastada sağ hemitoraksta, beş hastada sol hemitoraksta ve bir hastada iki taraflı idi. Güvenli bronşiyal kapatma parankimi germeden pulmoner hacim kaybını engelledi. Ameliyata bağlı komplikasyonlar bir hastada plevral efüzyon, iki hastada atelektazi, bir hastada yara enfeksiyonu ve üç hastada pnömoni idi. Bilgisayarlı tomografi ile ölçülen kist çapları ortalama 10 cm idi. Hastanede ortalama kalış süresi 7.5 gün idi. So nuç: Güncel kist hidatik tedavisi kistin cerrahi ile tam olarak çıkarılmasını takiben pulmoner parankimin genişlemesine izin vermelidir. Parankim koruyucu ve minimal invaziv torakotomi tekniği ile ameliyat edilen hastaların hiçbirinde rezeksiyona gerek kalmadı. Tekniğimizin avantajları; düşük komplikasyon oranı ve kistin minimal invaziv torakotomi ile kapitonaj gerektirmeden tek bir drenle çıkılmasıdır. Anah tarsöz cük ler: Yeni bir teknik; dev kist hidatikler; minimal invazif torakotomi.

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Parenchyma-Saving Surgical Treatment of Giant Pulmonary Hydatid Cysts

Cited by 30 publications

References 7 publications

Surgery for parasitic lung infestations: roles in diagnosis and treatment

Surgery for parasitic lung infestations: roles in diagnosis and treatment

Pulmonary cystic echinococcosis

Parenchyma-preserving and minimally invasive thoracotomy technique in giant pulmonary hydatid cysts

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