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Pulmoner hidatik kistin intrabronşiyal rüptürünün klinik özellikleri ve cerrahi tedavisi

Yıl 2023, Cilt: 16 Sayı: 1, 11 - 16, 31.01.2023

Öz

Giriş: İntrabronşiyal rüptüre hidatik kistlerde morbidite ve mortalite intakt kistlere göre çok daha fazladır. Bu çalışmada amacımız, intrabronşiyal rüptüre hidatik kist nedeniyle opere ettiğimiz hastaların klinik ve radyolojik özelliklerini, cerrahi tedavi ve postoperatif sonuçlarını sunmaktır.
Materyal ve Metod: Ocak 2010 ile Aralık 2020 arasında, kliniğimizde 37 hastada intrabronşiyal pulmoner hidatik kist rüptürü nedeniyle 39 operasyon gerçekleştirildi. Hastaların yaş, cinsiyet, semptom, hidatik kistin sayısı, büyüklüğü, tarafı ve yeri, preoperatif radyolojik değerlendirilmesi, uygulanan cerrahi yöntem, postoperatif komplikasyonlar, göğüs tüpü kalış süresi, hastane yatış süresi ve hastaların takip süreleri hasta dosyaları incelenerek not edildi.
Bulgular: Hastaların 23’ ü (%62,1) erkek, 14’ü (%37,8) bayan ve yaş ortalaması 32,6 (18-62) idi. Hastalarımızın 5’inde rezeksiyon uygulanır iken geriye kalan tüm kistlerde parankim koruyucu kistotomi ve kapitonaj yöntemi tercih edildi. Postoperatif uzamış hava kaçağı 3 hastada görülürken, 2 hastade atelektazi ve 1 hastada yara yeri enfeksiyonu gelişti. Peroperatif ve postoperatif hiçbir hastada mortalite görülmedi. Takip süresince hiçbir hastada nüks saptanmadı.
Sonuç: İntrabronşial rüptüre hidatik kistler yüksek preoperatif ve postoperatif komplikasyon riskine sahiptir. Antihelmintik tedavi perforasyon riski nedeniyle hidatik kist cerrahisi mümkün olmayan hastalarda verilmeli ve intrabronşiyal rüptüre hidatik kistlerde nüksü önlemek amaçlı postoperatif olarak verilmelidir.

Kaynakça

  • Chaouachi B, Nouri A, Ben-Salah S, Lakhoua R, Saied H. Hydatid cyst of the lung in children. Apropos of 643 cases. Pediatrie. 1988;43:769–73.
  • Cangir AK, Sahin E, Enon S, Kavukçu S, Akay H, Okten I, et al. Surgical treatment of pulmonary hydatid cysts in hildren. J Pediatr Surg. 2001;36:917–20.
  • el Kabiri H, Traibi A, El Hammoumi M, El Oueriachi F, Arsalane A. Parenchyma sparing procedures is possible for most pulmonary hydatid disease without recurrence and low complications. Med Arch. 2012;66:332–5.
  • Ashour MH, Hajjar WM, Ishaq M, Alamassi M, Saleh W, Al Kattan KM, et al. Pulmonary hydatid cysts: the naturally occurring models for rupture. Asian Cardiovasc Thorac Ann. 2016;24:670–5.
  • Yüksel M, Kır A, Ercan S, Batırel HF and Baysungur V. Correlation between sizes and intracystic pressures of hydatid cysts. Eur J Cardiothoracic Surg 1997; 12: 903–906.
  • Dogan R, Yuksel M, Çetın G, Suzer K, Alp M, Kaya S and Unlu M. Surgical treatment of hydatid cysts of the lung: report on 1055 patients. Thorax 1989; 44: 192-199.
  • Wen H, Yang WG. Public health importance of cystic echinococcosis in China. Acta Trop 1997;67:133–45.
  • Gil-Grande LA, Rodriguez-Caaberio F, Prieto JG, et al. Randomized controlled trial to efficacy of albendazole in intra-abdominal hydatid disease. Lancet 1993;342:1269 –72.
  • Horton RJ. Albendazole in treatment of human cystic echinococcosis: 12 years experience. Acta Tropica 1997;64:79 –93. Peleg H, Best LA, Gaitini D. Simultaneous operation for hydatid cysts of right lung and liver. J Thorac Cardiovasc Surg 1985;90:783–7.
  • Aarons BJ. Thoracic surgery for hydatid disease. World J Surg 1999;23:1105–9.
  • Kurkcuoglu IC, Eroglu A, Karaoglanoglu N, Polat P. Complication of albendazole treatment in hydatid disease of lung. Eur J Cardiothorac Surg 2002;22:649 –50.
  • Yalcinkaya I, Er M, Ozbay B, Ugras S. Surgical treatment of hydatid cyst of the lung: review of 30 cases. Eur Respir J 1999;13:441–4.
  • Ramos G, Orduna A, Garcia-Yuste M. Hydatid cyst of the lung: diagnosis and treatment. World J Surg 2002;25:46 –57.
  • Xanthakis D, Efthimiadis M, Papadakis G, et al. Hydatid disease of the chest. Report of 91 patients surgically treated. Thorax 1972;27:517–28.
  • Akhan O, Özmen MN, Dincer A, Göçmen A and Kalyoncu F. Percutaneous treatment of pulmonary hydatid cysts. Cardiovasc Intervent Radiol 1994; 17: 271-275.
  • Astudillo L, Martin-Blondel G, Sans N, Dhaste G, Couret B and Arlet-Suau E. Solitary nodular form of bronchiolitis obliterans organizing pneumonia. Am J Med 2004; 117: 887–888.
  • Kabiri EH, Kabiri M, Atoini F, Zidane A, Arsalane A. Surgical treatment of pulmonary hydatid cysts in childhood. Arch Pediatr. 2006;13(12):1495–9. Zidi A, Ben Miled-Mrad K, Hantous-Zannad S, Fathallah B, Mestiri I, Baccouche I, et al. Computed tomography of complicated pulmonary hydatid cyst by rupture in the bronchi. J Radiol. 2007;88:59–64.
  • Kabiri EH, El Hammoumi M, Kabiri M. Surgical treatment of hydatidothorax in children: a retrospective study of 19 patients. J Pediatr Surg. 2020;55:433–6.
  • Topçu S, Kurul IC, Taştepe I, Bozkurt D, Gülhan E, Cetin G. Surgical treatment of pulmonary hydatid cysts in children. J Thorac Cardiovasc Surg. 2000;120:1097–101.
  • Yaldiz S, Gursoy S, Ucvet A, Yaldiz D, Kaya S. Capitonnage results in low postoperative morbidity in the surgical treatment of pulmonary echinococcosis. Ann Thorac Surg. 2012;93:962–6.
  • Aldahmashi M, Alassal M, Kasb I, Elrakhawy H. Conservative surgical management for pulmonary hydatid cyst: analysis and outcome of 148 cases. Can Respir J. 2016;2016:1.
  • Aribas OK, Kanat F, Gormus N, Turk E. Pleural complications of hydatid disease. J Thorac and Cardiovasc Surg 2002;123:492–7.
  • Balci AE, Eren N, Eren S, Ulku R. Ruptured hydatid cysts of the lung in children: clinical review and results of surgery. Ann Thorac Surg 2002;74:889 –92.
  • Kuzucu A, Ulutas H, Reha Celik M, Yekeler E. Hydatid cysts of the lung: Lesion size in relation to clinical presentation and therapeutic approach. Surg Today. 2014; 44(1):131-6.

Clinical features and surgical treatment of intrabronchial rupture of pulmonary hydatid cyst

Yıl 2023, Cilt: 16 Sayı: 1, 11 - 16, 31.01.2023

Öz

Aim: Morbidity and mortality in intrabronchial ruptured hydatid cysts are much higher than in intact cysts. Our aim in this study is to present the clinical and radiological features, surgical treatment and postoperative results of the patients we operated for intrabronchial ruptured hydatid cyst.
Material and method: Between January 2010 and December 2020, 39 operations were performed in 37 patients for intrabronchial pulmonary hydatid cyst rupture in our clinic. The patients' age, gender, symptoms, number, size, side and location of the hydatid cyst, preoperative radiological evaluation, surgical method, postoperative complications, chest tube length of stay, hospitalization period and follow-up periods of the patients were noted by examining the patient files.
Results: Of the patients, 23 (62.1%) were male, 14 (37.8%) were female, and the mean age was 32.6 (18-62). While resection was performed in 5 of our patients, parenchymal-preserving cystotomy and capitonage method was preferred in all remaining cysts. Postoperative prolonged air leakage was observed in 3 patients, atelectasis in 2 patients and wound infection in 1 patient. No mortality was observed in any of the patients perioperatively and postoperatively. No recurrence was detected in any patient during the follow-up period. Conclusion: Intrabronchial ruptured hydatid cysts have a high risk of preoperative and postoperative complications. Antihelminthic therapy should be given to patients who cannot undergo hydatid cyst surgery due to the risk of perforation and should be given postoperatively to prevent recurrence in intrabronchial ruptured hydatid cysts.

Kaynakça

  • Chaouachi B, Nouri A, Ben-Salah S, Lakhoua R, Saied H. Hydatid cyst of the lung in children. Apropos of 643 cases. Pediatrie. 1988;43:769–73.
  • Cangir AK, Sahin E, Enon S, Kavukçu S, Akay H, Okten I, et al. Surgical treatment of pulmonary hydatid cysts in hildren. J Pediatr Surg. 2001;36:917–20.
  • el Kabiri H, Traibi A, El Hammoumi M, El Oueriachi F, Arsalane A. Parenchyma sparing procedures is possible for most pulmonary hydatid disease without recurrence and low complications. Med Arch. 2012;66:332–5.
  • Ashour MH, Hajjar WM, Ishaq M, Alamassi M, Saleh W, Al Kattan KM, et al. Pulmonary hydatid cysts: the naturally occurring models for rupture. Asian Cardiovasc Thorac Ann. 2016;24:670–5.
  • Yüksel M, Kır A, Ercan S, Batırel HF and Baysungur V. Correlation between sizes and intracystic pressures of hydatid cysts. Eur J Cardiothoracic Surg 1997; 12: 903–906.
  • Dogan R, Yuksel M, Çetın G, Suzer K, Alp M, Kaya S and Unlu M. Surgical treatment of hydatid cysts of the lung: report on 1055 patients. Thorax 1989; 44: 192-199.
  • Wen H, Yang WG. Public health importance of cystic echinococcosis in China. Acta Trop 1997;67:133–45.
  • Gil-Grande LA, Rodriguez-Caaberio F, Prieto JG, et al. Randomized controlled trial to efficacy of albendazole in intra-abdominal hydatid disease. Lancet 1993;342:1269 –72.
  • Horton RJ. Albendazole in treatment of human cystic echinococcosis: 12 years experience. Acta Tropica 1997;64:79 –93. Peleg H, Best LA, Gaitini D. Simultaneous operation for hydatid cysts of right lung and liver. J Thorac Cardiovasc Surg 1985;90:783–7.
  • Aarons BJ. Thoracic surgery for hydatid disease. World J Surg 1999;23:1105–9.
  • Kurkcuoglu IC, Eroglu A, Karaoglanoglu N, Polat P. Complication of albendazole treatment in hydatid disease of lung. Eur J Cardiothorac Surg 2002;22:649 –50.
  • Yalcinkaya I, Er M, Ozbay B, Ugras S. Surgical treatment of hydatid cyst of the lung: review of 30 cases. Eur Respir J 1999;13:441–4.
  • Ramos G, Orduna A, Garcia-Yuste M. Hydatid cyst of the lung: diagnosis and treatment. World J Surg 2002;25:46 –57.
  • Xanthakis D, Efthimiadis M, Papadakis G, et al. Hydatid disease of the chest. Report of 91 patients surgically treated. Thorax 1972;27:517–28.
  • Akhan O, Özmen MN, Dincer A, Göçmen A and Kalyoncu F. Percutaneous treatment of pulmonary hydatid cysts. Cardiovasc Intervent Radiol 1994; 17: 271-275.
  • Astudillo L, Martin-Blondel G, Sans N, Dhaste G, Couret B and Arlet-Suau E. Solitary nodular form of bronchiolitis obliterans organizing pneumonia. Am J Med 2004; 117: 887–888.
  • Kabiri EH, Kabiri M, Atoini F, Zidane A, Arsalane A. Surgical treatment of pulmonary hydatid cysts in childhood. Arch Pediatr. 2006;13(12):1495–9. Zidi A, Ben Miled-Mrad K, Hantous-Zannad S, Fathallah B, Mestiri I, Baccouche I, et al. Computed tomography of complicated pulmonary hydatid cyst by rupture in the bronchi. J Radiol. 2007;88:59–64.
  • Kabiri EH, El Hammoumi M, Kabiri M. Surgical treatment of hydatidothorax in children: a retrospective study of 19 patients. J Pediatr Surg. 2020;55:433–6.
  • Topçu S, Kurul IC, Taştepe I, Bozkurt D, Gülhan E, Cetin G. Surgical treatment of pulmonary hydatid cysts in children. J Thorac Cardiovasc Surg. 2000;120:1097–101.
  • Yaldiz S, Gursoy S, Ucvet A, Yaldiz D, Kaya S. Capitonnage results in low postoperative morbidity in the surgical treatment of pulmonary echinococcosis. Ann Thorac Surg. 2012;93:962–6.
  • Aldahmashi M, Alassal M, Kasb I, Elrakhawy H. Conservative surgical management for pulmonary hydatid cyst: analysis and outcome of 148 cases. Can Respir J. 2016;2016:1.
  • Aribas OK, Kanat F, Gormus N, Turk E. Pleural complications of hydatid disease. J Thorac and Cardiovasc Surg 2002;123:492–7.
  • Balci AE, Eren N, Eren S, Ulku R. Ruptured hydatid cysts of the lung in children: clinical review and results of surgery. Ann Thorac Surg 2002;74:889 –92.
  • Kuzucu A, Ulutas H, Reha Celik M, Yekeler E. Hydatid cysts of the lung: Lesion size in relation to clinical presentation and therapeutic approach. Surg Today. 2014; 44(1):131-6.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Cerrahi
Bölüm Araştırma Makalesi
Yazarlar

Hıdır Esme

Yayımlanma Tarihi 31 Ocak 2023
Gönderilme Tarihi 25 Temmuz 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 16 Sayı: 1

Kaynak Göster

Vancouver Esme H. Pulmoner hidatik kistin intrabronşiyal rüptürünün klinik özellikleri ve cerrahi tedavisi. JSurgArts. 2023;16(1):11-6.

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