Ayed Adel K, Alshawaf Emad
Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait.
Med Princ Pract. 2003 Apr-Jun;12(2):112-6. doi: 10.1159/000069117.
To report our experience of surgical procedures in the management of hydatid cysts of the lung and to assess the effect of postoperative chemotherapy.
In a longitudinal cohort study, 64 consecutive patients who presented with hydatid cysts of the lung from 1994 to 1998 were included. The main measures were: characteristics on presentation, operative techniques, postoperative morbidity, and the outcome of treatment. The mean age was 28 years (range 4-65 years). The most common symptoms were cough, chest pain, fever, and hemoptysis. Chest radiographs and computed tomograms were the main method of diagnosis. Pulmonary cystotomy and capitonnage were performed in 46 patients. Pulmonary resection was needed in 8 of 64 patients. Simultaneous combined resection of hydatid cysts through thoracotomy with transdiaphragmatic removal of liver cysts was performed in one stage in 13 patients.
Chest radiographs and CT scans showed a smoothly outlined spherical opacity in 45 patients. Other radiographic findings included ill-defined shadow (in 8 patients), pleural effusion (7 patients), air fluid level (3 patients), and hydropneumothorax in a single patient. There were 8 (12.5%) cases of immediate postoperative complications. These occurred mostly in patients who had cysts larger than 10 cm (p = 0.003). Thirty-four patients were treated by a 3-month course of albendazole chemotherapy. Four patients (6%) had recurrences of the disease during the follow-up period. These recurrences occurred in patients with large cysts >10 cm (p = 0.001).
Conservative surgical methods are the preferred surgical techniques. Postoperative chemotherapy with albendazole for 3 months is recommended.
报告我们在肺包虫囊肿治疗中手术操作的经验，并评估术后化疗的效果。
在一项纵向队列研究中，纳入了1994年至1998年间连续出现肺包虫囊肿的64例患者。主要测量指标包括：临床表现特征、手术技术、术后发病率及治疗结果。平均年龄为28岁（范围4 - 65岁）。最常见的症状为咳嗽、胸痛、发热和咯血。胸部X线片和计算机断层扫描是主要的诊断方法。46例患者进行了肺囊肿切开术和囊内缝合术。64例患者中有8例需要进行肺切除术。13例患者一期通过开胸术同时联合经膈肌切除肝囊肿的方式进行了包虫囊肿联合切除术。
胸部X线片和CT扫描显示45例患者有边界光滑的球形不透光区。其他影像学表现包括边界不清的阴影（8例患者）、胸腔积液（7例患者）、气液平面（3例患者）以及1例患者出现液气胸。术后立即出现并发症的有8例（12.5%）。这些并发症大多发生在囊肿大于10 cm的患者中（p = 0.003）。34例患者接受了为期3个月的阿苯达唑化疗。4例患者（6%）在随访期间疾病复发。这些复发发生在囊肿大于10 cm的患者中（p = 0.001）。
保守手术方法是首选的手术技术。建议术后使用阿苯达唑进行3个月的化疗。
