Hasdiraz Leyla, Oğuzkaya Fahri, Bilgin Mehmet
Department of Thoracic Surgery, Devlet Hospital, Erciyes University Medical School, Kayseri, Turkey.
ANZ J Surg. 2006 Jun;76(6):488-90. doi: 10.1111/j.1445-2197.2006.03761.x.
Hydatidosis is endemic in Turkey and many other areas of the world. The definitive treatment for pulmonary hydatidosis is surgical. The purpose of this study was the review of surgical therapy of our patients with pulmonary hydatid disease and the necessity of lobectomy.
We reviewed 107 patients: 26 of whom were women and 81 were men. The median age was 30 years (range, 7-57 years). Chest roentgenogram, abdominal ultrasound and computed tomography of the chest and upper abdomen were carried out as diagnostic study. All patients underwent thoracotomy and cystotomy with or without capitonnage.
Four patients had two cysts in the same lobe and one patient had three cysts (one perforated and two intact) in the left lower lobe (4.6%). In nine patients, the cysts were >10 cm in diameter (8.4%). In 18 patients, the cysts were suppurative (16.8%). None of the patients required lobectomy. Of the 107 patients, prolonged air leaks (n = 8), atelectasis (n = 3) and empyema (n = 3; two had empyema preoperatively because of pleural perforation of cysts and the other had prolonged air leak) were observed in the postoperative period. There was no death.
The effective treatment of hydatid cysts in the lung is the complete excision of the cyst with maximum preservation of lung parenchyma. We believe that the decision of lobectomy must be taken very carefully, even in the case of infected hydatid cysts, atelectasis, giant cysts and multiple cysts in the same lobe.
包虫病在土耳其及世界其他许多地区呈地方性流行。肺包虫病的 definitive 治疗方法是手术。本研究的目的是回顾我们的肺包虫病患者的手术治疗情况以及肺叶切除术的必要性。
我们回顾了 107 例患者：其中 26 例为女性，81 例为男性。中位年龄为 30 岁（范围 7 - 57 岁）。进行胸部 X 线、腹部超声以及胸部和上腹部计算机断层扫描作为诊断性检查。所有患者均接受了开胸手术及囊肿切开术，术中或未进行内翻缝合。
4 例患者在同一肺叶有两个囊肿，1 例患者左下叶有三个囊肿（1 个穿孔，2 个完整）（4.6%）。9 例患者的囊肿直径 >10 cm（8.4%）。18 例患者的囊肿为化脓性（16.8%）。无一例患者需要肺叶切除术。107 例患者中，术后观察到有持续性漏气（n = 8）、肺不张（n = 3）和脓胸（n = 3；2 例术前因囊肿胸膜穿孔出现脓胸，另 1 例有持续性漏气）。无死亡病例。
肺包虫囊肿的有效治疗方法是在最大程度保留肺实质的情况下完整切除囊肿。我们认为，即使在感染性包虫囊肿、肺不张、巨大囊肿以及同一肺叶有多个囊肿的情况下，决定是否进行肺叶切除术也必须非常谨慎。
“definitive”在医学语境中可译为“决定性的、根治性的”等，这里结合语境暂译为“definitive”，具体可根据更准确的医学术语习惯调整。
