Arinc Sibel, Alpay Levent, Okur Erdal, Köksal Cengiz, Sogukpinar Ozlem, Kosif Aysun, Halezeroglu Semih, Atasalihi Ali
Department of Pulmonology, Sureyyapasa Center for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
Surg Today. 2008;38(11):983-6. doi: 10.1007/s00595-008-3759-x. Epub 2008 Oct 29.
To investigate the incidence and define the importance of recurrent pulmonary hydatid cysts in developing countries.
We analyzed the records of 312 patients with pulmonary hydatid cyst disease diagnosed in our center between 1999 and 2005.
A recurrent pulmonary hydatid cyst was diagnosed in 10 (3.2%) of the 312 patients [8 men and 2 women, mean age 36.9 (range 20-60) years]. The diagnosis was based on radiographic, clinical, or serological findings, established intraoperatively. The most frequent symptom of recurrent pulmonary hydatid cyst was hemoptysis (60%). The mean interval between diagnosis of the initial hydatid cyst and detection of recurrence was 8.75 (range 3-15) years. Bronchoscopy was performed in all patients, but proved diagnostic in only one. The localization of the initial and recurrent cysts differed in seven patients. A median follow-up period of 5 years revealed second recurrences in only two patients; manifesting as an intrapleural rupture of the cyst in one and as empyema in one. The recurrence was treated by resection in all patients; as cystectomy in eight patients, lobectomy in one patient, and pneumonectomy in one patient.
Pulmonary hydatid cyst may recur in the same or a different location in the lung. Patients with a pleural lesion must be followed up regularly for any signs of recurrence.
调查发展中国家复发性肺包虫囊肿的发病率并明确其重要性。
我们分析了1999年至2005年间在本中心诊断为肺包虫囊肿病的312例患者的记录。
312例患者中有10例(3.2%)被诊断为复发性肺包虫囊肿[8例男性和2例女性,平均年龄36.9岁(范围20 - 60岁)]。诊断基于影像学、临床或血清学检查结果,术中确诊。复发性肺包虫囊肿最常见的症状是咯血(60%)。初次包虫囊肿诊断与复发检测之间的平均间隔为8.75年(范围3 - 15年)。所有患者均接受了支气管镜检查,但仅1例确诊。7例患者初次囊肿和复发性囊肿的位置不同。中位随访期5年显示仅2例患者出现二次复发;1例表现为囊肿的胸膜内破裂,1例表现为脓胸。所有患者的复发均采用手术切除治疗;8例行囊肿切除术,1例行肺叶切除术,1例行全肺切除术。
肺包虫囊肿可能在肺的相同或不同位置复发。胸膜病变患者必须定期随访以观察任何复发迹象。