Vasquez J C, Montesinos E, Peralta J, Rojas L, DeLaRosa J, Leon J J
Thoracic and Cardiovascular Surgery, Portneuf Medical Center and Idaho State University, Pocatello, Idaho 83201, United States.
Thorac Cardiovasc Surg. 2009 Aug;57(5):295-302. doi: 10.1055/s-0029-1185604. Epub 2009 Jul 23.
Lung hydatid cyst caused by Echinococcus granulosus is endemic in many areas of the world. We aimed to compare the outcome of surgical treatment in intact and ruptured (infected or noninfected) cysts.
We reviewed the medical records of 115 patients with lung hydatid disease who were surgically treated between 2001 and 2005 in a tertiary hospital in Lima, Peru. Patients were divided into 3 groups based on cyst characteristics: intact cysts (n = 41), ruptured noninfected cysts (n = 47) and ruptured infected cysts (n = 27). If a patient had more than one type of cyst, the most severe form of disease was recorded. Data related to symptoms, morbidity and mortality were recorded and compared. We also calculated direct patient costs.
Mean age of patients was 23.6 +/- 15.1 years old. Ruptured cysts were present in 64 % of patients and giant cysts (> 10 cm diameter) were present in 26 % of patients. Hemoptysis was present in 47.0 % of patients and was more frequent in patients with ruptured infected cysts. Lung resection was performed in 58 % of patients. The most common postoperative complication was infection of the operative wound (6.08 %). Perioperative mortality was zero. Patients with ruptured cysts had a longer hospitalization time and higher total cost (12.28 +/- 0.92 days, US$ 890.34 +/- 303.35) than patients with intact cysts (10.17 +/- 0.79 days, US$ 724.81 +/- 14.38).
Surgical treatment of lung hydatid disease is safe, with a good outcome and a low mortality rate. The lung resection rate was higher than most published series and reflects the relatively high proportion of patients with giant and ruptured infected cysts.
细粒棘球绦虫引起的肺包虫囊肿在世界许多地区呈地方性流行。我们旨在比较完整囊肿和破裂（感染或未感染）囊肿的手术治疗结果。
我们回顾了2001年至2005年在秘鲁利马一家三级医院接受手术治疗的115例肺包虫病患者的病历。根据囊肿特征将患者分为3组：完整囊肿（n = 41）、破裂未感染囊肿（n = 47）和破裂感染囊肿（n = 27）。如果患者有不止一种类型的囊肿，则记录最严重的疾病形式。记录并比较与症状、发病率和死亡率相关的数据。我们还计算了患者的直接费用。
患者的平均年龄为23.6±15.1岁。64%的患者存在破裂囊肿，26%的患者存在巨大囊肿（直径>10 cm）。47.0%的患者出现咯血，在破裂感染囊肿患者中更常见。58%的患者进行了肺切除术。最常见的术后并发症是手术伤口感染（6.08%）。围手术期死亡率为零。与完整囊肿患者（10.17±0.79天，724.81±14.38美元）相比，破裂囊肿患者的住院时间更长，总费用更高（12.28±0.92天，890.34±303.35美元）。
肺包虫病的手术治疗是安全的，效果良好，死亡率低。肺切除率高于大多数已发表的系列报道，反映出巨大和破裂感染囊肿患者的比例相对较高。
