Department of Cardiovascular Surgery, Yüzüncü Yil University, Van, Turkey.
Med Sci Monit. 2009 Dec;15(12):CR600-5.
Hydatid disease is a parasitic infestation frequently seen in sheep- and cattle-raising areas of the world, and has been known since the time of Galen and Hippocrates. We retrospectively evaluated patients who underwent surgery in our department due to complicated giant intrathoracic hydatid cysts.
MATERIAL/METHODS: Twenty patients with complicated giant intrathoracic hydatid cysts were operated on between May 2001 and May 2007 in our department. There were 14 male and 6 female patients, with an age range from 10 to 47 years (mean 23.7+/-11.2 years).
The most common symptoms were cough, chest pain, fever, and dyspnea. The most common physical finding was decreased breathing sounds at the affected hemi-thorax. There were signs of cyst perforation of the bronchial space in 14 patients. The cysts were ruptured to the pleural space in 5 patients, with pleural effusion or localized empyema; 4 of them required decortication due to air trapping in the lung. The cyst was found to be intact but infected in 1 patient with cardiac cyst. Cystotomy plus capitonnage was the most frequently used surgical procedure, which was performed in 18 patients, while lobectomy was performed in 1 patient, and left ventriculotomy plus cystotomy plus capitonnage was performed in 1 patient.
All thoracic hydatid cysts should be operated on as soon as they are diagnosed in order to avoid complications, and surgery should be as conservative as possible. Since preoperative medical therapy can lead to perforation, additional adjuvant medical therapy should only be administered postoperatively to avoid recurrences.
包虫病是一种寄生虫感染，在世界范围内的绵羊和牛养殖区经常发生，早在盖伦和希波克拉底时代就已为人所知。我们回顾性评估了因复杂的巨大胸腔包虫囊肿而在我科接受手术的患者。
材料/方法：2001 年 5 月至 2007 年 5 月期间，我科对 20 例复杂的巨大胸腔包虫囊肿患者进行了手术。男性 14 例，女性 6 例，年龄 10-47 岁，平均年龄 23.7+/-11.2 岁。
最常见的症状是咳嗽、胸痛、发热和呼吸困难。最常见的物理发现是受累半胸呼吸音减弱。14 例患者存在支气管空间囊肿穿孔的迹象。5 例囊肿破裂至胸膜腔，伴有胸腔积液或局限性脓胸；其中 4 例因肺部空气滞留而需要行去皮质术。1 例心脏囊肿患者发现囊肿完整但感染。囊肿切开加填塞术是最常用的手术方法，18 例患者采用该方法，1 例患者行肺叶切除术，1 例患者行左心室切开加囊肿切开加填塞术。
一旦确诊，所有胸腔包虫囊肿均应手术治疗，以避免并发症，且手术应尽可能保守。由于术前药物治疗可能导致穿孔，因此应仅在术后给予额外的辅助药物治疗，以避免复发。
