Department of Surgery, Imam Khomeini General Hospital, Urmia University of Medical Sciences, Urmia, Iran.
World J Surg. 2013 Sep;37(9):2129-33. doi: 10.1007/s00268-013-2093-7.
There are contrary opinions regarding the surgical treatment of pulmonary hydatid cysts. We report our experience performing a modified version of uncapitonnage surgery, called "saucerization," for treating pulmonary hydatid cysts.
A total of 78 patients with pulmonary hydatid cysts were studied regarding their surgery outcome and the complication rate. The procedure used for cyst evacuation depended on whether the cyst had ruptured. If ruptured, cystotomy was done; otherwise, enucleation was preferred. To deal with the residual cavity in an uncapitonnage manner, we removed the thin margins of the pericyst and closed the bronchial openings at the cavity floor. All patients were followed up at least for 6 months.
The intensive care unit stay ranged from 1 to 9 days. Incomplete lung expansion (six patients) was the main postoperative complication followed by wound infection (four patients) and persistent air leak (≥7 days) (one patient). There was one death. Dependence on mechanical ventilation and subsequent septic shock were also observed. The other patients exhibited no complications during the follow-up period.
Our experience demonstrated a low complication rate associated with removing the thin margins of the residual cavity and changing the shape of it into a "saucer." The results were satisfactory and comparable to the results of other studies on pulmonary hydatid cysts.
对于肺包虫囊肿的手术治疗存在不同意见。我们报告了我们使用一种改良的去顶术(称为“碟形化”)治疗肺包虫囊肿的经验。
研究了 78 例肺包虫囊肿患者的手术结果和并发症发生率。囊液清除所采用的程序取决于囊肿是否破裂。如果破裂,行囊肿切开术;否则,首选剜除术。为了以非包裹的方式处理残余腔,我们切除囊壁的薄缘并关闭腔底部的支气管开口。所有患者均至少随访 6 个月。
重症监护病房的住院时间为 1 至 9 天。主要的术后并发症是不完全肺膨胀(6 例),其次是伤口感染(4 例)和持续漏气(≥7 天)(1 例)。有 1 例死亡。依赖机械通气和随后的感染性休克也有观察到。其他患者在随访期间无并发症。
我们的经验表明,切除残余腔的薄缘并将其形状改变为“碟形”可降低并发症发生率。结果令人满意,与其他肺包虫囊肿研究的结果相当。