Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
J Laparoendosc Adv Surg Tech A. 2020 Sep;30(9):1036-1039. doi: 10.1089/lap.2020.0228. Epub 2020 Jul 7.
We wish to describe a novel technique of transdiaphragmatic excision of hepatic hydatid in patients with synchronous ipsilateral lung hydatid. Two patients, aged 11 and 6 years, presented with large synchronous hydatid cyst in right lung and liver. Second patient had two large cysts in right lobe of liver in posterior-superior segment of VII and VIII. The patients underwent thoracoscopic excision of lung cyst, and in same sitting the liver hydatid was seen bulging through the diaphragm. The diaphragm was incised to expose the cyst beneath, with excision of hydatid. Port-in-cyst technique was used to excise the membranes. Both lung and liver cyst were successfully removed through thoracoscopic approach and a laparotomy was altogether avoided. Both patients did well in follow-up (3 years and 6 months). There are no respiratory issues in these patients. This is a novel approach for multiple synchronous hepatic and pulmonary hydatid. This can be applied in specific scenario as described. It gives a significant advantage of avoiding a laparotomy and thoracotomy in patients and thus reducing morbidity.
我们希望描述一种在同侧肺部和肝脏同时发生包虫病的患者中行膈肌切开肝包虫切除术的新方法。两名年龄分别为 11 岁和 6 岁的患者均患有右侧肺部和肝脏的大的包虫囊肿。第二位患者的右叶第七和第八段的后上部有两个大的囊肿。这些患者均接受了胸腔镜肺囊肿切除术，在同一手术中，发现肝包虫穿过膈肌向外突出。我们切开膈肌以暴露下方的囊肿，并进行包虫切除术。采用囊内入路技术切除囊壁。通过胸腔镜途径成功地切除了肺和肝脏的囊肿，完全避免了开腹手术。两名患者的随访情况均良好（3 年 6 个月）。这些患者没有出现呼吸问题。对于多个同时发生的肝和肺包虫病，这是一种新的方法。这种方法可以在特定情况下应用，如文中所述。它具有避免患者开腹和开胸手术的显著优势，从而降低了发病率。
