Thapaliya Pratikshya, Ahmad Tanveer, Abid Ambreen, Sikander Nazish, Mazcuri Misauq, Ali Nadir
Thoracic Surgery, Jinnah Postgraduate Medical Centre, Karachi, PAK.
Cureus. 2020 Dec 22;12(12):e12212. doi: 10.7759/cureus.12212.
Hydatid cyst (HC) of lung is a frequently encountered entity in Pakistan. The clinical and radiological manifestations of HC in lung depend on the integrity of the cyst. Patients may remain asymptomatic for years in cases of simple HC or may present with a wide variety of complications when it ruptures. The aim of this study was to compare management outcomes in simple and complex HCs.
This prospective, observational study was conducted from February 2019 until May 2020. Patients were divided into two groups: simple HC (Group A) and complex HC (Group B). Preoperative complications, surgical procedures, postoperative complications, duration of hospital stay, duration of chest tube placement and need for readmission were noted and compared between the two groups. All data was processed through the Statistical Package for the Social Sciences (SPSS) Statistics version 22 (IBM Corp., Armonk, NY).
Sixty-two patients were included out of which Group A had 28 (45.2%) patients and Group B had 34 (54.8%) patients. There were 39 (62.9%) males and 23 (37.1%) females. The mean age was 31.11 ± 11.02 years. Preoperative complications in Group B included empyema seen in 10 (28.5%) patients, rupture of cyst into bronchus in 8 (23.5%), biliopleural fistula in 4 (11.7%), hydropneumothorax in 2 (5.8%), bronchopleural fistula in 1 (2.9%), airway compromise in 1 (2.9%) and pneumonia in 1 (2.9%) patient. Group B required longer days of chest tube placement, longer intensive care unit stay and longer hospital stay (p<0.001). The frequency of postoperative intervention was more in group B (p<0.05), therefore requiring readmission.
Surgery has favorable outcomes in the management of HC of lung. Complications associated with complex HC not only requires preoperative intervention like chest tubes but can also lead to life-threatening complications. There is also a frequent need for additional procedures during surgery in cases with complex HC along with greater risk of postoperative complications. All these are associated with prolonged hospital stay, readmissions and greater morbidity. Hence, early diagnosis and referral is needed to avoid these preventable complications associated with cyst rupture.
肺包虫囊肿（HC）在巴基斯坦是一种常见病症。肺包虫囊肿的临床和放射学表现取决于囊肿的完整性。在单纯性肺包虫囊肿病例中，患者可能多年无症状，但囊肿破裂时可能会出现多种并发症。本研究的目的是比较单纯性和复杂性肺包虫囊肿的治疗效果。
本前瞻性观察性研究于2019年2月至2020年5月进行。患者分为两组：单纯性肺包虫囊肿组（A组）和复杂性肺包虫囊肿组（B组）。记录并比较两组患者的术前并发症、手术方式、术后并发症、住院时间、胸腔闭式引流管放置时间以及再次入院需求。所有数据通过社会科学统计软件包（SPSS）统计版本22（IBM公司，纽约州阿蒙克）进行处理。
共纳入62例患者，其中A组28例（45.2%），B组34例（54.8%）。男性39例（62.9%），女性23例（37.1%）。平均年龄为31.11±11.02岁。B组术前并发症包括10例（28.5%）患者出现脓胸，8例（23.5%）囊肿破裂入支气管，4例（11.7%）胆汁胸膜瘘，2例（5.8%）液气胸，1例（2.9%）支气管胸膜瘘，1例（2.9%）气道受压，1例（2.9%）患者发生肺炎。B组胸腔闭式引流管放置天数更长，重症监护病房住院时间更长，住院时间也更长（p<0.001）。B组术后干预频率更高（p<0.05），因此需要再次入院。
手术治疗肺包虫囊肿效果良好。与复杂性肺包虫囊肿相关的并发症不仅需要术前放置胸腔闭式引流管等干预措施，还可能导致危及生命的并发症。对于复杂性肺包虫囊肿病例，手术中也经常需要额外的操作，术后并发症风险更高。所有这些都与住院时间延长、再次入院以及更高的发病率相关。因此，需要早期诊断和转诊，以避免与囊肿破裂相关的这些可预防并发症。
