Department of Thoracic Surgery and Transplantation, Pomeranian Medical University in Szczecin, Alfreda Sokołowskiego 11, 70-891 Szczecin, Poland.
Department of Thoracic Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Rimini 1, 12462 Athens, Greece.
Medicina (Kaunas). 2023 Mar 10;59(3):543. doi: 10.3390/medicina59030543.
Human echinococcosis is a zoonotic infection caused by the larvae of the tapeworm species The liver is the most common location for a primary echinococcosis. However, the parasite may bypass or spread from the liver to the lungs, causing primary or secondary pulmonary echinococcosis, respectively. Pulmonary echinococcosis is a clinically challenging condition in which anthelminthic regiments are important, but surgery has the central role in removing the cysts and preventing recurrences. Surgical treatment may involve cystotomy, enucleation, capitonnage, or atypical resections, which occasionally are in combination with hepatic procedures. The utilization of modern devices is greatly underdescribed in surgery for thoracic infections, even though these facilitate much of the work. Therefore, this article aims to describe pulmonary echinococcosis and the role of modern surgical devices in the treatment process. Furthermore, we report surgical treatment of three different cases of pulmonary echinococcosis. Surgeries of uncomplicated and ruptured hepatic or pulmonary cysts are described. Simple small pulmonary echinococcal lesions can be excised by endostaplers both for diagnostic and curative reasons. Larger cysts can be removed by energy devices unless large bronchial air leaks occur. Complicated cysts require treatment by more extensive techniques. Inexperienced surgeons should not abstain but should carefully decide preoperatively how to proceed.
人包虫病是一种由绦虫物种的幼虫引起的人畜共患感染。肝脏是原发性包虫病最常见的部位。然而，寄生虫可能绕过或从肝脏传播到肺部，分别导致原发性或继发性肺包虫病。肺包虫病是一种具有临床挑战性的疾病，驱虫治疗很重要，但手术在去除囊肿和预防复发方面起着核心作用。手术治疗可能涉及囊切开术、摘除法、填塞法或非典型切除术，这些方法偶尔与肝手术联合使用。尽管现代设备在胸部感染的手术中大大简化了工作，但在手术中对这些设备的利用却描述得很少。因此，本文旨在描述肺包虫病以及现代手术设备在治疗过程中的作用。此外，我们报告了三例不同的肺包虫病的手术治疗。描述了单纯性和破裂性肝或肺囊肿的手术治疗。简单的小的肺包虫性病变可以通过吻合器切除，无论是出于诊断还是治疗的原因。较大的囊肿可以通过能量设备去除，除非发生大的支气管空气泄漏。复杂的囊肿需要更广泛的技术治疗。经验不足的外科医生不应回避，但应在术前仔细决定如何进行。
