Imran Muhammad, Abid Khan Muhammad, Janas Ibrahim, Ullah Mehran, Ullah Hidayat, Baseer Abdul, Khan Fahad R
Thoracic Surgery, Lady Reading Hospital Medical Teaching Institute, Peshawar, PAK.
Cardiology, Lady Reading Hospital Medical Teaching Institute, Peshawar, PAK.
Cureus. 2025 Apr 19;17(4):e82575. doi: 10.7759/cureus.82575. eCollection 2025 Apr.
Objective The primary objective of this study was to evaluate the effectiveness and safety profile of various surgical interventions used to manage pulmonary hydatid cysts, comparing patient outcomes such as postoperative morbidity, hospital stay duration, postoperative mortality, and complication rates across different surgical techniques. Methods This retrospective observational cohort study was conducted at the Department of Thoracic Surgery at Lady Reading Hospital, Peshawar, Pakistan, from January 1, 2023, to December 31, 2023. Patients with surgical treatment of pulmonary hydatid cysts were included. Surgical techniques ranged from lung-sparing procedures, such as cystotomy with capitonnage, enucleation, and pericystectomy, to more extensive resections, including wedge resection, segmentectomy, lobectomy, and pneumonectomy. Primary outcomes included postoperative morbidity, hospital stay duration, pain scores, and 30-day mortality. Statistical analysis was performed using analysis of variance (ANOVA) and Fisher's exact test, with a significance threshold of p < 0.05. Results A total of 180 patients were included. The mean age of patients was 37.45 ± 11.28 years; 105 (58.33%) were men, and 75 (41.67%) were women. Cystotomy with capitonnage was performed in 97 patients (53.89%), showing the shortest hospital stay (9.4 ± 3.1 days) and the lowest morbidity (18 patients, 18.56%). Pneumonectomy was conducted in four patients (2.22%) and was associated with the longest hospital stay (17.8 ± 7.1 days) and the highest morbidity (three patients, 75.00%). Postoperative mortality occurred in three patients (1.67%), all of whom underwent extensive resections. The overall postoperative complication rate was 23.89% (43 patients), with chest pain in 99 patients (55.00%), cough in 81 (45.00%), and fever in 27 (15.00%). Statistically significant differences in hospital stay (ANOVA: p = 0.001) and morbidity (Fisher's exact test: p = 0.01) were found, favoring lung-sparing techniques. Conclusion Lung-sparing procedures, particularly cystotomy with capitonnage, were associated with superior outcomes, including shorter hospital stays, lower morbidity, and no mortality, in this cohort. These findings support the prioritization of conservative surgical approaches in managing pulmonary hydatid disease (HD), especially in endemic and resource-limited settings.
目的 本研究的主要目的是评估用于治疗肺包虫囊肿的各种手术干预措施的有效性和安全性，比较不同手术技术在术后发病率、住院时间、术后死亡率和并发症发生率等患者预后方面的差异。方法 本回顾性观察队列研究于2023年1月1日至2023年12月31日在巴基斯坦白沙瓦市雷丁夫人医院胸外科进行。纳入接受肺包虫囊肿手术治疗的患者。手术技术范围从保留肺组织的手术，如带帽囊肿切开术、摘除术和囊肿外切除术，到更广泛的切除术，包括楔形切除术、肺段切除术、肺叶切除术和全肺切除术。主要结局包括术后发病率、住院时间、疼痛评分和30天死亡率。采用方差分析（ANOVA）和Fisher精确检验进行统计分析，显著性阈值为p < 0.05。结果 共纳入180例患者。患者的平均年龄为37.45±11.28岁；男性105例（58.33%），女性75例（41.67%）。97例患者（53.89%）接受了带帽囊肿切开术，其住院时间最短（9.4±3.1天），发病率最低（18例，18.56%）。4例患者（2.22%）接受了全肺切除术，其住院时间最长（17.8±7.1天），发病率最高（3例，75.00%）。3例患者（1.67%）发生术后死亡，均接受了广泛切除术。总体术后并发症发生率为23.89%（43例患者），胸痛99例（55.00%），咳嗽81例（45.00%），发热27例（15.00%）。在住院时间（ANOVA：p = 0.001）和发病率（Fisher精确检验：p = 0.01）方面发现了统计学显著差异，支持保留肺组织的技术。结论 在该队列中，保留肺组织的手术，特别是带帽囊肿切开术，与更好的预后相关，包括住院时间更短、发病率更低且无死亡。这些发现支持在治疗肺包虫病（HD）时优先采用保守手术方法，尤其是在流行地区和资源有限的环境中。
