Akin Suleyman Emre, Oguzlar Furkan Cagri, Ayyildiz Veysel Atilla, Camas Hasan Ekrem, Dongel Isa, Yazkan Rasih
Thoracic Surgery Department, Suleyman Demirel University Faculty of Medicine, Isparta, TUR.
Emergency Medicine Department, Suleyman Demirel University Faculty of Medicine, Isparta, TUR.
Cureus. 2025 Jul 14;17(7):e87899. doi: 10.7759/cureus.87899. eCollection 2025 Jul.
Background Pulmonary hydatid cyst (PHC) rupture is a serious complication that can increase surgical difficulty and postoperative morbidity. Identifying preoperative predictors of rupture is essential for patient risk stratification and optimal surgical timing. This study aimed to evaluate clinical, radiological, and laboratory factors associated with cyst rupture, with a particular focus on the anatomical relationship with lung fissures. Methods A retrospective analysis was conducted on 37 patients who underwent surgery for pulmonary hydatid cysts between January 2012 and December 2021. Patients were categorized into ruptured and intact cyst groups. Demographic, radiological, hematological, and operative data were compared. Logistic regression was used to identify independent predictors of rupture. Results Cyst rupture was observed in 19 patients (51.4%). Preoperative C-reactive protein (CRP) levels and the presence of fissure connection were significantly higher in the ruptured group (p < 0.05). Multivariate logistic regression revealed that fissure relationship was an independent predictor of rupture (odds ratio {OR}: 5.150; 95% confidence interval {CI}: 0.957-27.719; p = 0.049). Cyst size and location were not significant predictors in the adjusted model. The model showed acceptable fit (Hosmer-Lemeshow p = 0.094) and moderate predictive power (Nagelkerke R² = 0.447). Conclusion Fissure involvement is a key anatomical risk factor for pulmonary hydatid cyst rupture and should be carefully assessed during preoperative imaging. The early identification of fissure-associated cysts may guide surgical planning, reduce complications, and improve patient outcomes.
背景 肺包虫囊肿（PHC）破裂是一种严重的并发症，可增加手术难度和术后发病率。识别破裂的术前预测因素对于患者风险分层和最佳手术时机至关重要。本研究旨在评估与囊肿破裂相关的临床、影像学和实验室因素，特别关注与肺裂的解剖关系。方法 对2012年1月至2021年12月期间接受肺包虫囊肿手术的37例患者进行回顾性分析。将患者分为囊肿破裂组和完整囊肿组。比较人口统计学、影像学、血液学和手术数据。采用逻辑回归分析确定破裂的独立预测因素。结果 19例患者（51.4%）出现囊肿破裂。破裂组术前C反应蛋白（CRP）水平和存在裂连通情况显著更高（p<0.05）。多因素逻辑回归显示，裂关系是破裂的独立预测因素（比值比{OR}：5.150；95%置信区间{CI}：0.957 - 27.719；p = 0.049）。在调整模型中，囊肿大小和位置不是显著的预测因素。该模型显示拟合良好（Hosmer - Lemeshow p = 0.094）且具有中等预测能力（Nagelkerke R² = 0.447）。结论 肺裂受累是肺包虫囊肿破裂的关键解剖学危险因素，术前影像学检查时应仔细评估。早期识别与肺裂相关的囊肿可指导手术规划，减少并发症，改善患者预后。
