Moore R D, Urschel J D, Fraser R E, Nakai S S, Geeraert A J
Department of Surgery, University of Alberta, Edmonton.
Can J Surg. 1994 Feb;37(1):20-2.
To determine the optimal treatment of sylvatic cystic hydatid lung disease.
Retrospective case study.
Five Edmonton hospitals serving northern Alberta and parts of the Northwest Territories.
Fourteen patients with cystic (Echinococcus granulosus) hydatid lung disease.
Cyst enucleation, wedge resection and pulmonary lobectomy.
Eradication of pulmonary hydatid disease and complications of treatment.
Mean patient age was 32 years. Eight patients were symptomatic. Liver cysts were present in three patients. One of the three patients managed by observation required surgery for an expanding cyst. Surgery (13 procedures in 12 patients) was successful in eradicating pulmonary hydatid disease: 8 cyst enucleations, 3 wedge resections and 2 lobectomies were done. There was only one major postoperative complication (pneumatocele requiring repeat surgery). Intraoperative cyst rupture occurred in five cases, but anaphylaxis or seeding did not result. There were no bronchopleural fistulae.
Sylvatic cystic hydatid lung disease is more benign than pastoral hydatid disease. Patients with asymptomatic cysts should be managed by observation. Surgery, consisting of endocyst enucleation or wedge resection, is indicated for symptomatic, enlarging or infected cysts.
确定野生型囊型包虫病肺部疾病的最佳治疗方法。
回顾性病例研究。
为阿尔伯塔省北部和西北地区部分地区服务的五家埃德蒙顿医院。
14例囊型（细粒棘球绦虫）包虫病肺部疾病患者。
囊肿摘除术、楔形切除术和肺叶切除术。
根除肺部包虫病及治疗并发症。
患者平均年龄为32岁。8例患者有症状。3例患者存在肝囊肿。3例接受观察治疗的患者中有1例因囊肿增大需要手术。手术（12例患者进行了13次手术）成功根除了肺部包虫病：进行了8次囊肿摘除术、3次楔形切除术和2次肺叶切除术。术后仅出现1例严重并发症（肺大泡需要再次手术）。术中囊肿破裂5例，但未导致过敏反应或种植转移。无支气管胸膜瘘。
野生型囊型包虫病肺部疾病比牧区型包虫病更具良性。无症状囊肿患者应进行观察。对于有症状、增大或感染的囊肿，建议采用包括内囊摘除术或楔形切除术在内的手术治疗。
