Halezeroglu S, Celik M, Uysal A, Senol C, Keles M, Arman B
Heybeliada Chest Disease and Chest Surgery Center, Istanbul, Turkey.
J Thorac Cardiovasc Surg. 1997 Apr;113(4):712-7. doi: 10.1016/S0022-5223(97)70228-9.
Hydatid disease is a parasitic infection caused by Echinococcus granulosus, characterized by cystic lesions in the liver, lungs, and, rarely, in other parts of the body. The large cysts in the lung are a special clinical entity called giant hydatid cysts. Characteristics on presentation, operative techniques, and postoperative morbidity and mortality rates in 47 patients with 50 giant pulmonary hydatid cysts 10 cm in diameter or larger were reported in this study.
Cystotomy plus the obliteration of the residual cavity by imbricating sutures from within (capitonnage) was the most frequently used operative technique (n = 31), followed by pericystectomy plus capitonnage (n = 6), closure of bronchial openings plus pericystectomy (n = 6), and lobectomy (n = 3).
The mean age of patients with giant hydatid cyst of the lung was lower than the age of those with usual-sized cysts (p = 0.04). Five patients had prolonged air leaks (more than 10 days), three had empyema, and one had pneumonia in the opposite lung after the operation. One patient died of cardiorespiratory collapse during the operation. There was one recurrence during follow-up.
The increase in the diameter of the cyst in younger ages was correlated with higher lung tissue elasticity and the delay in diagnosis because of delayed symptoms in these patients. Although postoperative complications occurred in 19.1% of patients, all were managed by conservative measures, and there were no indications that the affected lung should have been treated with resection instead of a parenchyma-saving operation.
包虫病是由细粒棘球绦虫引起的一种寄生虫感染，其特征是肝脏、肺部出现囊性病变，很少在身体其他部位出现。肺部的大囊肿是一种特殊的临床实体，称为巨大包虫囊肿。本研究报告了47例患有50个直径10厘米或更大的巨大肺包虫囊肿患者的临床表现、手术技术以及术后发病率和死亡率。
囊肿切开术加从内部用褥式缝合封闭残余腔隙（内翻缝合）是最常用的手术技术（n = 31），其次是囊肿切除术加内翻缝合（n = 6）、支气管开口闭合加囊肿切除术（n = 6）和肺叶切除术（n = 3）。
巨大肺包虫囊肿患者的平均年龄低于普通大小囊肿患者的年龄（p = 0.04）。5例患者术后出现长时间漏气（超过10天），3例发生脓胸，1例对侧肺发生肺炎。1例患者在手术期间死于心肺功能衰竭。随访期间有1例复发。
年轻患者囊肿直径的增加与肺组织弹性较高以及因症状延迟导致诊断延迟有关。尽管19.1%的患者术后出现并发症，但均通过保守措施处理，没有迹象表明患肺应采用切除术而非保留实质的手术进行治疗。
