TRANSTHORACIC APPROACH TO HYDATID CYSTS IN THE DOME OF THE LIVER

Abstract

Background and aim: The cases of 10 liver hydatid cysts without thoracic involvement are presented that were operated on with a transthoracic approach and the results are reviewed in the light of the relevant literature.

Material and methods: A total of 10 cases, who were operated on using a transthoracic approach (5 male, 5 female), were evaluated retrospectively.

Results: The mean age was 37.7 years (range 16-52 years). One female had 3 cysts, 1 had 2 cysts, and a solitary cyst was present in the remaining patients. All patients were operated on transthoracally. The postoperative course was uneventful in all patients except the 1 case that had 3 hydatid cysts, which was complicated with prolonged drainage from the chest tube. This drainage decreased gradually over 20 days and the chest tube was removed on the postoperative 21st day. The average hospital stay was 9.4 days (range, 6 - 24 days). Conclusion: Hydatid cysts located in the dome of the liver were safely operated on using a transthoracic approach and no serious complications were encountered. It was concluded that if the abdominal approach seems to be difficult, a transthoracic approach should be preferred in order to obtain the hydatid cyst safely and without difficulty.

Keywords

• Hydatid cyst. Transthoracic approach. Liver . Complication

References

1. 1. Sayek I, Tirnaksiz MB, Dogan R. Cystic hydatid disease: current trends in diagnosis and management. Surg Today 2004; 34: 987-96.
2. 2. Kavukçu S, Kılıc D, Tokat AO, et al. Parenchyma-preserving surgery in the management of pulmonary hydatid cysts. J Invest Surg 2006: 19: 61-8.
3. 3. Smego RA, Sebanego P. Treatment options for hepatic cystic echinococcosis. Int J Infect Dis 2005; 9: 69-76.
4. 4. Smyrniotis VE, Kostopanagiotou EK, Farantos CI, Katis CI, Kostopanagiotou GG. Transthoracic versus transabdominal surgical approach for Echinococcal cysts located over the superoposterior aspect of the right lobe of the liver. World J Surg 2003; 27: 699–702.
5. 5. Sahin E, Enön S, Cangir AK, et al. Single-stage transthoracic approach for right lung and liver hydatid disease. J Thorac Cardiovasc Surg 2003; 126: 769-73.6. Kilani T, Hammami SE, Horchani H, et al. Hydatid disease of the liver with thoracic involvement. World J Surg 2001; 25: 40–5.
6. 7. Athanassiadi K, Kalavrouziotis G, Loutsidis A, Bellenis I, Exarchos N. Surgical treatment of echinococcosis by a transthoracic approach: a review of 85 cases. Eur J Cardiothorac Surg 1998; 14: 134-40.
7. 8. Ko S, Nakajima Y, Kanehiro H, et al. Transthoracic transdiaphragmatic approach for hepatectomy of Couinaud's segments VII and VIII. World J Surg 1997; 21: 86-90.
8. 9. Kouraklis G, Dosios T, Glinavou A, Kouvaraki M, Karatzas G. An alternative approach for the surgical management of hydatid disease of the liver. Langenbecks Arch Surg 2001; 386: 62-4.