Surgical treatment of hydatithorax: A retrospective study of 24 patients

Öz

Aim: Intrapleural perforation of a hydatid cyst can lead to serious complications such as pleural effusion, pneumothorax, empyema, secondary pleural hydatid disease, acute respiratory failure, and anaphylactic shock. Our aim in this study is to present the clinical features of the patients we operated for hydatid cyst perforated into the pleural space and to share our surgical experience. Material and Method: Between January 2010 and December 2020, 24 patients who applied to our clinic and were operated on due to perforation of the pulmonary hydatid cyst into the pleural space were retrospectively analyzed. Age, gender, symptoms, size and location of the hydatid cyst, surgical procedure, postoperative complications, chest tube length of stay and hospitalization duration were reviewed and noted in the patient files. Results: The mean age of the patients was 36.4 (18-67) years. Of the patients, 14 (58%) were male and 10 (41%) were female. There was 7.4 (0-19) days between the onset of symptoms and admission to the hospital. While 19 (79%) patients had pleural effusion, 5 (20%) had hydropneumothorax. Cystotomy and capitonnage were performed in 23 (95%) patients, segmentectomy in 1 (4.1%) and decortication in 10 (41%) patients. Postoperative complications were seen in 4 (16%) patients. Conclusion: Perforated hydatid cyst should not be forgotten in the differential diagnosis of pleural effusion, pneumothorax and empyema. Preoperative medical treatment should be performed in patients with pneumonia due to perforated hydatid cyst, and in patients with massive pleural effusion, significant pneumothorax or empyema, after adequate chest tube drainage, the operation should be performed without delay.

Anahtar Kelimeler

• Hydatithorax
• surgery
• Hydatid cyst

Hidatitoraksın Cerrahi Tedavisi: 24 Hastayı Kapsayan Retrospektif Bir Çalışma

Öz

Giriş: Hidatik kistin plevral aralığa perforasyonu plevral efüzyon, pnömotoraks, ampiyem, sekonder plevral hidatik hastalık, akut solunum yetmezliği ve anaflaktik şok gibi ciddi komplikasyonlara yol açabilir. Bu çalışmadaki amacımız plevral aralığa perfore olan hidatik kist nedeniyle opere ettiğimiz hastaların klinik özelliklerini sunmak ve cerrahi deneyimlerimizi paylaşmaktır. Materyal ve Metod: 2010 ocak- 2020 aralık tarihleri arasında akciğer hidatik kistinin plevral aralığa perfore olması sonucu kliniğimize başvuran ve opere edilen 24 hasta geriye dönük olarak incelendi. Hastaların yaş, cinsiyet, semptom, hidatik kistin büyüklüğü ve yeri, uygulanan cerrahi işlem, postoperatif komplikasyonlar, göğüs tüpü kalış süresi ve hastane yatış süresi hasta dosyaları incelenerek not edildi. Bulgular: Hastaların ortalama yaşları 36,4 (18-67) idi. Hastaların 14’u (%58) erkek, 10’u (%41) ise bayan idi. Semptomların başlaması ile hastaneye başvuru arasında 7,4 (0-19) gün vardı. Hastaların 19’unda (%79) plevral efüzyon var iken, 5’inde (%20) hidropnömotoraks var idi. Hastaların 23’ünde (%95) kistotomi ve kapitonaj, 1’inde (%4,1) segmentektomi, 10’unde (%41) ampiyem nedeniyle dekortikasyon uygulandı. Postoperatif komplikasyon 4 (%16) hastada görüldü. Sonuç: Plevral efüzyon, pnömotoraks ve ampiyemin ayırıcı tanısında perfore hidatik kist unutulmamalıdır. Perfore hidatik kiste bağlı pnömoni olan hastalarda preoperatif medikal tedavi, masif plevral efüzyon, belirgin pnömotoraks veya ampiyem olan hastalarda ise yeterli göğüs tüpü drenajı sonrası operasyon geciktirilmeden yapılmalıdır.

Anahtar Kelimeler

• Hidatitoraks
• Cerrahi
• Hidatik kist

Kaynakça

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