Pulmoner hidatik kistin intrabronşiyal rüptürünün klinik özellikleri ve cerrahi tedavisi

Öz

Giriş: İntrabronşiyal rüptüre hidatik kistlerde morbidite ve mortalite intakt kistlere göre çok daha fazladır. Bu çalışmada amacımız, intrabronşiyal rüptüre hidatik kist nedeniyle opere ettiğimiz hastaların klinik ve radyolojik özelliklerini, cerrahi tedavi ve postoperatif sonuçlarını sunmaktır. Materyal ve Metod: Ocak 2010 ile Aralık 2020 arasında, kliniğimizde 37 hastada intrabronşiyal pulmoner hidatik kist rüptürü nedeniyle 39 operasyon gerçekleştirildi. Hastaların yaş, cinsiyet, semptom, hidatik kistin sayısı, büyüklüğü, tarafı ve yeri, preoperatif radyolojik değerlendirilmesi, uygulanan cerrahi yöntem, postoperatif komplikasyonlar, göğüs tüpü kalış süresi, hastane yatış süresi ve hastaların takip süreleri hasta dosyaları incelenerek not edildi. Bulgular: Hastaların 23’ ü (%62,1) erkek, 14’ü (%37,8) bayan ve yaş ortalaması 32,6 (18-62) idi. Hastalarımızın 5’inde rezeksiyon uygulanır iken geriye kalan tüm kistlerde parankim koruyucu kistotomi ve kapitonaj yöntemi tercih edildi. Postoperatif uzamış hava kaçağı 3 hastada görülürken, 2 hastade atelektazi ve 1 hastada yara yeri enfeksiyonu gelişti. Peroperatif ve postoperatif hiçbir hastada mortalite görülmedi. Takip süresince hiçbir hastada nüks saptanmadı. Sonuç: İntrabronşial rüptüre hidatik kistler yüksek preoperatif ve postoperatif komplikasyon riskine sahiptir. Antihelmintik tedavi perforasyon riski nedeniyle hidatik kist cerrahisi mümkün olmayan hastalarda verilmeli ve intrabronşiyal rüptüre hidatik kistlerde nüksü önlemek amaçlı postoperatif olarak verilmelidir.

Anahtar Kelimeler

• Hidatik kist
• rüptür
• tedavi

Clinical features and surgical treatment of intrabronchial rupture of pulmonary hydatid cyst

Öz

Aim: Morbidity and mortality in intrabronchial ruptured hydatid cysts are much higher than in intact cysts. Our aim in this study is to present the clinical and radiological features, surgical treatment and postoperative results of the patients we operated for intrabronchial ruptured hydatid cyst. Material and method: Between January 2010 and December 2020, 39 operations were performed in 37 patients for intrabronchial pulmonary hydatid cyst rupture in our clinic. The patients' age, gender, symptoms, number, size, side and location of the hydatid cyst, preoperative radiological evaluation, surgical method, postoperative complications, chest tube length of stay, hospitalization period and follow-up periods of the patients were noted by examining the patient files. Results: Of the patients, 23 (62.1%) were male, 14 (37.8%) were female, and the mean age was 32.6 (18-62). While resection was performed in 5 of our patients, parenchymal-preserving cystotomy and capitonage method was preferred in all remaining cysts. Postoperative prolonged air leakage was observed in 3 patients, atelectasis in 2 patients and wound infection in 1 patient. No mortality was observed in any of the patients perioperatively and postoperatively. No recurrence was detected in any patient during the follow-up period. Conclusion: Intrabronchial ruptured hydatid cysts have a high risk of preoperative and postoperative complications. Antihelminthic therapy should be given to patients who cannot undergo hydatid cyst surgery due to the risk of perforation and should be given postoperatively to prevent recurrence in intrabronchial ruptured hydatid cysts.

Anahtar Kelimeler

• Hydatid cyst
• rupture
• treatment

Kaynakça

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