Akciğer hidatik kist olgularımızda cerrahi yaklaşımımız

Öz

Akciğer kist hidatiği yurdumuzda sık görülen paraziter bir enfeksiyondur. Bu çalışmada kliniğimizde akciğer kist hidatik nedeniyle opere edilen hastaların demografik özellikleri, klinik prezentasyonu, tedavisi ve sonuçlarını literatür eşliğinde değerlendirmeyi amaçladık. Son 4 yıllık dönemde akciğer kist hidatiği nedeniyle ameliyat edilen 74 hastanın hastane kayıtları incelendi. Hastaların kayıtlarında bulunan yaş, cinsiyet, kist özellikleri (sayı, yer, boyut, multiloküle, rüptür, radyoloji raporuna göre inflamasyon, enfeksiyon, kalsifikasyon ve plevral efüzyon), semptom ve bulgular, hastanede yatış süresi, tedavi yöntemleri, cerrahi prosedürler ve nüks kaydedildi. Olguların 42’si (%56,7) erkekti. Hastaların yaşı 5 ile 74 arasında değişmekte olup ortalama yaş 36,52 ± 12,6 yıl idi. Akciğer kist hidatiğinin boyutu 3 ile 19 cm (ortalama = 6.37±3.86) idi. Eşlik eden enfeksiyon 6 (%8,1) kist hidatik vakasında kaydedilmiş olup, bunların 3'ü (%4,05) ampiyem ve diğer 3’ü (%4,05) ise pnömoni idi. Cerrahi yöntem açısından, 2 (%2,7) olguya lobektomi, 6 (%8,1) olguya wedge rezeksiyon yapılırken, 66 (%89,1) olguya akciğer koruyucu (kistotomi ve kapinotaj) ameliyat yapılmıştır. İncelenen 74 kayıt arasında, kist hidatik nüksü kaviter lezyon şeklinde 4 (%5,4) vakada saptanmıştır. Akciğer hidatik kistinin en sık görüldüğü yer sağ alt lobdur. Akciğer koruyucu cerrahi, kist hidatik tedavisi için tercih edilen yöntemdir. Çalışmamızda nadir olmayan nüks, pulmoner kist hidatik tedavisinin zorlayıcı bir özelliğidir.

Anahtar Kelimeler

• Hidatik Kist
• Akciğer
• Cerrahi

Our surgical approach in cases of pulmonary hydatid cyst

Öz

Hydatid cyst of the lung is a common parasitic infection in Turkey. In this study, we aimed to evaluate the demographic characteristics, clinical presentation, treatment and outcomes of patients operated for pulmonary hydatid cyst in our clinic in the light of the literature. Hospital records of 74 patients operated for hydatid cyst of the lung in the last 4 years were analysed. Age, gender, cyst characteristics (number, location, size, multiloculated, multiloculated, rupture, inflammation, infection, calcification and pleural effusion according to radiological report), symptoms and findings, duration of hospitalisation, treatment methods, surgical procedures and recurrence were recorded. Forty-two (56.7%) of the patients were male. The age of the patients ranged from 5 to 74 years with a mean age of 36.52 ± 12.6 years. The size of the pulmonary hydatid cyst ranged from 3 to 19 cm (mean = 6.37 ± 3.86). Concomitant infection was recorded in 6 (8.1%) cases, of which 3 (4.05%) were empyema and the other 3 (4.05%) were pneumonia. In terms of surgical method, lobectomy was performed in 2 (2.7%) cases, wedge resection in 6 (8.1%) cases, and lung preservation surgery (cystotomy and capinotage management) was performed in 66 (89.1%) cases. Among the 74 records analysed, hydatid cyst recurrence was found in 4 (5.4%) cases as cavitary lesions. The most common location of the hydatid cyst of lung is the right lower lobe. Lung conserving surgery is the preferred method for the treatment of hydatid cysts. Recurrence, which was not uncommon in our study, is a challenging feature of pulmonary hydatid cyst treatment.

Anahtar Kelimeler

• Hydatid cyst
• Lung
• Surgery

Kaynakça

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