Cerrahi olarak tedavi edilen dev ve daha küçük boyuttaki akciğer kist hidatiklerinin karşılaştırmalı analizi

Yıl 2017, Cilt: 8 Sayı: 4, 184 - 190, 15.12.2017

Berkant Özpolat Rasih Yazkan Nesimi Günal Koray Dural

https://doi.org/10.18663/tjcl.354361

Öz

Amaç: Bu
çalışmanın amacı akciğerin dev kist hidatiklerinin daha küçük boydaki hidatik
kistlerle karşılaştırılmasıdır.

Gereç ve
Yöntemler: Akciğer kist hidatiği nedeniyle ameliyat edilen 62
hasta geriye dünük olarak değerlendirildi. Hastalar dev kist hidatik (Grup A,
n=23) ve daha küçük çapta olanlar (Grup B, n=39) olmak üzere iki gruba ayrıldı.
Gruplar yaş, cinsiyet, semptomlar, kist yerleşimi ve sayısı, preoperative
komplikasyonlar, uygulanan cerrahi girişim şekli, postoperative uzamış hava
kaçağı, göğüs tüpü alınma günü, postoperative komplikasyonlar, hastanede kalış
süresi, morbidite ve mortalite açısından karşılaştırıldı.

Bulgular: Yaş,
cinsiyet, kist yerleşim yeri açısından anlamlı fark saptanmadı ((P = 0.925, P =
0.293, P = 0.179). Grup A’da 21 (%91) vakada kistler tek , Grup B’de vakaların
yaklaşık 1/3’ünde birden fazla kist saptandı. Kistleri tek olması anlamlı
bulundu (P = 0.005). Grup A’da 13 (%56) vakada kistotomi + kapitonaj
yapılırken, Grup B’de 8 (%20) vakada yapılmıştı.  Kistotomi + kapitonaj yöntemi Grup B’de Grup
A’ya göre anlamlı olarak yüksekti. Uzamış hava kaçağı Grup A’da 8 (%20), Grup
B’de 2 (%5) vakada gözlendi. Ortalama göğüs tüpü çekilme günü Grup A’da 4.57 ±
2.48 gün, Grup B’de 2.49 ± 1.63 gün ve hastanede kalış süresi Grup A’da 8.48 ±
3.39 gün ve Grup B’de 5.69 ± 1.80 gün olup her iki parametre istatistiksel
olarak anlamlıydı (P < 0.001 ve P < 0.001). Postoperatif komplikasyonlar
Grup A’da iki, Grup B’de üç vakada gözlendi. Her iki grupta da mortalite yoktu.    

Sonuçlar: Dev akciğer kistlerinin soliter görülme ihtimali
fazla, ortalama göğüs tüpü çekilme ve hastanede kalış süresi uygulanan
operasyondan bağımsız olarak uzamıştır. Kapitonajlı veya kapitonajsız
yöntemlerin uygulandığı her iki grupta küratif cerrahi girişimlerin sonuçları
mükemmeldir.   

Anahtar Kelimeler

Kist hidatik, akciğer, cerrahi, torakotomi, komplikasyon

A comparative analysis of giant and smaller hydatid cysts of lung treated surgically

Öz

Aim: We aimed to
compare several features of giant hydatid cysts of the lung, with smaller cysts
both treated surgically.

Material and Methods: A retrospective evaluation of 62 patients operated for hydatid cysts of lung were done. The patients were divided into two
groups whether the pulmonary cyst was giant (group A, n = 23) or smaller in
diameter (group B, n = 39). The groups were compared for age, gender, clinical
symptoms, cyst location and number, preoperative complication, type of surgical
procedure performed, postoperative prolonged air leak, chest tube removal day,
postoperative complications, duration of
hospitalization, morbidity and mortality.

Results: No
significant difference was detected between mean age, gender and site of
location of the cyst (P = 0.925, P = 0.293, P = 0.179). Twenty-one (91%) of the
cases had solitary cyst in group A, whereas nearly 1/3 had multiple cysts in
group B. Solitary predominance for giant hydatid cysts was significant (P =
0.005). Cystotomy plus non-capitonnage method was performed in 13 (56%) cases
in group A and, 8 (20%) cases in group B. The frequency of cystotomy plus
capitonnage method was significantly higher in group B compared to group A
(p=0.004). Prolonged air leak was seen in 5 (22%) cases in group A and 2 (5%)
cases in group B. Mean chest tube removal time was 4.57 ± 2.48 days in group A
and 2.49 ± 1.63 days in group B. Duration of hospitalization was 8.48 ± 3.39
days in group A and 5.69 ± 1.80
in group B and the difference for both parameters were
significant statistically (P < 0.001 and P < 0.001). Postoperative
complications other than prolonged air leak were seen in two cases in group A
and three cases in group B. There was no mortality in either groups.

Conclusions: The giant hydatid cysts had a
predominance to be solitary and mean chest tube removal time and duration of hospitalization was prolonged independent from type of operation
performed. Conservative surgical interventions, whether
capitonnage or non-capitonnage methods were performed, had excellent outcomes
in both groups.

Anahtar Kelimeler

Hydatid cyst, lung, surgery, thoracotomy, cystotomy, complication

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