Atila EROĞLU, Ali Bilal ULAŞ, Yener AYDIN, Bayram ALTUNTAŞ

Surgical management of primary mediastinal hydatid cysts: a 30-year experience

Amaç: Bu çalışmada cerrahi ile tedavi edilen primer mediastinal kist hidatikli, nispeten geniş bir hasta grubunun sonuçları değerlendirildi.Ça lış ma pla nı: Ocak 1985 - Ocak 2015 tarihleri arasında tanısı konulan ve kliniğimizde cerrahi olarak tedavi edilen primer mediastinal kist hidatikli 24 hasta (14 erkek, 10 kadın; ort. yaş 32 yıl; dağılım 11-73 yıl) retrospektif olarak değerlendirildi. Hastaların dokuzuna sağ torakotomi, yedisine sol torakotomi, beşine video yardımlı torakoskopik cerrahi, üçüne ise median sternotomi uygulandı. En sık uygulanan işlem total kistektomi idi (n=19, %79.2). Vital yapılara ciddi adezyon nedeni ile beş hastada kistotomi ve parsiyel kistektomi gerekti (%20.8).Bul gu lar: Ameliyat sonrası dönemde bir hastada plevral efüzyon gelişti. Medyan hastanede kalış süresi 6.5 gün idi (dağılım, 1-13 gün). Kistlerin cerrahi tedavi sonuçları tatmin edici idi. Ameliyat sonrasında hastalara günde iki kez bölünmüş dozlarda 10 mg/kg/gün oral albendazol verildi. Ameliyat sonrası morbidite, mortalite ve nüks gözlenmedi.So nuç: Primer mediastinal kist hidatikler nadir görülmesine rağmen özellikle endemik bölgelerde mediastinal kistlerin ayırıcı tanısında akılda tutulmalıdır. Son zamanlarda mediastinal kist hidatiklerin torakoskopik tedavisi etkili ve güvenli bir şekilde uygulanabilmektedir

Primer mediastinal kist hidatiklerin cerrahi tedavisi: 30 yıllık deneyim

Background: This study aims to evaluate the results of a relatively large cohort of patients with primary mediastinal hydatid cysts who were treated with surgery.Methods: We retrospectively evaluated 24 patients with primary mediastinal hydatid cysts (14 males, 10 females; mean age 32 years; range 11 to 73 years) who were diagnosed between January 1985 and January 2015 and surgically treated in our clinic. Of the patients, nine were performed right thoracotomy, seven were performed left thoracotomy, five were performed video assisted thoracoscopic surgery, and three were performed median sternotomy. The most frequently performed procedure was total cystectomy (n=19, 79.2%). Five patients required cystotomy and partial cystectomy due to dense adhesion to vital structures (20.8%).Results: One patient developed pleural effusion in the postoperative period. The median duration of hospital stay was 6.5 days (range, 1 to 13 days). Surgical treatment outcomes of cysts were satisfactory. Patients were administered 10 mg/kg/day oral albendazole postoperatively in divided doses twice a day. No morbidity, mortality, or recurrence was observed postoperatively.Conclusion: Although primary mediastinal hydatid cysts are rare, they should be kept in mind in differential diagnosis of mediastinal cysts particularly in endemic regions. Recently, thoracoscopic treatment of mediastinal hydatid cysts is carried out efficiently and safely.

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