BERKANT ÖZPOLAT, Rasih YAZKAN, NESİMİ GÜNAL, KORAY DURAL

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

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

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.

Keywords:

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

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