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Abstract

We read the letter by Oncel and colleagues [1Oncel M. Sunam G.S. Yildiran H. Videothoracoscopy for pulmonary hydatidosis (letter).Ann Thorac Surg. 2016; 101: 1242Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar] and thank the authors for their contribution. Hydatid cyst disease is still a challenging problem in developing countries. We congratulate the authors for their 55 cases of hydatid cysts and their approach with videothoracoscopy.Nowadays, it is becoming quite common for thoracic surgeons to perform lobectomy, sleeve resection, even pneumonectomy through a videothoracoscopic approach. We believe that being a parasitic disease, hydatid cyst disease should be considered or even forced to be a candidate for a videothoracoscopic operation.The authors have reported that they use serum sale as a scolicidal agent. We aspirate the cystic cavity with a closed-circuit aspirator. Then, we inject as a scolicidal agent a diluted 2% povidone-iodine solution in an amount that is less than the aspirated cyst fluid. Serum sale can be used as a scolicidal agent; however, we use only diluted povidone-iodine solution.We started the videothoracoscopic approach to hydatid cyst disease with 4 patients [2Alpay L. Lacin T. Atinkaya C. et al.Video-assisted thoracoscopic removal of pulmonary hydatid cysts.Eur J Cardiothorac Surg. 2012; 42: 971-975Crossref PubMed Scopus (11) Google Scholar]. This number has increased to 30 lately and is still rising [3Alpay L. Lacin T. Ocakcioglu I. et al.Is video-assisted thoracoscopic surgery adequate in treatment of pulmonary hydatidosis?.Ann Thorac Surg. 2015; 100: 258-262Abstract Full Text Full Text PDF PubMed Scopus (18) Google Scholar]. Despite our decreasing conversion rates, we still have patients in whom we believe that it is not safe to perform cystotomy and capitonnage with videothoracoscopy. The surgical principles of hydatid cyst disease operations are important. We believe that if the surgeon does not think that it is safe enough or there is a risk for spillage, it is better to enlarge the utility incision to a minithoracotomy.In conclusion, the videothoracoscopic approach is safe in hydatid cyst disease, with good outcomes and better patient and surgeon satisfaction. We read the letter by Oncel and colleagues [1Oncel M. Sunam G.S. Yildiran H. Videothoracoscopy for pulmonary hydatidosis (letter).Ann Thorac Surg. 2016; 101: 1242Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar] and thank the authors for their contribution. Hydatid cyst disease is still a challenging problem in developing countries. We congratulate the authors for their 55 cases of hydatid cysts and their approach with videothoracoscopy. Nowadays, it is becoming quite common for thoracic surgeons to perform lobectomy, sleeve resection, even pneumonectomy through a videothoracoscopic approach. We believe that being a parasitic disease, hydatid cyst disease should be considered or even forced to be a candidate for a videothoracoscopic operation. The authors have reported that they use serum sale as a scolicidal agent. We aspirate the cystic cavity with a closed-circuit aspirator. Then, we inject as a scolicidal agent a diluted 2% povidone-iodine solution in an amount that is less than the aspirated cyst fluid. Serum sale can be used as a scolicidal agent; however, we use only diluted povidone-iodine solution. We started the videothoracoscopic approach to hydatid cyst disease with 4 patients [2Alpay L. Lacin T. Atinkaya C. et al.Video-assisted thoracoscopic removal of pulmonary hydatid cysts.Eur J Cardiothorac Surg. 2012; 42: 971-975Crossref PubMed Scopus (11) Google Scholar]. This number has increased to 30 lately and is still rising [3Alpay L. Lacin T. Ocakcioglu I. et al.Is video-assisted thoracoscopic surgery adequate in treatment of pulmonary hydatidosis?.Ann Thorac Surg. 2015; 100: 258-262Abstract Full Text Full Text PDF PubMed Scopus (18) Google Scholar]. Despite our decreasing conversion rates, we still have patients in whom we believe that it is not safe to perform cystotomy and capitonnage with videothoracoscopy. The surgical principles of hydatid cyst disease operations are important. We believe that if the surgeon does not think that it is safe enough or there is a risk for spillage, it is better to enlarge the utility incision to a minithoracotomy. In conclusion, the videothoracoscopic approach is safe in hydatid cyst disease, with good outcomes and better patient and surgeon satisfaction. Videothoracoscopy for Pulmonary HydatidosisThe Annals of Thoracic SurgeryVol. 101Issue 3PreviewWe read with interest the article by Alpay and colleagues [1]. We appreciate their experiences. We agree that video-asisted thoracoscopy can have less postoperative pain, better cosmetic results, and shorter surgical time for the surgical treatment of pulmonary hydatid cyst disease. Full-Text PDF