Lung Hydatid Research Articles

Lung Hydatid Cyst Surgical Treatment: Our Clinical Experience

Lung Hydatid Cyst Surgical Treatment: Our Clinical Experience

Concurrent brain and lung hydatid cyst in a paediatric patient: Anaesthetic challenges.

Concurrent brain and lung hydatid cyst in a paediatric patient: Anaesthetic challenges.

Perforated lung hydatid cyst presenting with tension pneumothorax and cardiac arrest.

Perforated lung hydatid cyst presenting with tension pneumothorax and cardiac arrest.

Experience with Video Assisted Tthoracoscopic Surgery for Lung Hydatid Cysts in Pediatric Patients

Experience with Video Assisted Tthoracoscopic Surgery for Lung Hydatid Cysts in Pediatric Patients

Long-term outcome of minimal access surgery for hydatidosis in children: a single institutional experience

Human cystic echinococcosis continues to be a public health problem worldwide. The standard treatment of hydatidosis in children is open surgical intervention for removal of the cyst completely without spillage. The limited use of minimal invasive surgery (MIS) in hydatidosis has been due to the concern of inadequate removal and spillage, leading to recurrence or dissemination of the disease. Recently, a few authors have reported the successful use of minimal invasive surgery (MIS) for management of hydatid disease in children. We present our experience with successful use of MIS in the management of hydatid disease involving lung and liver in children. Between 2006 and 2017, data of 22 children treated for hydatid disease in our institute were reviewed. The diagnosis was made radiologically with Computerised Tomography scan of chest and abdomen. All children received albendazole therapy prior to and after the surgery. Thoracoscopic/laparoscopic procedures were undertaken sequentially in all children. Children with synchronous disease involving lung and liver had an interval of 2 weeks between procedures. The techniques of puncture, aspiration, injection and re-aspiration (PAIR) and also our modifications of cyst removal are described. There were a total of 22 children with liver and or lung involvement. Four children had synchronous lung and liver involvement and four children had bilateral lung involvement. The duration of the procedure ranged from 60 to 90 min. There were 3 (18) conversions in the thoracic group and 1 (12) in the laparoscopic group. PAIR technique with our modification of cyst extraction was used in all except in one child. Capitonnage of the cyst wall in lung hydatidosis was not done. There were no postoperative events. Recurrence of the lesion at original site was seen in two children, one each in laparoscopic and thoracoscopic group. Occurrence of new lesion or dissemination of the disease was not identified on a mean follow-up of 7 years. Our series demonstrates the safe and effective utility of MIS in management of pulmonary and liver hydatid in children. Use of MIS does not lead to dissemination of the disease. Albendazole therapy is an useful adjunct prior to surgery. Single lung ventilation with isolation of uninvolved lung is useful during surgery for lung hydatid.

The diagnostic value of fiberoptic bronchoscopy in ruptured lung hydatid cysts.

This study aims to evaluate the diagnostic yield of fiberoptic bronchoscopy in ruptured pulmonary hydatid cysts indistinguishable from pulmonary masses on imaging techniques. Between January 2000 and January 2018, a total of 45 consecutive patients (27 males, 18 females; mean age 46.4±13.5 years; range, 23 to 78 years) who underwent fiberoptic bronchoscopy to establish the definitive diagnosis following radio-diagnostic procedures were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, preoperative diagnostic studies, bronchoscopic findings, and postoperative diagnosis were recorded. Endobronchial hyperemia (n=42) and purulent secretion (n=34) are the most common findings of bronchoscopy. The most specific finding was the presence of pieces of cystic membranes in 23 patients. Scolices were seen in five patients in bronchial aspirate. In one patient, both pieces of cystic membranes and scolices in bronchial aspirate were detected. The preliminary diagnosis of a hydatid cyst was made based on these findings in 28 patients (62.2%) preoperatively. The definitive diagnosis of a hydatid cyst was confirmed through thoracotomy in all patients. Bronchoscopy is a particularly valuable method in the definitive diagnosis of ruptured lung hydatid cysts. The definite diagnosis is based on the visualization of the endobronchial membrane during bronchoscopy or scolices in the bronchial aspirate. It can be also used to prevent complications such as bronchial dissemination and asphyxia due to intra-bronchial membrane pieces.

Presentation the new surgicaly approach in the treatment of pediatric lung hydatid disease non–captonage procedure without closure of the communication bronchial opening

Introduction: Treatment of pediatric lung hydatid disease is primarily surgical, and any suspicion on hydatid lung disease justified indication for surgical intervention. The aim of our research is to investigate efficacy and safety of treatment of residual cavity by "non-capitonage" method, without closure of communicating bronchial opening compared to the classic "capitonage" method with closure of communicating bronchial opening. Patients and Methods: The study included 80 patients of both sexes under aged 18 years, who were surgically treated at the Clinic for Child Surgery and the Department of Thoracic Surgery, Clinical Center University in Sarajevo (KCUS) and Childrens Surgical Clinic of the Institute of Children's Diseases, Clinical Center of Montenegro in Podgorica due to pulmonary echinococcosis, based on clearly defined criteria for inclusion and exclusion from the study. 40 patients (group A) were subjected to non-capitonnage treatment of residual cavity that remained after the removal of parasites and partial pericystectomy without closure of orificium of bronchial opening. The control group consisted of 40 patients who had done narrowing of residual pericystic cavity with closure of bronchial opening. This is a multicenter, open-targeted clinical comparative study of safety of surgery procedures and intraoperative findings. Important aspects of these procedures being assessed included: the duration of the surgical procedure, the amount of administered blood products, drainage length, the amount of secretion, duration of drainage fistula, the time required for reexpansion of lungs, and variables of complications (such as : occurrence of empyema, atelectasis, postoperative fever, postoperative wound infection). Postoperative effectiveness (efficacy) was measured by a record of length of stay in the intensive care unit and hospital stay, as well as radiological findings of the subjects lungs six months after surgery. Results: In the control group we observed that the overall time of surgery was longer compared to the study group. Man-Vitni’s U test confirmed a statistically significant difference between the results of the test and control groups, U = 285.50, z = 4.957, p = 0.0001. Additionally, we observed a slightly larger amount of fluid drained in the control group vs. the study group. Man-Vitni’s U test revealed a statistically significant difference in the amount of drained fluid between the study and control groups, U = 325.50, z = 4.583, p = 0.0001. In the study group there were no cases of postoperative pulmonary atelectasis, while in the control group were 16 (40.0%) patients with documented atelectasis. Mean time to reexpansion of the lung using the control radiological findings was 11 days in the study group (Md = 11.000 days, n = 40) vs. 16 days in the control group of patients (MD = 16.000 days, n = 40) . We also observed that the control group of subjects had significantly longer time in the intensive care unit compared with the experimental group (U = 426.00, z = 3.654, p = 0.0003). Subjects in the control group had significantly longer hospitalizations compared with the experimental group (U = 373.50, z = 4.112, p = 0.0001) as well. Conclusions: We report here meaningful differences in two surgical approaches to the managamanet of hydatid disease in our medical system. Non-capitonnage surgical methods resulted in a significantly shorter duration of surgery, smaller drainage of secretions, atelectasis and pleural empyema events, shorter time required for reexpansion of the surgically intervened lungs and better overall outcomes, vs. the control surgical approach 6 months postoperatively. In our experience, non-capitonnage surgical methods compared much more favorably when compared to the capitonnage method, as reflected in the significantly shorter postoperative stay of patients in the intensive care unit and in hospital. The treatment of any residual pericystic cavity of pulmonary echinoccocus in children, especially if it is a giant, complicated and multiple hydatid cysts should be the method of "non-closure" or "no-narrowing" (non-capitonnage) due to the rapid overlaying of residual pericystic cavity by epithelial cells originating from surrounding pleura and lung parenchyma

Minimally invasive approach for pulmonary hydatid cyst

Hydatid diseases still remain an important health problem in some countries. The primary choice of treatment has been long accepted as surgical treatment including cystectomy/cystotomy with or without capitonnage performed for every cyst. The most important principal for pulmonary hydatid surgery is to preserve as much parenchyma as possible. Anatomical resection is needed in very small fraction of patients. With parallel of improvements in minimally invasive surgery in thoracic surgery, video-assisted thoracoscopic surgical treatment has been reported to be utilized in the management of pulmonary hydatid cyst. The main advantages of minimally invasive techniques is their milder perioperative trauma and less pain as avoiding spreading the intercostal areas. That resulted in lower postsurgical pain, shorter hospital stay, fewer complications and faster recovery after the surgery, better quality of life. Minimally invasive management to the management of lung hydatid cyst including uniportal approach has been proven to be safe and effective and seems to serve better outcomes. The optimal procedures performed should be determined on an individualized basis and requires a careful preoperative evaluation.

Lung hydatid cyst, an immunological process, not a pearl formation.

Lung hydatid cyst, an immunological process, not a pearl formation.

Incidental finding of cardiac hydatid cysts, report of two cases

BackgroundHydatid is a parasitic infection which can affect any organ of body. In some organs like liver and lung; it can be found regularly while in other organs like heart, it is seen very rarely. Cardiac hydatid cysts comprise less than of 2% of hydatid infection cases and may be detected incidentally.Case presentationAuthors report two cases of cardiac hydatid cysts in young adult patients living in rural areas of the country with positive animal contact. Both patients were complained from shortness of breath and cough. Contrast enhanced chest computed tomography (CT) revealed left ventricular wall hydatid cysts in addition to lung and liver hydatid cysts.ConclusionCardiac hydatid cyst is a rare finding with wide range of signs and symptoms. These may be suspected in patients coming from endemic areas. Echocardiographic follow up of patients with liver or lung hydatid cysts can be helpful.

Is Bilateral Staged Muscle-Sparing Thoracotomy Performed within 1 Week for Lung Hydatid Cysts Safe for Pediatric Patients?

Median sternotomy or staged thoracotomies are generally the preferred surgical treatment options for bilateral lung hydatid cysts. According to literature, it is usually recommended to wait from 3 weeks to 3 months between bilateral staged thoracotomies. The aim of this study is to compare postoperative complications, hospitalization days and morbidity and mortality ratios between unilateral thoracotomy and bilateral staged thoracotomy groups and to evaluate the safety of performing bilateral staged thoracotomy within 1 week for lung hydatid cysts in pediatric patients. In total, 112 patients under the age of 16 years who underwent surgery between 2000 and 2016 because of pulmonary hydatid cysts were included in this study. The patients were classified into two groups as Group 1 (unilateral muscle-sparing thoracotomy) and Group 2 (bilateral staged muscle-sparing thoracotomy applied within 1 week). There were 91 patients in Group 1 and 21 patients in Group 2. No statistically significant differences were detected when both groups were compared by age, gender, perforation rates, follow-up period and postoperative complications. To prevent hydatid cysts complications, the elapsed time between two thoracotomies should be not only long enough to evaluate the postoperative complications but also relatively short to prevent possible complications that may develop in the other lung. In our opinion, a patient follow-up of 3-7 days between thoracotomies is sufficient for the assessment of patients' clinical status and possible complications.

Recurrent Multi-Organ Cystic Echinococcosis

Abstract Cystic echinococcosis is the disease that occupies, together with trichinosis, the first place in the zoonoses in Romania. We present the case of a 75-year-old urban patient known for echinococcosis, firstly operated for bone cysts in the right coxofemoral joint at the age of 24, then in 2000 she was operated for a lung hydatid cyst and in 2011 she underwent a surgery for recurrent bone echinococcosis. After a 7-year lull, she returns due to the appearance of tumorous masses in the abdominal right flank, the right thigh, accompanied by pain in the right coxofemoral joint, functional impotence of the right lower limb, asthenia, anorexia. Based on clinical, immunological, imagistic examinations, the diagnosis of cystic echinococcosis localised in the liver, bone and muscle was established. Since the patient in association had ischaemic heart disease in NYHA III (New York Heart Association) congestive heart failure, surgical treatment was delayed and preoperative treatment with Albendazole 10-15mg/kg/day was started. Initially we will apply a conservative treatment, laparoscopic drainage and aspiration of the contents, saline instillation and aspiration.

Analysis of pulmonary hydatid cysts underwent surgery

Introduction: Hydatid cyst is a parasitic disease caused by Echinococcus granulosus. The liver and lungs are the most frequently involved organs. The treatment of lung hydatid disease is surgery. We aimed to discuss the results of surgically treated patients with pulmonary hydatid cysts in light of the related literature. Materials and Method: 85 patients were divided into two groups as complicated and non-complicated. Patients who had more than one cyst in the same lobe or patients with multiple lung cysts in different locations were excluded in the study. The significance of the results was assessed by Fisher's exact test. P values<0.05 were considered as significant. Findings: While the number of non-complicated patients was 58 (68%), it was 27 (32%) for complicated patients. In the statistical analysis, gender difference was not significant for both groups (p>0.05). Additionally, the disease was not significant in terms of right or left lung location (p>0.05). For both groups, the disease was not significant in terms of the location of lobe. Statistically, gender was found to be not significant on bronchus or pleural expanding (for male p>0.05, for female p>0.05). But, the right lung lesions were found to be significant in terms of the expansion in both bronchus and pleura (p<0.05). Centrally located lesions were found to be statistically significant in terms of bronchial expansion (p<0.05). Discussion: Hydatid disease is particularly common in places where farming is still widespread. We believe that the only treatment method is people's awareness and surgical procedures.

Evaluation of characteristics of the patients who undergo surgical treatment for lung hydatid cyst

Evaluation of characteristics of the patients who undergo surgical treatment for lung hydatid cyst

Is bilateral staged muscle sparing thoracotomy in one week for lung hydatid cysts safe for pediatric patients?

Is bilateral staged muscle sparing thoracotomy in one week for lung hydatid cysts safe for pediatric patients?

The Results of Conservative Approaches for Pulmonary Hydatid Cysts.

Pulmonary hydatid cysts remains a public health problem in Morocco. We present the results of the conservative methods for treating the pulmonary hydatid cysts in 56 patients including the giants forms (&gt;10 cm) and the complicated cases. 71 cystectomies, one pericystectomy and one wegde resection realized by thoracotomy. There were 33 men and 23 women. The median age was 25 years (range 8-64 years). The lower lobes were affected in 72%. Hepatic cysts were associated in 13 patients (23%). The median duration of postoperative drainage was 6 days (range 2-48 days) and the median duration of hospitalization was 9 days (range 5-28 months). The median duration of follow-up was 15 months (range 3-46 months). Univariate analysis did not reveal significance when we compared the postoperative course according to the localizations on the lungs, the nature of the cysts, the presence of infection and the size of cysts. The conservative approaches, mainly cystectomies area safe and effective method for lung hydatid cysts, if the closure of the bronchial fistulas is well performed, that the capitonnage is adapted to the size of the residual cavity, and its location in the lung to avoid bronchial torsion and deformation. We suggest this technique for the management of lung hydatid cysts, outside the cases of significant destroyed pulmonary parenchyma mainly thus located on the middle lobe. We believe that lobectomy must be taken very carefully, mainly in infant and the older patients. Keywords: Cystectomy, Hydatid Cyst, Morocco, Lung, Results, Surgery.

Analysis of hospital records of children with hydatid cyst in south of Iran.

The clinical manifestations of hydatidosis are various and related to anatomic location. Defining frequent symptoms and signs of the disease is imperative for early management of it. The aim of this report was to analyse the clinical features of infected children with hydatid cysts located in different organs. In this study, medical charts of 57 children between 3 and 16years of age with hydatid cyst admitted to Pediatric Wards of Nemazee Hospital were evaluated over a 12year period (from 2003 to 2014, prospectively). All the epidemiologic, clinical, paraclinical and therapeutic data were collected. The frequencies of hydatidosis in males and females were 42.1 and 56.1%, respectively. Hydatid cysts were found in the liver and lungs in 59.6 and 33.3% patients respectively and 2 patients had an asymptomatic cyst in the heart with concomitant liver and lung cysts. The right upper quadrant pain (100%) was the most common symptom in the liver cysts. Phlegm (78.9%), Dyspnea (57.9%), acute (47.4%) and chronic cough (47.4%) were mostly seen in lung hydatid cysts. Some symptoms such as fever (68.4%) and weakness (59.6%) were the most common presenting symptoms in both groups. All children were treated through surgical approaches plus medical treatment. In the present report, liver was the most common site of involvement in children. Liver hydatidosis should be considered in children with upper quadrant pain and pulmonary hydatidosis in children complaining of phlegm and dyspnoea.

Clinical and Morphopathological Considerations in Pulmonary Hydatid Cyst Complicated by Endobronchial Rupture in Children

Abstract The authors present a clinical case that aims to elucidate the diagnostic tactics and the efficiency of the chystostomy procedure performed in children with complicated endobronchial lung hydatid cyst and the potential serious postoperative complications that may occur in the case of this non-capitonary residual cavity technique after pulmonary echinococectomy. Faced with the clinical, surgical and morphopathological investigations of the endobronchus ruptured lung hydatid cyst, the authors conclude that the spectra of morphological pathogenesis present in these cases are responsible for the development of persistent aerostatic disorder, resulting in a long-term postoperative morbidity, which confirms the need to optimize the methods of surgical correction of postechinococectomial residual cavities.

Hydatid Cyst Of Lung

Lung hydatid cyst may be primary or secondary. In our case, the cyst was a single one locating in right middle lobe. Hydatidosis locating in different sites, particularly the liver may be associated. Initial growth of primary hydatidosis is asymptomatic. The evolution of the cyst may produce bronchial fistulization and intrapleural rupture. Breaking of primary visceral hydatid cyst in a vein or heart producing hydatidosis is rare. Progressive respiratory deficiency and right ventricular failure due to multiple malignant primary hydatidosis is a special form. The recognition of certain details of the lesion and discoverothers are not visible by conventional radiography, can be done by ultrasonography, computed tomography and magnetic resistance imaging. Surgery is the treatment of choice. Chemotherapy is used in general as a complement to surgical treatment to prevent recurrence. The goal of surgery is to remove the parasite and to treat the bronchialpericyst pathology with other associated lesions. The results are now commonly satisfactory. Prolonged air leakage and pleural infection are most frequent complication.KYAMC Journal Vol. 4, No.-2, Jan 2014, Page 427-430

The relation between the location and the perforation rate of lung hydatid cysts in children

The pressure, size, and central or peripheral location of lung hydatid cysts are the most studied topics among the factors affecting perforation. The aim of this study is to investigate the relation between the location and the perforation rate of lung hydatid cysts in children. 197 patients under the age of 16 years, who were operated between January 2000 and December 2016 due to pulmonary hydatid cysts, were evaluated retrospectively. Patients who had giant hydatid cysts (n=27), bilateral hydatid cysts (n=24), and more than one cyst in one lung (n=12) were excluded to create a more homogeneous group to enable investigation of the relation between the location and the perforation rates of hydatid cysts. Finally, 134 patients who had only one hydatid cyst were classified into two groups: Group 1 with perforated cysts and Group 2 with intact hydatid cysts. 70.9% of the patients were male. In total, 134 cysts were detected and 41% were perforated. The highest perforation rates were detected in the right middle lobe (70%) and the lingula (66.7%). There was a statistically significant difference between the location of the cysts and the perforation rates (p=0.018). Also hydatid cysts located in the right middle lobe and the lingula had higher postoperative complication rates than hydatid cysts located in the upper and lower lobes (p=0.018). We recommend surgical treatment as soon as possible in children with hydatid cysts located in the right middle lobe and lingula to prevent the risk of perforation.